Quantification of cerebral blood flow, cerebral blood volume, and blood–brain‐barrier leakage with DCE‐MRI

Abstract

Dynamic susceptibility contrast MRI (DSC-MRI) is the current standard for the measurement of Cerebral Blood Flow (CBF) and Cerebral Blood Volume (CBV), but it is not suitable for the measurement of Extraction Flow (EF) and may not allow for absolute quantification. The objective of this study was to develop and evaluate a methodology to measure CBF, CBV, and EF from T1-weighted dynamic contrast-enhanced MRI (DCE-MRI). A twocompartment modeling approach was developed, which applies both to tissues with an intact and with a broken Blood-BrainBarrier (BBB). The approach was evaluated using measurements in normal grey matter (GM) and white matter (WM) and in tumors of 15 patients. Accuracy and precision were estimated with simulations of normal brain tissue. All tumor and normal tissue curves were accurately fitted by the model. CBF (mL/100 mL/min) was 82 ± 21 in GM and 23 ± 14 in WM, CBV (mL/100 mL) was 2.6 ± 0.8 in GM and 1.3 ± 0.4 in WM. EF (mL/100 mL/min) was close to zero in GM (−0.009 ± 0.05) and WM (−0.03 ± 0.08). Simulations show an overlap between CBF values of WM and GM, which is eliminated when Contrast-to-Noise (CNR) is improved. The model provides a consistent description of tracer kinetics in all brain tissues, and an accurate assessment of perfusion and permeability in reference tissues. The measurement sequence requires optimization to improve CNR and the precision in the perfusion parameters. With this approach, DCE-MRI presents a promising alternative to DSC-MRI for quantitative bolustracking in the brain.

Cerebral Blood Volume Affects Blood–Brain Barrier Integrity in an Acute Transient Stroke Model

“…31,32 Many previous studies have reported significantly decreased ADC and R 2 in cases of overt BBB disruption, suggesting that these parameters may be correlative indices for describing strokeinduced BBB damage. [13][14][15][16][17] On the contrary, in the current study, we observed similar infarct ADC and R 2 values that were independent of the WEI. The discrepancy principally results from different scales of BBB injury between studies.…”

“…According to previous study results, alterations in CBV, ADC, and R 2 were positively predictive of BBB disruption, as all of these parameters significantly decreased in ischemic stroke characterized by extravasation of contrast materials. [13][14][15][16][17] However, under such heavy ischemic stresses that lead to overt vascular disruption, changes in these MRI parameters may be derived not only from the weakened BBB itself, but also from other ischemia-affected tissue/vascular conditions including cytotoxicity, inflammation, and edema formation. 3,18,19 Therefore, overly simplified dichotomous division of stroke cases according to the presence of apparent trans-BBB leakage does not definitively identify the causative factors in the BBB disruption.…”

UMMPerfusion: an Open Source Software Tool Towards Quantitative MRI Perfusion Analysis in Clinical Routine

“…This is desirable, i.e., when studying brain barrier leakage [51], tumors [52], or kidney filtration [4,11,18]. Such tasks can be performed when applying compartment models [6,19].…”

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

“…8,9,15 For that reason, some authors have proposed performing 2 injections of 0.05 mmol/kg of gadolinium for DCE MR imaging to minimize the error arising from the conversion of signal intensity to gadolinium concentration from magnitude images. 16 While saturation of signal intensity could lead to an underestimation of the contrast agent concentration, the presence of inflow effects could lead to an overestimation. 17 Our magnitude-VIF based K trans and V p estimates were higher than those derived from the phase method.…”