scholarly journals Role of Dynamic Susceptibility Contrast Perfusion MRI in Glioma Progression Evaluation

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Guanmin Quan ◽  
Kexin Zhang ◽  
Yawu Liu ◽  
Jia-Liang Ren ◽  
Deyou Huang ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Cerebral Blood Volume ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Enhancement Pattern ◽  
Dsc Mri ◽  
Susceptibility Contrast ◽  
True Progression ◽  
Glioma Progression

Accurately and quickly differentiating true progression from pseudoprogression in glioma patients is still a challenge. This study aims to explore if dynamic susceptibility contrast- (DSC-) MRI can improve the evaluation of glioma progression. We enrolled 65 glioma patients with suspected gadolinium-enhancing lesion. Longitudinal MRI follow-up (mean 590 days, range: 210–2670 days) or re-operation (n = 3) was used to confirm true progression (n = 51) and pseudoprogression (n = 14). We assessed the diagnostic performance of each MRI variable and the different combinations. Our results showed that the relative cerebral blood volume (rCBV) in the true progression group (1.094, 95%CI: 1.135–1.636) was significantly higher than that of the pseudoprogression group (0.541 ± 0.154) p < 0.001 . Among the 18 patients who had serial DSC-MRI, the rCBV of the progression group (0.480, 95%CI: 0.173–0.810) differed significantly from pseudoprogression (-0.083, 95%CI: −1.138–0.620) group p = 0.015 . With an rCBV threshold of 0.743, the sensitivity and specificity for discriminating true progression from pseudoprogression were 76.5% and 92.9%, respectively. The Cho/Cr and Cho/NAA ratios of the true progression group (2.520, 95%CI: 2.331–2.773; 2.414 ± 0.665, respectively) were higher than those of the pseudoprogression group (1.719 ± 0.664; 1.499 ± 0.500, respectively) ( p = 0.001 , p < 0.001 , respectively). The areas under ROC curve (AUCs) of enhancement pattern, MRS, and DSC-MRI for the differentiation were 0.782, 0.881, and 0.912, respectively. Interestingly, when combined enhancement pattern, MRS, and DSC-MRI variables, the AUC was 0.965 and achieved sensitivity 90.2% and specificity 100.0%. Our results suggest that DSC-MRI can significantly improve the diagnostic performance for identifying glioma progression. DSC-MRI combined with conventional MRI may promptly distinguish true gliomas progression from pseudoprogression when the suspected gadolinium-enhancing lesion was found, without the need for a long-term follow-up.

Attempts to improve absolute quantification of cerebral blood flow in dynamic susceptibility contrast magnetic resonance imaging: a simplified T1-weighted steady-state cerebral blood volume approach

2007 ◽  
Vol 48 (5) ◽  
pp. 550-556 ◽  
Author(s):  
R. Wirestam ◽  
L. Knutsson ◽  
J. Risberg ◽  
S. Börjesson ◽  
E.-M. Larsson ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Steady State ◽  
Water Exchange ◽  
Cerebral Blood Volume ◽  
Dynamic Susceptibility ◽  
Resonance Imaging ◽  
Dynamic Susceptibility Contrast ◽  
Dsc Mri ◽  
Contrast Magnetic Resonance ◽  
Susceptibility Contrast

Background: Attempts to retrieve absolute values of cerebral blood flow (CBF) by dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) have typically resulted in overestimations. Purpose: To improve DSC-MRI CBF estimates by calibrating the DSC-MRI-based cerebral blood volume (CBV) with a corresponding T1-weighted (T1W) steady-state (ss) CBV estimate. Material and Methods: 17 volunteers were investigated by DSC-MRI and 133Xe SPECT. Steady-state CBV calculation, assuming no water exchange, was accomplished using signal values from blood and tissue, before and after contrast agent, obtained by T1W spin-echo imaging. Using steady-state and DSC-MRI CBV estimates, a calibration factor K = CBV(ss)/CBV(DSC) was obtained for each individual. Average whole-brain CBF(DSC) was calculated, and the corrected MRI-based CBF estimate was given by CBF(ss) = K×CBF(DSC). Results: Average whole-brain SPECT CBF was 40.1±6.9 ml/min·100 g, while the corresponding uncorrected DSC-MRI-based value was 69.2±13.8 ml/min·100 g. After correction with the calibration factor, a CBF(ss) of 42.7±14.0 ml/min·100 g was obtained. The linear fit to CBF(ss)-versus-CBF(SPECT) data was close to proportionality ( R = 0.52). Conclusion: Calibration by steady-state CBV reduced the population average CBF to a reasonable level, and a modest linear correlation with the reference 133Xe SPECT technique was observed. Possible explanations for the limited accuracy are, for example, large-vessel partial-volume effects, low post-contrast signal enhancement in T1W images, and water-exchange effects.

