Dynamic susceptibility-contrast magnetic resonance imaging with contrast agent leakage correction aids in predicting grade in pediatric brain tumours: a multicenter study


Background: Relative cerebral blood volume (rCBV) measured using dynamic susceptibility-contrast MRI can differentiate between low- and high-grade pediatric brain tumors. Multicenter studies are required for translation into clinical practice. Objective: We compared leakage-corrected dynamic susceptibility-contrast MRI perfusion parameters acquired at multiple centers in low- and high-grade pediatric brain tumors. Materials and methods: Eighty-five pediatric patients underwent pre-treatment dynamic susceptibility-contrast MRI scans at four centers. MRI protocols were variable. We analyzed data using the Boxerman leakage-correction method producing pixel-by-pixel estimates of leakage-uncorrected (rCBV uncorr) and corrected (rCBV corr) relative cerebral blood volume, and the leakage parameter, K 2. Histological diagnoses were obtained. Tumors were classified by high-grade tumor. We compared whole-tumor median perfusion parameters between low- and high-grade tumors and across tumor types. Results: Forty tumors were classified as low grade, 45 as high grade. Mean whole-tumor median rCBV uncorr was higher in high-grade tumors than low-grade tumors (mean ± standard deviation [SD] = 2.37±2.61 vs. –0.14±5.55; P<0.01). Average median rCBV increased following leakage correction (2.54±1.63 vs. 1.68±1.36; P=0.010), remaining higher in high-grade tumors than low grade-tumors. Low-grade tumors, particularly pilocytic astrocytomas, showed T1-dominant leakage effects; high-grade tumors showed T2*-dominance (mean K 2=0.017±0.049 vs. 0.002±0.017). Parameters varied with tumor type but not center. Median rCBV uncorr was higher (mean = 1.49 vs. 0.49; P=0.015) and K 2 lower (mean = 0.005 vs. 0.016; P=0.013) in children who received a pre-bolus of contrast agent compared to those who did not. Leakage correction removed the difference. Conclusion: Dynamic susceptibility-contrast MRI acquired at multiple centers helped distinguish between children’s brain tumors. Relative cerebral blood volume was significantly higher in high-grade compared to low-grade tumors and differed among common tumor types. Vessel leakage correction is required to provide accurate rCBV, particularly in low-grade enhancing tumors.

Publication DOI: https://doi.org/10.1007/s00247-021-05266-7
Divisions: College of Health & Life Sciences > School of Psychology
College of Health & Life Sciences > Aston Institute of Health & Neurodevelopment (AIHN)
College of Health & Life Sciences
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Uncontrolled Keywords: Blood volume,Brain,Children,Dynamic susceptibility-contrast magnetic resonance imaging,Leakage correction,Magnetic resonance imaging,Multicenter,Perfusion,Tumor,Pediatrics, Perinatology, and Child Health,Radiology Nuclear Medicine and imaging
Publication ISSN: 1432-1998
Last Modified: 14 May 2024 07:28
Date Deposited: 08 Apr 2022 10:35
Full Text Link:
Related URLs: https://link.sp ... 247-021-05266-7 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2022-05
Published Online Date: 2022-03-15
Accepted Date: 2021-12-11
Submitted Date: 2020-10-29
Authors: Withey, Stephanie B
MacPherson, Lesley
Oates, Adam
Powell, Stephen
Novak, Jan (ORCID Profile 0000-0001-5173-3608)
Abernethy, Laurence
Pizer, Barry
Grundy, Richard
Morgan, Paul S
Bailey, Simon
Mitra, Dipayan
Arvanitis, Theodoros N
Auer, Dorothee P
Avula, Shivaram
Peet, Andrew C



Version: Published Version

License: Creative Commons Attribution

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