title: Improved Leakage Correction for Single-Echo Dynamic Susceptibility Contrast Perfusion MRI Estimates of Relative Cerebral Blood Volume in High-Grade Gliomas by Accounting for Bidirectional Contrast Agent Exchange.
abstract: Contrast agent extravasation through a disrupted blood-brain barrier potentiates inaccurate DSC MR imaging estimation of relative CBV. We explored whether incorporation of an interstitial washout rate in a leakage-correction model for single-echo, gradient-echo DSC MR imaging improves relative CBV estimates in high-grade gliomas.
  
  
  
  We modified the traditional model-based postprocessing leakage-correction algorithm, assuming unidirectional contrast agent extravasation (Boxerman-Weisskoff model) to account for bidirectional contrast agent exchange between intra- and extravascular spaces (bidirectional model). For both models, we compared the goodness of fit with the parent leakage-contaminated relaxation rate curves by using the Akaike Information Criterion and the difference between modeled interstitial relaxation rate curves and dynamic contrast-enhanced MR imaging by using Euclidean distance in 21 patients with glioblastoma multiforme.
  
  
  
  The bidirectional model had improved Akaike Information Criterion versus the bidirectional model in >50% of enhancing tumor voxels in all 21 glioblastoma multiformes (77% ± 9%; P < .0001) and had reduced the Euclidean distance in >50% of enhancing tumor voxels for 17/21 glioblastoma multiformes (62% ± 17%; P = .0041). The bidirectional model and dynamic contrast-enhanced-derived kep demonstrated a strong correlation (r = 0.74 ± 0.13). On average, enhancing tumor relative CBV for the Boxerman-Weisskoff model exceeded that for the bidirectional model by 16.6% ± 14.0%.
  
  
  
  Inclusion of the bidirectional exchange in leakage-correction models for single-echo DSC MR imaging improves the model fit to leakage-contaminated DSC MR imaging data and significantly improves the estimation of relative CBV in high-grade gliomas.
authors.affiliation: From the UCLA Brain Tumor Imaging Laboratory (K.L., B.M.E.), Center for Computer Vision and Imaging Biomarkers Department of Bioengineering (K.L., B.M.E.), Henry Samueli School of Engineering and Applied Science Departments of Radiological Sciences (K.L., W.B.P., B.M.E.).
authors.forename: K
authors.identifier: 0000-0002-0523-1575
authors.initials: K
authors.lastname: Leu
authors.affiliation: Department of Diagnostic Imaging (J.L.B.), Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: J L
authors.identifier: 0000-0002-0594-1542
authors.initials: JL
authors.lastname: Boxerman
authors.affiliation: UCLA Neuro-Oncology Program (T.F.C., A.L., P.L.N., B.M.E.), University of California, Los Angeles, Los Angeles, California.
authors.forename: T F
authors.identifier: 0000-0002-8656-7483
authors.initials: TF
authors.lastname: Cloughesy
authors.affiliation: UCLA Neuro-Oncology Program (T.F.C., A.L., P.L.N., B.M.E.), University of California, Los Angeles, Los Angeles, California Neurology (A.L., P.L.N.).
authors.forename: A
authors.identifier: 0000-0002-7265-2986
authors.initials: A
authors.lastname: Lai
authors.affiliation: UCLA Neuro-Oncology Program (T.F.C., A.L., P.L.N., B.M.E.), University of California, Los Angeles, Los Angeles, California Neurology (A.L., P.L.N.).
authors.forename: P L
authors.identifier: 0000-0003-4064-6079
authors.initials: PL
authors.lastname: Nghiemphu
authors.affiliation: Neurosurgery (L.M.L.), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
authors.forename: L M
authors.identifier: 0000-0002-4053-0052
authors.initials: LM
authors.lastname: Liau
authors.affiliation: Departments of Radiological Sciences (K.L., W.B.P., B.M.E.).
authors.forename: W B
authors.identifier: 0000-0003-4803-1992
authors.initials: WB
authors.lastname: Pope
authors.affiliation: From the UCLA Brain Tumor Imaging Laboratory (K.L., B.M.E.), Center for Computer Vision and Imaging Biomarkers Department of Bioengineering (K.L., B.M.E.), Henry Samueli School of Engineering and Applied Science UCLA Neuro-Oncology Program (T.F.C., A.L., P.L.N., B.M.E.), University of California, Los Angeles, Los Angeles, California Departments of Radiological Sciences (K.L., W.B.P., B.M.E.) Biomedical Physics (B.M.E.) bellingson@mednet.ucla.edu.
authors.forename: B M
authors.identifier: 0000-0002-2764-6640
authors.initials: BM
authors.lastname: Ellingson
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D000071937:Cerebral Blood Volume; D003287:Contrast Media; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging*; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical
chemical_list: D003287:Contrast Media