scholarly journals Intra-tumoural perfusion habitats showed prognostic value in glioblastoma patients

2019 ◽  
Vol 21 (Supplement_4) ◽  
pp. iv3-iv3
Author(s):  
Chao Li ◽  
Chang Sun ◽  
Shuo Wang ◽  
Stephen Price
Keyword(s):  
Cerebral Blood Volume ◽  
Cox Regression ◽  
Mean Transit Time ◽  
Tumour Microenvironment ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Post Contrast ◽  
Dsc Mri ◽  
Contrast Enhanced ◽  
Susceptibility Contrast

Abstract The perfusion within glioblastoma is associated with tumour microenvironment and may create invasive tumor habitats that could potentially be revealed by perfusion imaging. The purpose of this study is to characterize the peritumoural habitats of glioblastoma for treatment target. Dynamic susceptibility contrast-enhancement (DSC) MRI was acquired pre-operatively on 115 newly-diagnosed glioblastoma patients. All images were co-registered to post-contrast T1-weighted images. The relative cerebral blood volume (rCBV), mean transit time (MTT) and relative cerebral blood flow (rCBF) maps were generated from the DSC images. The contrast-enhanced and peritumoural tumor regions were semi-automatically segmented from the post-contrast T1-weighted and FLAIR images. To delineate the habitats of different perfusion levels, a two clusters mixture model with Gaussian distribution was fitted to the rCBV, rCBF, and MTT within both contrast-enhanced and peritumoural regions. Perfusion parameters of the identified habitats were compared, and the prognostic values of habitats were investigated using survival analysis. The results showed that although non-enhanced, the peritumoral high perfusion (PHP) habitat demonstrated similar perfusion level with the contrast high perfusion (CHP) habitat, with similar rCBV (PHP: 1.13 ± 0.18, 95% CI [1.10, 1.15]; CHP: 1.21 ± 0.25, 95% CI [1.16, 1.21]) and rCBF (PHP: 1.08 ± 0.23, 95% CI [1.05, 1.08]; CHP: 1.08 ± 0.19, 95% CI [1.05, 1.08]). Multivariate Cox regression showed that the volumes of both habitats were associated with worse patient overall survival (PHP: P = 0.032; HR= 7.09; CHP: P = 0.008; HR= 12.01). Our results suggest that the intra-tumoural perfusion habitats may potentially offer treatment targets.

scholarly journals Favorable Outcome in a Case of Von Balo’s Sclerosis Mimicking a Juvenile Stroke at the Onset A New Possible Role of Dynamic Susceptibility Contrast (Dsc) Perfusion-Weighted Imaging (PWI).

2021 ◽  
Author(s):  
ASSUNTA TRINCHILLO ◽  
Alessandra D'Amico ◽  
Elena Salvatore
Keyword(s):  
Favorable Outcome ◽  
Dynamic Susceptibility ◽  
Mri Imaging ◽  
Dynamic Susceptibility Contrast ◽  
Active Lesion ◽  
Perfusion Weighted Imaging ◽  
Dsc Mri ◽  
Mri Sequences ◽  
Susceptibility Contrast

Abstract We describe a juvenile stroke-like onset of Von Balò’s sclerosis, with a favorable outcome after 4 years of follow up, even if treatment’s protocols could not have been completed, because her low compliance. Following the patient with annual MRI imaging we surprisingly discovered associations between which was reported at a Perfusion-weighted Imaging (PWI) Dynamic susceptibility contrast (DSC)-MRI executed after 9 days from the exordium and patient’s clinical residues. By describing the case we focus on a new way to use PWI-DSC in order not only to determine areas of Blood-Brain-Barrier active lesion but also to have information on patients’ prognosis and to guide neurologist in his therapeutical choices. PWI can’t substitute other MRI sequences, which describe, in that moment of execution, how many cerebral areas are involved in the process of demyelization, but PWI, surely, is an excellent sequence to integrate diagnosis and improve patients’ clinical, diagnostic and therapeutic follow up.

