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Arterial input functions in dynamic susceptibility contrast MRI (DSC-MRI) in longitudinal evaluation of brain
Lea Starck1,2, Bente Sandvei Skeie3, Hauke Bartsch2,4
1Department of Physics and Technology, 1658University of Bergen, Bergen, Norway.
Background:
Dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) could be helpful to separate true disease progression from pseudo-progression in brain metastases when assessing the need for retreatment. However, the selection of arterial input functions (AIFs) is not standardized for analysis, limiting its use for this application.
Purpose:
To compare population-based AIFs, AIFs specific to each patient, and AIFs specific to every visit in the longitudinal follow-up of brain metastases.
Material And Methods:
Longitudinal data were collected from eight patients before treatment (6 of 8 patients) and after treatment (6-17 visits). Imaging was performed using a 1.5-T MRI system. Lesions were segmented by subtracting precontrast images from postcontrast images. Cerebral blood volume (rCBV) and cerebral blood flow (rCBF) were computed, and Pearson's product moment correlation coefficients were calculated to evaluate similarity of DSC parameters dependent on various AIF choices across time. AIF shape characteristics were compared. Parameter differences between white matter (WM) and gray matter (GM) were obtained to determine which AIF choice maximizes tissue differentiation.
Results:
Although DSC parameters follow similar patterns in time, the various AIF selections cause large parameter variations with relative standard deviations of up to ±60%. AIFs sampled in one patient across sessions more similar in shape than AIFs sampled across patients. Estimates of rCBV based on scan-specific AIFs differentiated better between perfusion in WM and GM than patient-specific or population-based AIFs (P ≤ 0.02).
Conclusion:
Results indicate that scan-specific AIFs are the best choice for DSC-MRI parameter estimations in the longitudinal follow-up of brain metastases.
Insights
Scan-specific arterial input functions (AIFs) improve dynamic susceptibility contrast MRI (DSC-MRI) analysis for brain metastases. Using AIFs from each scan enhances accuracy in assessing disease progression and differentiating tissue perfusion.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) aids in distinguishing true disease progression from pseudo-progression in brain metastases.
- Standardization of arterial input function (AIF) selection for DSC-MRI analysis is lacking, hindering its clinical application for treatment assessment.
Purpose of the Study:
- To compare the efficacy of population-based, patient-specific, and scan-specific arterial input functions (AIFs) in the longitudinal follow-up analysis of brain metastases using DSC-MRI.
- To evaluate how different AIF selection methods impact the accuracy and reliability of perfusion parameters.
Main Methods:
- Longitudinal DSC-MRI data from eight brain metastasis patients (6-17 visits post-treatment) were analyzed.
- Cerebral blood volume (rCBV) and cerebral blood flow (rCBF) were computed using various AIFs.
- Pearson correlation coefficients assessed parameter similarity over time; AIF shape and tissue differentiation (white matter vs. gray matter) were compared.
Main Results:
- DSC parameters showed temporal trends but varied significantly (up to ±60%) with different AIF choices.
- Scan-specific AIFs yielded more consistent AIF shapes compared to patient-specific or population-based AIFs.
- Estimates of rCBV using scan-specific AIFs demonstrated superior differentiation between white and gray matter perfusion (P ≤ 0.02).
Conclusions:
- Scan-specific arterial input functions (AIFs) are the optimal choice for DSC-MRI parameter estimation in the longitudinal monitoring of brain metastases.
- This standardization improves the reliability of DSC-MRI for assessing treatment response and disease progression.
