title: Correlative assessment of tumor microcirculation using contrast-enhanced perfusion MRI and intravoxel incoherent motion diffusion-weighted MRI: is there a link between them?
abstract: The purpose of this study was to correlate intravoxel incoherent motion (IVIM) imaging with classical perfusion-weighted MRI metrics in human gliomas. Parametric images for slow diffusion coefficient (D), fast diffusion coefficient (D*), and fractional perfusion-related volume (f) in patients with high-grade gliomas were generated. Maps of Fp (plasma flow), vp (vascular plasma volume), PS (permeability surface-area product), ve (extravascular, extracellular volume), E (extraction ratio), ke (influx ratio into the interstitium), and tc (vascular transit time) from dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast-enhanced (DSC) MRI were also generated. A region-of-interest analysis on the contralateral healthy white matter and on the tumor areas was performed and the extracted parameter values were tested for any significant differences among tumor grades or any correlations. Only f could be significantly correlated to DSC-derived vp and tc in healthy brain tissue. Concerning the tumor regions, Fp was significantly positively correlated with D* and inversely correlated with f in DSC measurements. The D*, f, and f × D* values in the WHO grade III gliomas were non-significantly different from those in the grade IV gliomas. There was a trend to significant negative correlations between f and PS as well as between f × D* and ke in DCE experiments. Presumably due to different theoretical background, tracer properties and modeling of the tumor vasculature in the IVIM theory, there is no clearly evident link between D*, f and DSC- and DCE-derived metrics.
authors.affiliation: Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Bisdas
authors.forename: Christian
authors.initials: C
authors.lastname: Braun
authors.forename: Marco
authors.initials: M
authors.lastname: Skardelly
authors.forename: Jens
authors.initials: J
authors.lastname: Schittenhelm
authors.forename: Tze Hern
authors.initials: TH
authors.lastname: Teo
authors.forename: Choon Hua
authors.initials: CH
authors.lastname: Thng
authors.forename: Uwe
authors.initials: U
authors.lastname: Klose
authors.forename: Tong San
authors.initials: TS
authors.lastname: Koh
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D004058:Diffusion; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005910:Glioma / Q000098:blood supply*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D008962:Models, Theoretical; D009038:Motion; D059906:Neuroimaging / Q000379:methods*; D009942:Organometallic Compounds; D011446:Prospective Studies; D012984:Software; D015173:Supratentorial Neoplasms / Q000098:blood supply*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol
keywords: blood flow; gliomas; intravoxel incoherent motion analysis; perfusion MR; perfusion fraction