title: Repeatability of Cerebral Perfusion Using Dynamic Susceptibility Contrast MRI in Glioblastoma Patients.
abstract: OBJECTIVE
  This study evaluates the repeatability of brain perfusion using dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) with a variety of post-processing methods.
  
  
  METHODS
  Thirty-two patients with newly diagnosed glioblastoma were recruited. On a 3-T MRI using a dual-echo, gradient-echo spin-echo DSC-MRI protocol, the patients were scanned twice 1 to 5 days apart. Perfusion maps including cerebral blood volume (CBV) and cerebral blood flow (CBF) were generated using two contrast agent leakage correction methods, along with testing normalization to reference tissue, and application of arterial input function (AIF). Repeatability of CBV and CBF within tumor regions and healthy tissues, identified by structural images, was assessed with intra-class correlation coefficients (ICCs) and repeatability coefficients (RCs). Coefficients of variation (CVs) were reported for selected methods.
  
  
  RESULTS
  CBV and CBF were highly repeatable within tumor with ICC values up to 0.97. However, both CBV and CBF showed lower ICCs for healthy cortical tissues (up to 0.83), healthy gray matter (up to 0.95), and healthy white matter (WM; up to 0.93). The values of CV ranged from 6% to 10% in tumor and 3% to 11% in healthy tissues. The values of RC relative to the mean value of measurement within healthy WM ranged from 22% to 42% in tumor and 7% to 43% in healthy tissues. These percentages show how much variation in perfusion parameter, relative to that in healthy WM, we expect to observe to consider it statistically significant. We also found that normalization improved repeatability, but AIF deconvolution did not.
  
  
  CONCLUSIONS
  DSC-MRI is highly repeatable in high-grade glioma patients.
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Massachusetts Institute of Technology, Cambridge, MA, USA. Electronic address: kjafari@nmr.mgh.harvard.edu.
authors.forename: Kourosh
authors.initials: K
authors.lastname: Jafari-Khouzani
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Massachusetts Institute of Technology, Cambridge, MA, USA; The Intervention Centre, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
authors.forename: Kyrre E
authors.initials: KE
authors.lastname: Emblem
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors.forename: Jayashree
authors.initials: J
authors.lastname: Kalpathy-Cramer
authors.affiliation: The Intervention Centre, Rikshospitalet, Oslo University Hospital, Oslo, Norway; Department of Physics, University of Oslo, Oslo, Norway.
authors.forename: Atle
authors.initials: A
authors.lastname: Bjørnerud
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Vangel
authors.affiliation: Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Gerstner
authors.affiliation: Department of Radiology & Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Schmainda
authors.affiliation: H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
authors.forename: Kamran
authors.initials: K
authors.lastname: Paynabar
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors.forename: Ona
authors.initials: O
authors.lastname: Wu
authors.affiliation: Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Patrick Y
authors.initials: PY
authors.lastname: Wen
authors.affiliation: Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Batchelor
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Rosen
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Stufflebeam