Journal
JOURNAL OF MAGNETIC RESONANCE IMAGING
Volume 44, Issue 5, Pages 1229-1237Publisher
WILEY
DOI: 10.1002/jmri.25227
Keywords
leakage correction; bidirectional contrast agent flux; bevacizumab; DSC-MRI; perfusion MRI; glioblastoma
Funding
- American Cancer Society (ACS) [RSG-15-003-01-CCE]
- National Brain Tumor Society Research Grant
- Art of the Brain
- Ziering Family Foundation in memory of Sigi Ziering
- Singleton Family Foundation
- Clarance Klein Fund for Neuro-Oncology
- National Institute of Health National Institute of General Medical Sciences [GM08042]
- University of California Los Angeles Medical Scientist Training Program
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PurposeTo evaluate a leakage correction algorithm for T-1 and T2* artifacts arising from contrast agent extravasation in dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) that accounts for bidirectional contrast agent flux and compare relative cerebral blood volume (CBV) estimates and overall survival (OS) stratification from this model to those made with the unidirectional and uncorrected models in patients with recurrent glioblastoma (GBM). Materials and MethodsWe determined median rCBV within contrast-enhancing tumor before and after bevacizumab treatment in patients (75 scans on 1.5T, 19 scans on 3.0T) with recurrent GBM without leakage correction and with application of the unidirectional and bidirectional leakage correction algorithms to determine whether rCBV stratifies OS. ResultsDecreased post-bevacizumab rCBV from baseline using the bidirectional leakage correction algorithm significantly correlated with longer OS (Cox, P=0.01), whereas rCBV change using the unidirectional model (P=0.43) or the uncorrected rCBV values (P=0.28) did not. Estimates of rCBV computed with the two leakage correction algorithms differed on average by 14.9%. ConclusionAccounting for T-1 and T2* leakage contamination in DSC-MRI using a two-compartment, bidirectional rather than unidirectional exchange model might improve post-bevacizumab survival stratification in patients with recurrent GBM. J. Magn. Reson. Imaging 2016;44:1229-1237.
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