title: Blood-brain barrier permeability of normal-appearing white matter in patients with vestibular schwannoma: A new hybrid approach for analysis of T1-W DCE-MRI.
abstract: To develop and assess a "hybrid" method that combines a first-pass analytical approach and the Patlak plot (PP) to improve assessment of low blood-brain barrier permeability from dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) data.
  
  
  
  Seven patients with vestibular schwannoma were enrolled. T1-W DCE imaging was acquired on a 1.5T scanner. Normal-appearing white matter (NAWM) was divided into four regions of interest (ROIs) based on the magnitude of changes in longitudinal relaxation rate (ΔR1) after gadolinium administration. Kinetic analysis of ROI-averaged contrast agent concentration curves was performed using both the conventional PP and the hybrid method. Computer simulated uptake curves that resemble those from NAWM were analyzed with both methods. Percent deviations (PD) of the "measured" values from the "true" values were calculated to evaluate accuracy and precision of the two methods.
  
  
  
  The simulation showed that, at a noise level of 4% (a noise level similar to the in vivo data) and using a signal intensity (SI) averaging scheme, the new hybrid method achieved a PD of 0.9 ± 2.7% for vp, and a PD of -5.4 ± 5.9% for Ktrans. In comparison, the PP method obtained a PD of 3.6 ± 11.3% for vp, and -8.3 ± 12.8% for Ktrans. One-way analyses of variance (ANOVAs) showed significant variations from the four WM regions (P < 10-15for ΔR1; P < 10-6for Ktrans; P < 10-4for vp).
  
  
  
  Both computer simulation and in vivo studies demonstrate improved reliability in vpand Ktransestimates with the hybrid method.
  
  
  
  3 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:79-93.
authors.affiliation: Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK.|CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, Manchester, UK.
authors.forename: Ka-Loh
authors.initials: KL
authors.lastname: Li
authors.affiliation: Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK.|CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, Manchester, UK.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK.|CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, Manchester, UK.
authors.forename: Sha
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK.|CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, Manchester, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Jackson
mesh_terms: D000368:Aged; D001812:Blood-Brain Barrier / Q000000981:diagnostic imaging* / Q000473:pathology; D002199:Capillary Permeability; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009464:Neuroma, Acoustic / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D066127:White Matter / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: DCE-MRI; Patlak plot; blood-brain barrier permeability; first-pass model; neurofibromatosis type 2; normal appearing white matter