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Repeatability of Cerebral Perfusion Using Dynamic Susceptibility Contrast MRI in Glioblastoma Patients
Kourosh Jafari-Khouzani1, Kyrre E Emblem2, Jayashree Kalpathy-Cramer1
1Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
Objectives:
This study evaluates the repeatability of brain perfusion using dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) with a variety of post-processing methods.
Methods:
Thirty-two patients with newly diagnosed glioblastoma were recruited. On a 3-T MRI using a dual-echo, gradient-echo spin-echo DSC-MRI protocol, the patients were scanned twice 1 to 5 days apart. Perfusion maps including cerebral blood volume (CBV) and cerebral blood flow (CBF) were generated using two contrast agent leakage correction methods, along with testing normalization to reference tissue, and application of arterial input function (AIF). Repeatability of CBV and CBF within tumor regions and healthy tissues, identified by structural images, was assessed with intra-class correlation coefficients (ICCs) and repeatability coefficients (RCs). Coefficients of variation (CVs) were reported for selected methods.
Results:
CBV and CBF were highly repeatable within tumor with ICC values up to 0.97. However, both CBV and CBF showed lower ICCs for healthy cortical tissues (up to 0.83), healthy gray matter (up to 0.95), and healthy white matter (WM; up to 0.93). The values of CV ranged from 6% to 10% in tumor and 3% to 11% in healthy tissues. The values of RC relative to the mean value of measurement within healthy WM ranged from 22% to 42% in tumor and 7% to 43% in healthy tissues. These percentages show how much variation in perfusion parameter, relative to that in healthy WM, we expect to observe to consider it statistically significant. We also found that normalization improved repeatability, but AIF deconvolution did not.
Conclusions:
DSC-MRI is highly repeatable in high-grade glioma patients.
Insights
Dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) demonstrates high repeatability for assessing brain perfusion in high-grade glioma patients. This technique reliably measures cerebral blood volume and cerebral blood flow, crucial for treatment monitoring.
Area of Science:
- Radiology
- Neuro-oncology
- Medical Imaging
Background:
- Glioblastoma treatment requires accurate monitoring of brain perfusion.
- Dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) is a key technique for assessing perfusion parameters like cerebral blood volume (CBV) and cerebral blood flow (CBF).
- Evaluating the repeatability of DSC-MRI is crucial for its reliable clinical application.
Purpose of the Study:
- To assess the repeatability of DSC-MRI for brain perfusion measurements in patients with newly diagnosed glioblastoma.
- To compare the repeatability of various post-processing methods, including contrast agent leakage correction, normalization, and arterial input function (AIF) deconvolution.
Main Methods:
- Thirty-two glioblastoma patients underwent two DSC-MRI scans 1-5 days apart on a 3-T MRI scanner.
- Perfusion maps (CBV and CBF) were generated using different post-processing techniques.
- Repeatability was evaluated using intra-class correlation coefficients (ICCs) and repeatability coefficients (RCs) in tumor and healthy tissues.
Main Results:
- DSC-MRI showed high repeatability for CBV and CBF within tumors (ICC up to 0.97).
- Repeatability was lower in healthy cortical and white matter tissues.
- Normalization improved repeatability, while AIF deconvolution did not significantly impact it.
Conclusions:
- DSC-MRI is a highly repeatable method for evaluating brain perfusion in patients with high-grade gliomas.
- The findings support the use of DSC-MRI for monitoring treatment response and disease progression in glioblastoma.
