Diagnostic Accuracy of Dynamic Contrast-Enhanced MR Imaging Using a Phase-Derived Vascular Input Function in the Preoperative Grading of Gliomas

Abstract

BACKGROUND AND PURPOSE:The accuracy of tumor plasma volume and K trans estimates obtained with DCE MR imaging may have inaccuracies introduced by a poor estimation of the VIF. In this study, we evaluated the diagnostic accuracy of a novel technique by using a phase-derived VIF and "bookend" T1 measurements in the preoperative grading of patients with suspected gliomas.

Comparison of the Diagnostic Accuracy of DSC- and Dynamic Contrast-Enhanced MRI in the Preoperative Grading of Astrocytomas

“…The diagnostic accuracies of DCE-derived parameters in this study were in the range of previously published data from 2 studies, 1 by using a hot spot method and 1 by using histogram analysis. 13,18 The accuracy of DSC-derived rCBV in this study was also similar to that in previous studies using hot spot analysis. 1,19 Using the bookend T1 mapping and phase-derived VIF, we also found that DCE-derived Vp and K trans were lower for grade II than for grade III astrocytomas.…”

“…This limitation can be overcome by using phase images to derive the VIF. [9][10][11][12][13] Phase measurements are less biased by intensity changes from inflow and relaxation effects. Magnitude-derived vascular input functions can underestimate the contrast concentration measurement during the first pass (if Ͼ5 mmol/L), especially when a high-relaxivity agent is used.…”

“…This step was performed off-line by using in-house software written in IDL (Exelis Visual Information Solutions, Boulder, Colorado) and is described in previous articles. 10,13 The gadoliniumversus-time curve was imported as the arterial input function in kinetic modeling analysis software (nordicICE software, Version 2; NordicNeuroLab, Bergen, Norway) for a voxel-by-voxel estimation of plasma volume obtained from the phase-derived vascular input function (Vp_⌽) and the volume transfer constant obtained from phase-derived vascular input function (K trans _⌽).…”

“…[9][10][11][12] While measurement of precontrast tissue T1 is typically included in DCE-MR imaging studies, an additional measurement of tissue T1 postinjection ("bookend" method) might also improve the reproducibility of perfusion values in gliomas. 13,14 To our knowledge, there have been few comparative studies between DCE and DSC imaging in patients with gliomas. 15,16 The main objective of our study was to compare the diagnostic accuracy of DCE-MR imaging with DSC-MR imaging in the preoperative grading of astrocytomas at 3T by using a high-relaxivity agent.…”

Improved Brain Tumor Classification by Sodium MR Imaging: Prediction ofIDHMutation Status and Tumor Progression

“…Advanced physiologic 1 H-MR imaging techniques such as perfusion-weighted imaging, diffusion-weighted imaging, and spectroscopy ( 1 H-MR spectroscopy) provide relevant information for tumor characterization as well. For example, tumor grade is associated with relative cerebral blood volume [32][33][34] ; volume transfer coefficient [35][36][37][38] ; apparent diffusion coefficient 39,40 ; and cerebral metabolite ratios, for example, the choline to N-acetylaspartate 33 and the choline to creatine ratios. 33,41 Also, relative cerebral blood volume, 34,[42][43][44][45][46][47][48] volume transfer coefficient, 35,49 apparent diffusion coefficient, 50-52 and metabolite ratios, for example, the choline to Nacetylaspartate ratio, 53 aid prediction of PFS.…”