Low‐dose T1W DCE‐MRI for early time points perfusion measurement in patients with intracranial tumors: A pilot study applying the microsphere model to measure absolute cerebral blood flow

Li, Ka‐Loh; Lewis, Daniel; Jackson, Alan; Zhao, Sixiang; Zhu, Xiaoping

doi:10.1002/jmri.25979

Cited by 9 publications

(15 citation statements)

References 40 publications

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“…The GBCA dose (0.02 mmol/kg) was chosen based on both the numerical simulations and previous low‐dose investigations 44‐46 . In the simulations, the SD of the noise was defined as the averaged signal intensity of tumor over the nominal SNR at the standard dose, and was fixed for the other doses, leading to lower true SNR proportionate to the decreased signal intensity for lower dose.…”

Section: Discussionmentioning

confidence: 99%

“…The GBCA dose (0.02 mmol/kg) was chosen based on both the numerical simulations and previous low-dose investigations. [44][45][46] In the simulations, the SD of the noise was defined as the averaged signal intensity of tumor over the nominal SNR at the standard dose, and was fixed for the other doses, leading to lower true SNR proportionate to the decreased signal intensity for lower dose. Based on Equations 5-7, the signal intensity drops faster when the dose decreases (as shown in Supporting Information Figure S4), causing increased bias and variation of the estimation.…”

Section: F I G U R E 7 (A)mentioning

confidence: 99%

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Five‐dimensional quantitative low‐dose Multitasking dynamic contrast‐ enhanced MRI: Preliminary study on breast cancer

Wang

Fan

et al. 2021

Magnetic Resonance in Med

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To develop a low-dose Multitasking DCE technique (LD-MT-DCE) for breast imaging, enabling dynamic T 1 mapping-based quantitative characterization of tumor blood flow and vascular properties with whole-breast coverage, a spatial resolution of 0.9 × 0.9 × 1.1 mm 3 , and a temporal resolution of 1.4 seconds using a 20% gadolinium dose (0.02 mmol/kg). Methods: Magnetic resonance Multitasking was used to reconstruct 5D images with three spatial dimensions, one T 1 recovery dimension for dynamic T 1 quantification, and one DCE dimension for contrast kinetics. Kinetic parameters F p , v p , K trans , and v e were estimated from dynamic T 1 maps using the two-compartment exchange model. The LD-MT-DCE repeatability and agreement against standard-dose MT-DCE were evaluated in 20 healthy subjects. In 7 patients with triple-negative breast cancer, LD-MT-DCE image quality and diagnostic results were compared with that of standarddose clinical DCE in the same imaging session. One-way unbalanced analysis of variance with Tukey test was performed to evaluate the statistical significance of the kinetic parameters between control and patient groups. Results: The LD-MT-DCE technique was repeatable, agreed with standard-dose MT-DCE, and showed excellent image quality. The diagnosis using LD-MT-DCE matched well with clinical results. The values of F p , v p , and K trans were significantly different between malignant tumors and normal breast tissue (P < .001, < .001, and < .001, respectively), and between malignant and benign tumors (P = .020, .003, and < .001, respectively). Conclusion: The LD-MT-DCE technique was repeatable and showed excellent image quality and equivalent diagnosis compared with standard-dose clinical DCE.

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Section: Discussionmentioning

confidence: 99%

Section: F I G U R E 7 (A)mentioning

confidence: 99%

Five‐dimensional quantitative low‐dose Multitasking dynamic contrast‐ enhanced MRI: Preliminary study on breast cancer

Wang

Fan

et al. 2021

Magnetic Resonance in Med

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“…25 Through this approach, voxel-wise maps of mean diffusivity (MD) and fractional anisotropy (FA) were generated. Voxel-wise maps of microvascular kinetic parameters and absolute cerebral blood flow (CBF ET ) estimates were derived from the low-dose, high-temporal-resolution DCE-MRI data sets using the extended Tofts model 21 and a previously developed T1-weighted early time points method, 26 respectively. Individual tumors were manually delineated on the coregistered T1-weighted postcontrast image to create a tumor object mask.…”

Section: Mri Data Analysismentioning

confidence: 99%

The microenvironment in sporadic and neurofibromatosis type II–related vestibular schwannoma: the same tumor or different? A comparative imaging and neuropathology study

