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Published on: February 28, 2021
Extended perfusion protocol for MS lesion quantification
Eleftherios Kontopodis1,2, Kostas Marias3, Georgios C Manikis1,2
1Foundation for Research and Technology - Hellas, Institute of Computer Science, Computational Bio-Medicine Laboratory, N. Plastira 100, Vassilika Vouton, GR-700 13 Heraklion, Crete, Greece.
Abstract:
This study aims to examine a time-extended dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) protocol and report a comparative study with three different pharmacokinetic (PK) models, for accurate determination of subtle blood-brain barrier (BBB) disruption in patients with multiple sclerosis (MS). This time-extended DCE-MRI perfusion protocol, called Snaps, was applied on 24 active demyelinating lesions of 12 MS patients. Statistical analysis was performed for both protocols through three different PK models. The Snaps protocol achieved triple the window time of perfusion observation by extending the magnetic resonance acquisition time by less than 2 min on average for all patients. In addition, the statistical analysis in terms of adj-R 2 goodness of fit demonstrated that the Snaps protocol outperformed the conventional DCE-MRI protocol by detecting 49% more pixels on average. The exclusive pixels identified from the Snaps protocol lie in the low k trans range, potentially reflecting areas with subtle BBB disruption. Finally, the extended Tofts model was found to have the highest fitting accuracy for both analyzed protocols. The previously proposed time-extended DCE protocol, called Snaps, provides additional temporal perfusion information at the expense of a minimal extension of the conventional DCE acquisition time.
Insights
A new extended dynamic contrast-enhanced MRI (DCE-MRI) protocol, Snaps, improves detection of subtle blood-brain barrier (BBB) disruption in multiple sclerosis (MS) patients. This method offers enhanced perfusion observation with minimal extra scan time.
Area of Science:
- Radiology and Imaging
- Neuroscience
- Medical Physics
Background:
- Multiple Sclerosis (MS) involves blood-brain barrier (BBB) disruption.
- Accurate detection of subtle BBB changes is crucial for MS management.
- Conventional dynamic contrast-enhanced MRI (DCE-MRI) has limitations in capturing subtle BBB dynamics.
Purpose of the Study:
- To evaluate a time-extended DCE-MRI protocol (Snaps) for improved BBB disruption detection in MS.
- To compare the Snaps protocol against a conventional DCE-MRI protocol using pharmacokinetic (PK) models.
- To assess the impact of extended acquisition time on perfusion observation and data accuracy.
Main Methods:
- Applied the Snaps time-extended DCE-MRI protocol to 24 active demyelinating lesions in 12 MS patients.
- Performed statistical analysis comparing Snaps with a conventional DCE-MRI protocol using three PK models.
- Analyzed goodness of fit (adj-R^2) to determine protocol performance and pixel detection rates.
Main Results:
- The Snaps protocol tripled the perfusion observation window with only a minimal increase in acquisition time (<2 min).
- Snaps detected 49% more pixels on average compared to the conventional protocol, identifying subtle BBB disruptions.
- The extended Tofts model demonstrated the highest fitting accuracy for both protocols.
Conclusions:
- The time-extended Snaps DCE-MRI protocol enhances the detection of subtle BBB disruptions in MS.
- This protocol provides valuable additional temporal perfusion information with minimal added scan time.
- The findings support the use of Snaps for more sensitive assessment of BBB integrity in neurological diseases.
