title: Bidirectional Contrast agent leakage correction of dynamic susceptibility contrast (DSC)-MRI improves cerebral blood volume estimation and survival prediction in recurrent glioblastoma treated with bevacizumab.
abstract: To evaluate a leakage correction algorithm for T1and T2* artifacts arising from contrast agent extravasation in dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) that accounts for bidirectional contrast agent flux and compare relative cerebral blood volume (CBV) estimates and overall survival (OS) stratification from this model to those made with the unidirectional and uncorrected models in patients with recurrent glioblastoma (GBM).
  
  
  
  We determined median rCBV within contrast-enhancing tumor before and after bevacizumab treatment in patients (75 scans on 1.5T, 19 scans on 3.0T) with recurrent GBM without leakage correction and with application of the unidirectional and bidirectional leakage correction algorithms to determine whether rCBV stratifies OS.
  
  
  
  Decreased post-bevacizumab rCBV from baseline using the bidirectional leakage correction algorithm significantly correlated with longer OS (Cox, P = 0.01), whereas rCBV change using the unidirectional model (P = 0.43) or the uncorrected rCBV values (P = 0.28) did not. Estimates of rCBV computed with the two leakage correction algorithms differed on average by 14.9%.
  
  
  
  Accounting for T1and T2* leakage contamination in DSC-MRI using a two-compartment, bidirectional rather than unidirectional exchange model might improve post-bevacizumab survival stratification in patients with recurrent GBM. J. Magn. Reson. Imaging 2016;44:1229-1237.
authors.affiliation: UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, California, USA.|Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.|Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, California, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Leu
authors.affiliation: Department of Diagnostic Imaging, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA.
authors.forename: Jerrold L
authors.initials: JL
authors.lastname: Boxerman
authors.affiliation: UCLA Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, California, USA.|Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Lai
authors.affiliation: UCLA Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, California, USA.|Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
authors.forename: Phioanh L
authors.initials: PL
authors.lastname: Nghiemphu
authors.affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
authors.forename: Whitney B
authors.initials: WB
authors.lastname: Pope
authors.affiliation: UCLA Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, California, USA.|Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Cloughesy
authors.affiliation: UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, California, USA. bellingson@mednet.ucla.edu.|Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA. bellingson@mednet.ucla.edu.|Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, California, USA. bellingson@mednet.ucla.edu.|UCLA Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, California, USA. bellingson@mednet.ucla.edu.|Department of Biomedical Physics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA. bellingson@mednet.ucla.edu.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Ellingson
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000074322:Antineoplastic Agents, Immunological / Q000627:therapeutic use; D016477:Artifacts; D000068258:Bevacizumab / Q000627:therapeutic use; D001810:Blood Volume; D001811:Blood Volume Determination / Q000379:methods; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging* / Q000401:mortality; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000074322:Antineoplastic Agents, Immunological; D000068258:Bevacizumab
keywords: DSC-MRI; bevacizumab; bidirectional contrast agent flux; glioblastoma; leakage correction; perfusion MRI