Lewis

Donofrio

O’Leary

et al. 2021

Journal of Neurosurgery

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OBJECTIVEInflammation and angiogenesis may play a role in the growth of sporadic and neurofibromatosis type 2 (NF2)–related vestibular schwannoma (VS). The similarities in microvascular and inflammatory microenvironment have not been investigated. The authors sought to compare the tumor microenvironment (TME) in sporadic and NF2-related VSs using a combined imaging and tissue analysis approach.METHODSDiffusion MRI and high-temporal-resolution dynamic contrast-enhanced (DCE) MRI data sets were prospectively acquired in 20 NF2-related and 24 size-matched sporadic VSs. Diffusion metrics (mean diffusivity, fractional anisotropy) and DCE-MRI–derived microvascular biomarkers (transfer constant [Ktrans], fractional plasma volume, tissue extravascular-extracellular space [ve], longitudinal relaxation rate, tumoral blood flow) were compared across both VS groups, and regression analysis was used to evaluate the effect of tumor size, pretreatment tumor growth rate, and tumor NF2 status (sporadic vs NF2-related) on each imaging parameter. Tissues from 17 imaged sporadic VSs and a separate cohort of 12 NF2-related VSs were examined with immunohistochemistry markers for vessels (CD31), vessel permeability (fibrinogen), and macrophage density (Iba1). The expression of vascular endothelial growth factor (VEGF) and VEGF receptor 1 was evaluated using immunohistochemistry, Western blotting, and double immunofluorescence.RESULTSImaging data demonstrated that DCE-MRI–derived microvascular characteristics were similar in sporadic and NF2-related VSs. Ktrans (p < 0.001), ve (p ≤ 0.004), and tumoral free water content (p ≤ 0.003) increased with increasing tumor size and pretreatment tumor growth rate. Regression analysis demonstrated that with the exception of mean diffusivity (p < 0.001), NF2 status had no statistically significant effect on any of the imaging parameters or the observed relationship between the imaging parameters and tumor size (p > 0.05). Tissue analysis confirmed the imaging metrics among resected sporadic VSs and demonstrated that across all VSs studied, there was a close association between vascularity and Iba1+ macrophage density (r = 0.55, p = 0.002). VEGF was expressed by Iba1+ macrophages.CONCLUSIONSThe authors present the first in vivo comparative study of microvascular and inflammatory characteristics in sporadic and NF2-related VSs. The imaging and tissue analysis results indicate that inflammation is a key contributor to TME and should be viewed as a therapeutic target in both VS groups.

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“…To permit high spatial resolution assessment of changes in tumour microvascular parameters following SRS treatment, a previously tissue-validated DCE-MRI analysis technique, termed LEGATOS ( LE vel and rescale the Ga dolinium contrast concentrations curves of high-temporal TO high S patial DCE-MRI) was adopted 34 , 35 . For vascular input function (VIF) estimation the dynamic MRI signal from voxels in the superior sagittal sinus (SSS) was used 36 . An example VIF used for the DCE-MRI analysis is shown in Supplementary Fig.…”

Section: Methodsmentioning

confidence: 99%

Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI

Lewis

McHugh

et al. 2021

Sci Rep

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Stereotactic radiosurgery (SRS) is an established, effective therapy against vestibular schwannoma (VS). The mechanisms of tumour response are, however, unknown and in this study we sought to evaluate changes in the irradiated VS tumour microenvironment through a multinuclear MRI approach. Five patients with growing sporadic VS underwent a multi-timepoint comprehensive MRI protocol, which included diffusion tensor imaging (DTI), dynamic contrast-enhanced (DCE) MRI and a spiral 23Na-MRI acquisition for total sodium concentration (TSC) quantification. Post-treatment voxelwise changes in TSC, DTI metrics and DCE-MRI derived microvascular biomarkers (Ktrans, ve and vp) were evaluated and compared against pre-treatment values. Changes in tumour TSC and microvascular parameters were observable as early as 2 weeks post-treatment, preceding changes in structural imaging. At 6 months post-treatment there were significant voxelwise increases in tumour TSC (p < 0.001) and mean diffusivity (p < 0.001, repeated-measures ANOVA) with marked decreases in tumour microvascular parameters (p < 0.001, repeated-measures ANOVA). This study presents the first in vivo evaluation of alterations in the VS tumour microenvironment following SRS, demonstrating that changes in tumour sodium homeostasis and microvascular parameters can be imaged as early as 2 weeks following treatment. Future studies should seek to investigate these clinically relevant MRI metrics as early biomarkers of SRS response.

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Low‐dose T1W DCE‐MRI for early time points perfusion measurement in patients with intracranial tumors: A pilot study applying the microsphere model to measure absolute cerebral blood flow

Abstract: 1 Technical Efficacy: Stage 4 J. MAGN. RESON. IMAGING 2018;48:543-557.

Cited by 9 publications

References 40 publications

Five‐dimensional quantitative low‐dose Multitasking dynamic contrast‐ enhanced MRI: Preliminary study on breast cancer

Five‐dimensional quantitative low‐dose Multitasking dynamic contrast‐ enhanced MRI: Preliminary study on breast cancer

The microenvironment in sporadic and neurofibromatosis type II–related vestibular schwannoma: the same tumor or different? A comparative imaging and neuropathology study

Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI

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