title: Comparison of actual with default hematocrit value in dynamic contrast enhanced MR perfusion quantification in grading of human glioma.
abstract: Dynamic contrast enhanced (DCE) MRI is used to grade and to monitor the progression of glioma while on treatment. Usually, a fixed hematocrit (Hct) value for adults is assumed to be ~45%; however, it is actually known for individual variations. Purpose of this study was to investigate the effect of measured Hct values in glioma grading using DCE-MRI.
  
  
  
  Fifty glioma patients were included in this study. Kinetic and hemodynamic parameters were estimated for each patient using assumed as well as measured Hct values. To look the changes in Hct value over time, Hct was measured multiple times from 10 of these glioma patients who were on treatment. Simulation was done to look for the effect of extreme variations of Hct values on perfusion metrics. The data was compared to look for significant differences in the perfusion metrics derived from assumed and measured Hct values.
  
  
  
  The measured Hct value in patients was found to be (40.4±4.28)%. The sensitivity and specificity of DCE-MRI parameters in glioma grading were not significantly influenced by using measured vis-a-vis assumed Hct values. The serial Hct values from 10 patients who were on treatment showed a fluctuation of 15-20% over time. The simulated data showed linear influence of Hct values on kinetic parameters. The tumor grading was altered on altering the Hct values in borderline cases.
  
  
  
  Hct values influence the hemodynamic and kinetic metrics linearly and may affect glioma grading. However, perfusion metrics values might change significantly with large change in Hct values, especially in patients who are on chemotherapy necessitating its use in the DCE model.
authors.affiliation: Philips Health Systems, Philips India Ltd, Bangalore, India.
authors.forename: Prativa
authors.initials: P
authors.lastname: Sahoo
authors.affiliation: Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: Pradeep K
authors.initials: PK
authors.lastname: Gupta
authors.affiliation: Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Awasthi
authors.affiliation: Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Chandra M
authors.initials: CM
authors.lastname: Pandey
authors.affiliation: Department of Neurosurgery, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: Rana
authors.initials: R
authors.lastname: Patir
authors.affiliation: Department of Neurosurgery, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Vaishya
authors.affiliation: Philips Health Systems, Philips India Ltd, Gurgaon, India.
authors.forename: Indrajit
authors.initials: I
authors.lastname: Saha
authors.affiliation: Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India. Electronic address: rakeshree1@gmail.com.
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging / Q000473:pathology*; D006400:Hematocrit / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: Arterial input function; DCE MRI; Glioma grading; Hematocrit