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Deprecated: Implicit conversion from float 318.4 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Magn+Reson+Imaging 2021 ; 83 (ä): 77-88 Nephropedia Template TP
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A comprehensive evaluation and impact of normalization of generalized tracer kinetic model parameters to characterize blood-brain-barrier permeability in normal-appearing and tumor tissue regions of patients with glioma #MMPMID34311065
Sasi S D; Gupta RK; Patir R; Ahlawat S; Vaishya S; Singh A
Magn Reson Imaging 2021[Nov]; 83 (ä): 77-88 PMID34311065show ga
RATIONALE AND OBJECTIVES: To comprehensively evaluate robustness and variations of DCE-MRI derived generalized-tracer-kinetic-model (GTKM) parameters in healthy and tumor tissues and impact of normalization in mitigating these variations on application to glioma. MATERIALS (PATIENTS) AND METHODS: A retrospective study included pre-operative 31 high-grade-glioma(HGG), 22 low-grade-glioma(LGG) and 33 follow-up data from 10 patients a prospective study with 4 HGG subjects. Voxel-wise GTKM was fitted to DCE-MRI data to estimate K(trans), v(e), v(b). Simulations were used to evaluate noise sensitivity. Variation of parameters with-respect-to arterial-input-function (AIF) variation and data length were studied. Normalization of parameters with-respect-to mean values in gray-matter (GM) and white-matter (WM) regions (GM-Type-2, WM-Type-2) and mean curves (GM-Type-1, WM-Type-1) were also evaluated. Co-efficient-of-variation(CoV), relative-percentage-error (RPE), Box-Whisker plots, bar graphs and t-test were used for comparison. RESULTS: GTKM was fitted well in all tissue regions. K(trans) and v(e) in contrast-enhancing (CE) has shown improved noise sensitivity in longer data. v(b) was reliable in all tissues. Mean AIF and C(t) peaks showed ~38% and ~35% variations. During simulation, normalizations have mitigated variations due to changes in AIF amplitude in K(trans) and v(b)(.). v(e) was less sensitive to normalizations. CoV of K(trans) and v(b) has reduced ~70% after GM-Type-1 normalization and ~80% after GM-Type-2 normalization, respectively. GM-Type-1 (p = 0.003) and GM-Type-2 (p = 0.006) normalizations have significantly improved differentiation of HGG and LGG using K(trans). CONCLUSION: K(trans) and v(b) can be reliably estimated in normal-appearing brain tissues and can be used for normalization of corresponding parameters in tumor tissues for mitigating inter-subject variability due to errors in AIF. Normalized K(trans) and v(b) provided improved differentiation of HGG and LGG.