Feasibility of intravoxel incoherent motion in the assessment of tumor microvasculature and blood-brain barrier integrity: a case-based evaluation of gliomas.

Autor: Paschoal AM; LIM44, Instituto e Departamento de Radiologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, 05403-010, Brazil. andre.paschoal@hc.fm.usp.br.; Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, 14040-900, Brazil. andre.paschoal@hc.fm.usp.br.; InBrain Lab, FFCLRP, University of Sao Paulo, Ribeirao Preto, SP, 14040-900, Brazil. andre.paschoal@hc.fm.usp.br., Zotin MCZ; Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, 14040-900, Brazil.; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Costa LMD; InBrain Lab, FFCLRP, University of Sao Paulo, Ribeirao Preto, SP, 14040-900, Brazil., Santos ACD; Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, 14040-900, Brazil., Leoni RF; InBrain Lab, FFCLRP, University of Sao Paulo, Ribeirao Preto, SP, 14040-900, Brazil.
Jazyk: angličtina
Zdroj: Magma (New York, N.Y.) [MAGMA] 2022 Feb; Vol. 35 (1), pp. 17-27. Date of Electronic Publication: 2021 Dec 15.
DOI: 10.1007/s10334-021-00987-0
Abstrakt: Objective: To evaluate the feasibility of intravoxel incoherent motion (IVIM) in assessing blood-brain barrier (BBB) integrity and microvasculature in tumoral tissue of glioma patients.
Methods: Images from 8 high-grade and 4 low-grade glioma patients were acquired on a 3 T MRI scanner. Acquisition protocol included pre- and post-contrast T1- and T2-weighted imaging, FLAIR, dynamic susceptibility contrast (DSC), and susceptibility-weighted imaging (SWI). In addition, IVIM was acquired with 15 b-values and fitted under the non-negative least square (NNLS) model to output the diffusion (D) and pseudo-diffusion (D*) coefficients, perfusion fraction (f), and f times D* (fD*) maps.
Results: IVIM perfusion-related maps were sensitive to (1) blood flow and perfusion alterations within the microvasculature of brain tumors, in agreement with intra-tumoral susceptibility signal (ITSS); (2) enhancing areas of BBB breakdown in agreement with DSC maps as well as areas of BBB abnormality that was not detected on DSC maps; (3) enhancing perfusion changes within edemas; (4) detecting early foci of increased perfusion within low-grade gliomas.
Conclusion: The results suggest IVIM may be a promising approach to delineate tumor extension and progression in size, and to predict histological grade, which are clinically relevant information that characterize tumors and guide therapeutic decisions in patients with glioma.
(© 2021. The Author(s), under exclusive licence to European Society for Magnetic Resonance in Medicine and Biology (ESMRMB).)
Databáze: MEDLINE
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