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The impact of reliable prebolus T 1 measurements or a fixed T 1 value in the assessment of glioma patients with dynamic contrast enhancing MRI

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

Accurate quantification of hemodynamic parameters using dynamic contrast enhanced (DCE) MRI requires a measurement of tissue T 1 prior to contrast injection (T 1). We evaluate (i) T 1 estimation using the variable flip angle (VFA) and the saturation recovery (SR) techniques and (ii) investigate if accurate estimation of DCE parameters outperform a time-saving approach with a predefined T 1 value when differentiating high- from low-grade gliomas.

Methods

The accuracy and precision of T 1 measurements, acquired by VFA and SR, were investigated by computer simulations and in glioma patients using an equivalence test (p > 0.05 showing significant difference). The permeability measure, K trans, cerebral blood flow (CBF), and - volume, V p, were calculated in 42 glioma patients, using fixed T 1 of 1500 ms or an individual T 1 measurement, using SR. The areas under the receiver operating characteristic curves (AUCs) were used as measures for accuracy to differentiate tumor grade.

Results

The T 1 values obtained by VFA showed larger variation compared to those obtained using SR both in the digital phantom and the human data (p > 0.05). Although a fixed T 1 introduced a bias into the DCE calculation, this had only minor impact on the accuracy differentiating high-grade from low-grade gliomas, (AUCfix = 0.906 and AUCind = 0.884 for K trans; AUCfix = 0.863 and AUCind = 0.856 for V p; p for AUC comparison > 0.05).

Conclusion

T 1 measurements by VFA were less precise, and the SR method is preferable, when accurate parameter estimation is required. Semiquantitative DCE values, based on predefined T 1 values, were sufficient to perform tumor grading in our study.

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Acknowledgments

This work was supported by the Danish Ministry of Science, Technology and Innovation’s University Investment Grant (MINDLab).

Ethical Standards and Patient Consent

We declare that all human studies have been approved by the Danish National Committee on Health Research Ethics (Journal Number M-20100027) and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Dept. of Neuroradiology, Aarhus University Hospital, Nørrebrogade 44, DK-8000, Aarhus, Denmark

    Anna Tietze

  2. Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark

    Anna Tietze, Kim Mouridsen & Irene Klærke Mikkelsen

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  1. Anna Tietze
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  2. Kim Mouridsen
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Correspondence to Anna Tietze.

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Tietze, A., Mouridsen, K. & Mikkelsen, I.K. The impact of reliable prebolus T 1 measurements or a fixed T 1 value in the assessment of glioma patients with dynamic contrast enhancing MRI. Neuroradiology 57, 561–572 (2015). https://doi.org/10.1007/s00234-015-1502-z

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