scholarly journals Heterogeneity of Cortical Lesions in Multiple Sclerosis: An MRI Perfusion Study

2012 ◽  
Vol 33 (3) ◽  
pp. 457-463 ◽  
Author(s):  
Denis Peruzzo ◽  
Marco Castellaro ◽  
Massimiliano Calabrese ◽  
Elisa Veronese ◽  
Francesca Rinaldi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cortical Neurons ◽  
Cerebral Blood Volume ◽  
Mean Transit Time ◽  
Small Population ◽  
Dynamic Susceptibility ◽  
Cortical Lesions ◽  
Dynamic Susceptibility Contrast ◽  
Dsc Mri ◽  
Susceptibility Contrast

In this study, dynamic susceptibility contrast-magnetic resonance imaging (DSC-MRI) was used to quantify the cerebral blood flow (CBF), the cerebral blood volume (CBV), and the mean transit time (MTT) and to analyze the changes in cerebral perfusion associated with the cortical lesions in 44 patients with relapsing-remitting multiple sclerosis. The cortical lesions showed a statistically significant reduction in CBF and CBV compared with the normal-appearing gray matter, whereas there were no significant changes in the MTT. The reduced perfusion suggests a reduction of metabolism because of the loss of cortical neurons. A small population of outliers showing an increased CBF and/or CBV has also been detected. The presence of hyperperfused outliers may imply that perfusion could evolve during inflammation. These findings show that perfusion is altered in cortical lesions and that DSC-MRI can be a useful tool to investigate more deeply the evolution of cortical lesions in multiple sclerosis.

Predicting 1p/19q codeletion status using diffusion-, susceptibility-, perfusion-weighted, and conventional MRI in IDH-mutant lower-grade gliomas

2020 ◽  
pp. 028418512097362
Author(s):  
Xiefeng Yang ◽  
Yu Lin ◽  
Zhen Xing ◽  
Dejun She ◽  
Yan Su ◽  
...  
Keyword(s):  
Predictive Value ◽  
Operating Characteristic ◽  
Cerebral Blood Volume ◽  
Characteristic Curve ◽  
Lower Grade ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Conventional Mri ◽  
Susceptibility Contrast ◽  
Sensitivity Specificity

Background Isocitrate dehydrogenase (IDH)-mutant lower-grade gliomas (LGGs) are further classified into two classes: with and without 1p/19q codeletion. IDH-mutant and 1p/19q codeleted LGGs have better prognosis compared with IDH-mutant and 1p/19q non-codeleted LGGs. Purpose To evaluate conventional magnetic resonance imaging (cMRI), diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) for predicting 1p/19q codeletion status of IDH-mutant LGGs. Material and Methods We retrospectively reviewed cMRI, DWI, SWI, and DSC-PWI in 142 cases of IDH mutant LGGs with known 1p/19q codeletion status. Features of cMRI, relative ADC (rADC), intratumoral susceptibility signals (ITSSs), and the value of relative cerebral blood volume (rCBV) were compared between IDH-mutant LGGs with and without 1p/19q codeletion. Receiver operating characteristic curve and logistic regression were used to determine diagnostic performances. Results IDH-mutant and 1p/19q non-codeleted LGGs tended to present with the T2/FLAIR mismatch sign and distinct borders ( P < 0.001 and P = 0.038, respectively). Parameters of rADC, ITSSs, and rCBVmax were significantly different between the 1p/19q codeleted and 1p/19q non-codeleted groups ( P < 0.001, P = 0.017, and P < 0.001, respectively). A combination of cMRI, SWI, DWI, and DSC-PWI for predicting 1p/19q codeletion status in IDH-mutant LGGs resulted in a sensitivity, specificity, positive predictive value, negative predictive value, and an AUC of 80.36%, 78.57%, 83.30%, 75.00%, and 0.88, respectively. Conclusion 1p/19q codeletion status of IDH-mutant LGGs can be stratified using cMRI and advanced MRI techniques, including DWI, SWI, and DSC-PWI. A combination of cMRI, rADC, ITSSs, and rCBVmax may improve the diagnostic performance for predicting 1p/19q codeletion status.

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