Optimization of Acquisition and Analysis Methods for Clinical Dynamic Susceptibility Contrast MRI Using a Population-Based Digital Reference Object.
Optimization of Acquisition and Analysis Methods for Clinical Dynamic Susceptibility Contrast MRI Using a Population-Based Digital Reference Object.
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DOI：
10.3174/ajnr.a5827
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发表时间：
2018-11
期刊：
影响因子：
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通讯作者：
Quarles CC
中科院分区：
文献类型：
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作者：
Semmineh NB;Bell LC;Stokes AM;Hu LS;Boxerman JL;Quarles CC
胶质母细胞瘤DSC-MRI CBV图的准确性取决于采集和分析协议。由于体内验证的困难，多中心方案异质性对标准化倡议提出了挑战。本研究旨在比较使用数字参考对象（DRO）的常规使用协议的准确性。DRO由约10，000个模拟体素组成，重现了体内遇到的典型信号异质性。在6，912个参数组合中评价了采集和后处理方法对CBV可靠性的影响，包括造影剂给药方案、脉冲序列参数、场强和后处理方法。使用一致性相关系数（CCC）和变异系数（CV）评估准确度和精密度。在所有参数空间中，最佳方案包括全剂量造影剂预加载和团注、中间（60°）翻转角、30 ms TE和采用泄漏校正算法的后处理（CCC = 0.97，CV = 6.6%）。使用这些采集参数的无预加载或部分剂量预加载和推注的协议通常不太稳健。然而，无前负荷、全剂量推注和低（30°）翻转角的方案表现非常好（CCC = 0.93，1.5T时CV = 8.7%）和（CCC = 0.92，3 T时CV = 8.2%）。全剂量预负荷和推注方案最大限度地提高了CBV准确性并降低了变异性，这可以在临床试验中实现更小的样本量和更可靠的CBV变化检测。当需要较低的总造影剂剂量时，使用低翻转角、无预加载、全剂量推注协议可以提供有吸引力的替代方案。
The accuracy of DSC-MRI CBV maps in glioblastoma depends on acquisition and analysis protocols. Multi-site protocol heterogeneity has challenged standardization initiatives due to the difficulties of in vivo validation. This study seeks to compare the accuracy of routinely used protocols using a digital reference object (DRO). The DRO consists of approximately 10,000 simulated voxels recapitulating typical signal heterogeneity encountered in vivo. The influence of acquisition and post-processing methods on CBV reliability was evaluated across 6,912 parameter combinations, including contrast agent dosing schemes, pulse sequence parameters, field strengths, and post-processing methods. Accuracy and precision were assessed using the concordance correlation coefficient (CCC) and coefficient of variation (CV). Across all parameter space, the optimal protocol includes full-dose contrast agent preload and bolus, intermediate (60°) flip angle, 30 ms TE, and post-processing with a leakage correction algorithm (CCC = 0.97, CV = 6.6%). Protocols with no preload or fractional-dose preload and bolus using these acquisition parameters were generally less robust. However, a protocol with no preload, full-dose bolus, and low (30°) flip angle performed very well (CCC = 0.93, CV = 8.7% at 1.5T) and (CCC = 0.92, CV = 8.2% at 3T). Schemes with full-dose preload and bolus maximize CBV accuracy and reduce variability, which could enable smaller sample sizes and more reliable detection of CBV changes in clinical trials. When lower total contrast agent dose is desired, use of a low flip angle, no preload, full-dose bolus protocol may provide an attractive alternative.