Quantitative IVIM parameters evaluating perfusion changes in brain parenchyma in patients newly diagnosed with acute
Jianing Cui1, Jing Zheng2, Weiran Niu3
1Medical Imaging Department, Shanxi Medical University, Taiyuan, Shanxi, China.
Insights
Quantitative diffusion imaging reveals altered brain perfusion in acute leukemia (AL) patients. Specific IVIM parameters like the pseudoperfusion fraction (f) can help predict AL, offering insights into central nervous system involvement.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Acute leukemia (AL) can affect the central nervous system.
- Cerebral blood perfusion changes may occur in AL patients.
- Quantitative MRI techniques like Intravoxel Incoherent Motion (IVIM) can assess perfusion.
Purpose of the Study:
- To evaluate the utility of quantitative IVIM parameters in detecting cerebral blood perfusion changes in newly diagnosed AL patients.
- To compare IVIM parameters between AL patients and healthy controls.
Main Methods:
- Prospective study of 49 newly diagnosed AL patients and 40 healthy controls.
- Brain MRI with IVIM sequences to obtain parameters: diffusion coefficient (D), pseudodiffusion coefficient (D*), pseudoperfusion fraction (f), and water diffusion coefficient (sADC).
- Statistical analyses included unpaired t-tests, Mann-Whitney U-tests, logistic regression, and ROC curve analysis.
Main Results:
- AL patients showed significantly lower sADC and f values in both gray matter (GM) and white matter (WM) compared to healthy controls.
- The pseudoperfusion fraction (f) in GM and WM were identified as independent predictors of AL.
- Receiver operating characteristic (ROC) analysis indicated potential diagnostic value for f values.
Conclusions:
- Quantitative IVIM parameters differ between newly diagnosed AL patients and healthy individuals.
- Assessing cerebral blood flow perfusion using IVIM may offer new insights into CNS infiltration in AL.
- IVIM parameters, particularly the pseudoperfusion fraction (f), show promise in the evaluation of AL.
Purpose:
To study the value of quantitative IVIM parameters in evaluating cerebral blood perfusion changes in patients newly diagnosed with acute leukemia (AL) by comparing them with healthy participants.
Materials And Methods:
This prospective study consecutively recruited 49 participants with newly diagnosed AL and 40 normal controls between July 2020 and September 2022. All participants underwent an MRI of the brain using an axial T1-weighted and an IVIM sequence. The IVIM parameters (water diffusion coefficient, sADC, pseudoperfusion fraction, f; diffusion coefficient, D, pseudodiffusion coefficient, D *, and perfusion-diffusion ratio, PDR) and peripheral white blood cell (WBC) counts were obtained. An unpaired t-test or the Mann-Whitney U-test was performed to compare the differences in gray matter (GM) and white matter (WM) of healthy participants and AL patients and the differences in IVIM parameters between healthy participants and patients with AL. In addition, multivariate (logistic regression) analyses were used to identify independent predictors and then, the receiver operating characteristic curve (ROC) analyses were performed.
Results:
40 healthy participants and 49 patients with newly diagnosed AL were evaluated. In healthy participants, sADC, PDR, D and f values of GM were significantly higher than those of WM (t = 5.844, t = 3.838, t = 7.711, z = -2.184, respectively, all P < 0.05). In AL patients, the D, f and sADC values of GM were significantly higher than those of WM (t = 3.450, t = 6.262, t = 4.053, respectively, all P < 0.05). The sADC and f value from AL patients were significantly lower than those from healthy participants in GM (z = -2.537, P = 0.011; and z = -2.583, P = 0.010, respectively) and WM (z = -2.969, P = 0.003; z = -2.923, P = 0.003, respectively). The WBC counts of AL patients were significantly higher than those of healthy participants (t = 3.147, P = 0.002). Multivariate analyses showed that the f values of GM and WM were independent predictors of AL (P = 0.030, and 0.010, respectively), with the optimal cut-off value at 7.08% (AUC ROC curve: 0.661, specificity: 11.4%, sensitivity: 98%) and 13.77% (AUC ROC curve: 0.682, specificity: 79.5%, sensitivity: 59.2%).
Conclusion:
The IVIM parameters of brain parenchyma in patients newly diagnosed with AL differed from those of the healthy participants. The changes of cerebral blood flow perfusion are expected to provide new ideas for studying central nervous system infiltration in AL.
