Dynamic contrast-enhanced perfusion MR imaging measurements of endothelial permeability: differentiation between
Stanley Yang1, Meng Law, David Zagzag
1Department of Radiology/Division of Neuroradiology, New York University Medical Center, NY, USA.
Background And Purpose:
The measurement of relative cerebral blood volume (rCBV) and the volume transfer constant (K(trans)) by means of dynamic contrast-enhanced (DCE) perfusion MR imaging (pMRI) can be useful in characterizing brain tumors. The purpose of our study was to evaluate the utility of these measurements in differentiating typical meningiomas and atypical meningiomas.
Methods:
Fifteen patients with pathologically confirmed typical meningiomas and seven with atypical meningiomas underwent conventional imaging and DCE pMRI before resection. rCBV measurements were calculated by using standard intravascular indicator dilution algorithms. K(trans) was calculated from the same DCE pMRI data by using a new pharmacokinetic modeling (PM) algorithm. Results were compared with pathologic findings.
Results:
Mean rCBV was 8.02 +/- 4.74 in the 15 typical meningiomas and 10.50 +/- 2.1 in the seven atypical meningiomas. K(trans) was 0.0016 seconds(-1) +/- 0.0012 in the typical group and 0.0066 seconds(-1) +/- 0.0026 in the atypical group. The difference in K(trans) was statistically significant (P <.01, Student t test). Other parameters generated with the PM algorithm (plasma volume, volume of the extravascular extracellular space, and flux rate constant) were not significantly different between the two tumor types.
Conclusion:
DCE pMRI may have a role in the prospective characterization of meningiomas. Specifically, the measurement of K(trans) is of use in distinguishing atypical meningiomas from typical meningiomas.
Insights
Dynamic contrast-enhanced perfusion MRI (DCE-pMRI) can differentiate brain tumors. The volume transfer constant (K(trans)) measured using DCE-pMRI effectively distinguishes atypical meningiomas from typical ones.
Area of Science:
- Neuroradiology
- Medical Imaging
- Oncology
Background:
- Meningiomas are common primary brain tumors.
- Accurate differentiation between typical and atypical meningiomas is crucial for treatment planning.
- Dynamic contrast-enhanced perfusion MRI (DCE-pMRI) offers quantitative perfusion parameters.
Purpose of the Study:
- To evaluate the utility of relative cerebral blood volume (rCBV) and volume transfer constant (K(trans)) in differentiating typical and atypical meningiomas.
- To assess the role of DCE-pMRI in characterizing meningioma subtypes.
Main Methods:
- Fifteen typical and seven atypical meningiomas underwent DCE-pMRI before surgical resection.
- Relative cerebral blood volume (rCBV) was calculated using standard algorithms.
- Volume transfer constant (K(trans)) was derived using a novel pharmacokinetic modeling (PM) algorithm.
Main Results:
- Mean K(trans) was significantly higher in atypical meningiomas (0.0066 s⁻¹) compared to typical meningiomas (0.0016 s⁻¹; P <.01).
- Mean rCBV values showed a trend towards higher values in atypical meningiomas but did not reach statistical significance.
- Other PM-derived parameters, including plasma volume and extravascular extracellular space, were not significantly different between the groups.
Conclusions:
- DCE-pMRI, particularly K(trans) measurement, shows promise for prospective meningioma characterization.
- K(trans) is a valuable parameter for distinguishing atypical meningiomas from typical meningiomas.
- Further studies are warranted to confirm the clinical utility of DCE-pMRI in meningioma management.
