Repeatability of dynamic contrast enhanced v p parameter in healthy subjects and patients with brain tumors

Moran Artzi, Gilad Liberman, Deborah T. Blumenthal, Felix Bokstein, Orna Aizenstein, Dafna Ben Bashat*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To study the repeatability of plasma volume (vp) extracted from dynamic-contrast-enhanced (DCE) MRI in order to define threshold values for significant longitudinal changes, and to assess changes in patients with high-grade-glioma (HGG). Methods: Twenty eight healthy subjects, of which eleven scanned twice, were used to assess the repeatability of vp within the normal-appearing brain tissue and to define threshold values for significant changes based on least-detected-differences (LDD) of mean vp values and histogram comparisons using earth-mover’s-distance (EMD). Sixteen patients with HGG were scanned longitudinally with eight patients scanned before and following bevacizumab therapy. Longitudinal changes were assessed based on defined threshold values in comparison to RANO criteria. Results: The threshold values for significant changes were: LDD = 0.0024 (ml/100 ml, 21%) for mean vp and EMD = 4.14. In patients, in 20/24 comparisons, no significant longitudinal changes were detected for vp within the normal-appearing brain tissue. Concurring results were obtained between changes in lesion volume (RANO criteria) and LDD or EMD values in cases diagnosed with progressive-disease, yet in about 50% of cases diagnosed with partial-response preliminary results demonstrated significant increase in vp despite significant reductions in lesion volume. In two patients, these changes preceded progression detected at follow-up scans. In general, a good concordance was obtained between LDD and EMD. Conclusion: This study shows high repeatability of vp and provides threshold values for significant changes in longitudinal assessment of patients with brain tumors. Preliminary results suggest the use of vp-DCE parameter to improve assessment of therapy response in patients with high-grade-glioma.

Original languageEnglish
Pages (from-to)727-737
Number of pages11
JournalJournal of Neuro-Oncology
Volume140
Issue number3
DOIs
StatePublished - 15 Dec 2018

Keywords

  • DCE-MRI
  • Earth mover’s distance (EMD)
  • High grade brain tumors
  • Least detected changes (LDD)
  • Plasma volume (v)

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