title: Quantification of endothelial permeability, leakage space, and blood volume in brain tumors using combined T1 and T2* contrast-enhanced dynamic MR imaging.
abstract: This study describes a method for imaging brain tumors that combines T1-weighted (T1W) and T2*-weighted (T2*W) dynamic contrast-enhanced acquisitions. Several technical improvements have been made to produce high-quality three-dimensional mapping of endothelial permeability surface area product (k) and leakage space (vl), based on T1W data. Tumor blood volume maps are obtained from T2*W images with a complete removal of residual relaxivity effects. The method was employed in 15 patients with brain tumors (5 gliomas, 5 meningioma, and 5 acoustic schwannoma). Mean values of vl were significantly greater in acoustic schwannomas (53% +/- 9%) than in meningiomas (34% +/- 7%) or gliomas (22% +/- 4%). Mean values of vl in meningioma were significantly greater than those of gliomas. Mean values of rCBV correlated closely with k. There was also a positive correlation between k and vl for pixels with low k values. This relationship was weaker in areas of high k. The highest mean ratios of k to vl (k(ep)) were seen in two patients with glioblastoma, one patient with transitional cell meningioma, and one patient with angioblastic meningioma. Pixel-by-pixel comparison showed a strong correlation between rCBV and k in 11 of 15 patients. However, decoupling between pixel-wise rCBV and k was found in four patients who had lesions with moderate k and vl elevation but no increase of rCBV. Results from this study suggest that in assessing the angiogenic activities in brain tumors it is advisable to monitor simultaneously changes in tumor blood volume, vessel permeability, and leakage space of tumor neovasculature.
authors.affiliation: Division of Imaging Science and Biomedical Engineering, Stopford Medical School, University of Manchester, Manchester M13 9PT, United Kingdom.
authors.forename: X P
authors.initials: XP
authors.lastname: Zhu
authors.forename: K L
authors.initials: KL
authors.lastname: Li
authors.forename: I D
authors.initials: ID
authors.lastname: Kamaly-Asl
authors.forename: D R
authors.initials: DR
authors.lastname: Checkley
authors.forename: J J
authors.initials: JJ
authors.lastname: Tessier
authors.forename: J C
authors.initials: JC
authors.lastname: Waterton
authors.forename: A
authors.initials: A
authors.lastname: Jackson
mesh_terms: D000328:Adult; D000368:Aged; D001810:Blood Volume; D001812:Blood-Brain Barrier; D001921:Brain / Q000098:blood supply*; D001932:Brain Neoplasms / Q000098:blood supply* / Q000473:pathology; D002463:Cell Membrane Permeability; D002560:Cerebrovascular Circulation; D003287:Contrast Media; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D005910:Glioma / Q000098:blood supply* / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008579:Meningioma / Q000098:blood supply* / Q000473:pathology; D008875:Middle Aged; D008962:Models, Theoretical; D009464:Neuroma, Acoustic / Q000098:blood supply* / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media