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

Abstract

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
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
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

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