Effect of Applying Leakage Correction on rCBV Measurement Derived From DSC-MRI in Enhancing and Nonenhancing Glioma.
Effect of Applying Leakage Correction on rCBV Measurement Derived From DSC-MRI in Enhancing and Nonenhancing Glioma.
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DOI：
10.3389/fonc.2021.648528
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发表时间：
2021
影响因子：
4.7
通讯作者：
Warnert EAH
中科院分区：
文献类型：
--
作者：
Arzanforoosh F;Croal PL;van Garderen KA;Smits M;Chappell MA;Warnert EAH
相对脑血容量（rCBV）是最广泛使用的参数来自DSC灌注MR成像预测脑肿瘤的侵袭性。然而，准确的rCBV估计是具有挑战性的增强胶质瘤，因为造影剂外渗通过破坏血脑屏障（BBB），甚至对于非增强胶质瘤与完整的血脑屏障，由于一个升高的稳态造影剂浓度在血管系统后第一次通过。在这项研究中，两种不同的泄漏校正算法对增强和非增强肿瘤的rCBV估计的影响进行了彻底的调查。本研究回顾性使用了两个数据集：1.公开可用的TCIA数据集（49例患者，35例增强和14例非增强胶质瘤）; 2.在Erasmus MC（EMC，鹿特丹，NL）临床获得的数据集（47例患者，20例增强和27例非增强胶质脑病变）。本研究中研究的泄漏校正算法为：基于单向模型的算法，造影剂流量从血管内到血管外细胞外空间（EES）;基于双向模型的算法，还包括从EES到血管内空间的流量。在增强胶质瘤中，估计的平均对比增强肿瘤rCBV显著高于正常对照组。（Bonferroni校正的Wilcoxon符号秩检验，p < 0.05）当应用单向和双向校正时，患者之间的差异降低：4.00 ± 2.11（未校正），3.19 ± 1.65（单向）和2.91 ± 1.55 TCIA数据集为2.51 ± 1.3（未校正）、1.72 ± 0.84（单向）和1.59 ± 0.9（双向）。在非增强胶质瘤中，在应用本研究中使用的两种校正方法后，发现观察到的rCBV存在显著但较小的差异：1.42 ± 0.60（未校正），1.28 ± 0.46（单向）和1.24 ± 0.37 TCIA数据集为0.91 ± 0.49（未校正）、0.77 ± 0.37（单向）和0.67 ± 0.34（双向）。两种泄漏校正算法被发现改变rCBV估计与BBB中断增强胶质瘤，并在较小程度上在非增强胶质瘤。发现双向泄漏校正比单向泄漏校正的效果更强。
Relative cerebral blood volume (rCBV) is the most widely used parameter derived from DSC perfusion MR imaging for predicting brain tumor aggressiveness. However, accurate rCBV estimation is challenging in enhancing glioma, because of contrast agent extravasation through a disrupted blood-brain barrier (BBB), and even for nonenhancing glioma with an intact BBB, due to an elevated steady-state contrast agent concentration in the vasculature after first passage. In this study a thorough investigation of the effects of two different leakage correction algorithms on rCBV estimation for enhancing and nonenhancing tumors was conducted. Two datasets were used retrospectively in this study: 1. A publicly available TCIA dataset (49 patients with 35 enhancing and 14 nonenhancing glioma); 2. A dataset acquired clinically at Erasmus MC (EMC, Rotterdam, NL) (47 patients with 20 enhancing and 27 nonenhancing glial brain lesions). The leakage correction algorithms investigated in this study were: a unidirectional model-based algorithm with flux of contrast agent from the intra- to the extravascular extracellular space (EES); and a bidirectional model-based algorithm additionally including flow from EES to the intravascular space. In enhancing glioma, the estimated average contrast-enhanced tumor rCBV significantly (Bonferroni corrected Wilcoxon Signed Rank Test, p < 0.05) decreased across the patients when applying unidirectional and bidirectional correction: 4.00 ± 2.11 (uncorrected), 3.19 ± 1.65 (unidirectional), and 2.91 ± 1.55 (bidirectional) in TCIA dataset and 2.51 ± 1.3 (uncorrected), 1.72 ± 0.84 (unidirectional), and 1.59 ± 0.9 (bidirectional) in EMC dataset. In nonenhancing glioma, a significant but smaller difference in observed rCBV was found after application of both correction methods used in this study: 1.42 ± 0.60 (uncorrected), 1.28 ± 0.46 (unidirectional), and 1.24 ± 0.37 (bidirectional) in TCIA dataset and 0.91 ± 0.49 (uncorrected), 0.77 ± 0.37 (unidirectional), and 0.67 ± 0.34 (bidirectional) in EMC dataset. Both leakage correction algorithms were found to change rCBV estimation with BBB disruption in enhancing glioma, and to a lesser degree in nonenhancing glioma. Stronger effects were found for bidirectional leakage correction than for unidirectional leakage correction.
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