Optimization of Acquisition and Analysis Methods for Clinical Dynamic Susceptibility Contrast MRI Using a...

Area of Science:

• Radiology
• Neuro-oncology
• Medical Imaging

Background:

• Dynamic susceptibility contrast-enhanced MRI (DSC-MR) imaging is crucial for assessing glioblastoma.
• Protocol variations across institutions hinder standardization and in vivo validation of cerebral blood volume (CBV) maps.
• Digital Reference Objects (DROs) offer a standardized method for evaluating imaging protocols.

Purpose of the Study:

• To compare the accuracy of routinely used DSC-MR imaging protocols for glioblastoma CBV mapping.
• To evaluate the impact of acquisition and postprocessing parameters on CBV map reliability.
• To identify optimal protocols for accurate and precise CBV quantification.

Main Methods:

• A digital reference object (DRO) with simulated glioblastoma voxels was used.
• 6912 parameter combinations were tested, including contrast agent dosing, pulse sequences, field strengths, and postprocessing.
• Accuracy and precision were quantified using the concordance correlation coefficient (CCC) and coefficient of variation (CV).

Main Results:

• The optimal protocol involved full-dose contrast agent preload and bolus, intermediate flip angle (60°), 30-ms TE, and leakage correction (CCC=0.97, CV=6.6%).
• Protocols with reduced contrast doses were less robust, but a low flip angle (30°) protocol with no preload and full-dose bolus performed well at 1.5T and 3T (CCC ≈ 0.92, CV ≈ 8.5%).

Conclusions:

• Full-dose contrast agent protocols with preload and bolus significantly enhance CBV accuracy and reduce variability in glioblastoma.
• These optimized protocols can potentially reduce sample sizes and improve the reliability of CBV change detection in clinical trials.
• A low flip angle, no preload, full-dose bolus protocol presents a viable alternative when lower contrast doses are preferred.