Intravoxel incoherent motion MR imaging for prostate cancer: An evaluation of perfusion fraction and diffusion coefficient derived from different b‐value combinations

There has been a resurgent interest in intravoxel incoherent motion (IVIM) MR imaging to obtain perfusion as well as diffusion information on lesions, in which the diffusion was modeled as Gaussian diffusion. However, it was observed that this diffusion deviated from expected monoexponential decay at high b‐values and the reported perfusion in prostate is contrary to the findings in dynamic contrast‐enhanced (DCE) MRI studies and angiogenesis. Thus, this work is to evaluate the effect of different b‐values on IVIM perfusion fractions (f) and diffusion coefficients (D) for prostate cancer detection. The results show that both parameters depended heavily on the b‐values, and those derived without the highest b‐value correlated best with the results from DCE‐MRI studies; specifically, f was significantly elevated (7.2% vs. 3.7%) in tumors when compared with normal tissues, in accordance with the volume transfer constant (K^trans; 0.39 vs. 0.18 min^?1) and plasma fractional volume (v_p; 8.4% vs. 3.4%). In conclusion, it is critical to choose an appropriate range of b‐values in studies or include the non‐Gaussian diffusion contribution to obtain unbiased IVIM measurements. These measurements could eliminate the need for DCE‐MRI, which is especially relevant in patients who cannot receive intravenous gadolinium‐based contrast media. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

Survival analysis in patients with glioblastoma multiforme: predictive value of choline-to-N-acetylaspartate index, apparent diffusion coefficient, and relative cerebral blood volume

Purpose

To investigate the potential value of pre‐external‐beam radiation therapy (XRT) choline‐to‐NAA (N‐acetylaspartate) index (CNI), apparent diffusion coefficient (ADC), and relative cerebral blood volume (rCBV) for predicting survival in newly diagnosed patients with glioblastoma multiforme (GBM).

Materials and Methods

Twenty‐eight patients with GBM were studied using in vivo proton magnetic resonance spectroscopic imaging (¹H MRSI) and diffusion‐ and perfusion‐weighted imaging after surgery but prior to XRT. Patients were categorized on the basis of their volumes of morphologic and metabolic abnormalities (volume of CNI ≥ 2 and CNI values), normalized ADC (nADC), or rCBV values within the T1 contrast‐enhancing and T2 regions. The median survival time was compared.

Results

A significantly shorter median survival time was observed for patients with a large volume of metabolic abnormality than for those with a small abnormality (12.0 and 17.1 months, respectively, P = 0.002). A similar pattern was observed for patients with a low mean nADC value compared to those with high mean nADC value within the T2 region (11.2 and 21.7 months, respectively, P = 0.004). A shorter median survival time was also observed for patients with contrast‐enhancing residual disease than for those without the presence of contrast enhancement with marginal significance.

Conclusion

The pre‐XRT volume of the metabolic abnormality and the nADC value within the T2 region may be valuable in predicting outcome for patients with GBM. J. Magn. Reson. Imaging 2004;19:546–554. © 2004 Wiley‐Liss, Inc.

     

Correlation of early reduction in the apparent diffusion coefficient of water with blood flow reduction during middle cerebral artery occlusion in rats

To determine the relationship between reductions in the apparent diffusion coefficient of water (ADC) and in cerebral blood flow (CBF) during focal ischemia, we used diffusion-weighted magnetic resonance (D-MR) imaging and autoradiographic CBF analysis to examine rats subjected to 30 or 90 min of permanent middle cerebral artery (MCA) occlusion. In the 30-min occlusion group (n = 10), the area with substantially reduced ADC (15% or more below the contralateral level [ADC₁₅]) corresponded best to the area with CBF below 25 ml/100 g/min and was significantly smaller than the area with CBF below 50 ml/100 g/min (CBF₅₀), a level associated with reduced protein synthesis and delayed necrosis (40 ± 13% versus 74 ± 8% of the ischemic hemisphere; P < 0.0001). In the 90-min occlusion group (n = 6), the ADC₁₅ area corresponded best to the CBF₃₀ to CBF₃₅ area and was again significantly smaller than the CBF₅₀ area (54 ± 13% versus 73 ± 20%, P < 0.05). Thus, the area of substantially reduced ADC at 30 and 90 min represents only 53% and 74%, respectively, of the tissue at risk for infarction. These findings indicate a potential limitation in using early D-MR imaging to predict stroke outcome.     

Quantitative measurements of cerebral blood flow in rats using the FAIR technique: Correlation with previous lodoantipyrine autoradiographic studies

Flow-sensitive alternating inversion recovery (FAIR) is a recently introduced MRI technique for assessment of perfusion that uses blood water as an endogenous contrast agent. To characterize the FAIR signal dependency on spin tagging time (inversion time (Tl)) and to validate FAIR for cerebral blood flow (CBF) quantification, studies were conducted on the rat brain at 9.4 T using a conventional gradient-recalled echo sequence. The 7¹, of cerebral cortex and blood was found to be 1.9 and 2.2 s, respectively, and was used for CBF calculations. At short Tls (<0.8 s), the FAIR signal originates largely from vascular components with fast flows, resulting in an overestimation of CBF. For Tl > 1.5 s, the CBF calculated from FAIR is independent of the spin tagging time, suggesting that the observed FAIR signal originates predominantly from tissue/capillary components. CBF values measured by FAIR with Tl of 2.0 s were found to be in good agreement with those measured by the iodoantipyrine technique with autoradiogra-phy in rats under the same conditions of anesthesia and arterial pCO₂. The measured pCO₂ index on the parietal cortex using the FAIR technique was 6.07 ml/100 g/min per mmHg, which compares well with the pCO₂ index measured by other techniques. The FAIR technique was also able to detect the regional reduction in CBF produced by middle cerebral artery occlusion in rats.     

Sources of functional apparent diffusion coefficient changes investigated by diffusion-weighted spin-echo fMRI.

The mechanism behind previously observed changes in the apparent diffusion coefficient (ADC) during brain activation is not well understood. Therefore, we investigated the signal source and spatial specificity of functional magnetic resonance imaging (fMRI) ADC changes systematically in the visual cortex of cats using diffusion-weighted (DW) spin-echo (SE) fMRI with b-values of 2, 200, and 800 s/mm(2), and echo times (TE) of 16, 28, and 60 ms at 9.4 T. For b > or = 200 s/mm(2), no ADC changes were detected in brain parenchyma, suggesting a minimal tissue contribution to the ADC change. For b < or = 200 s/mm(2), TE-dependent ADC increases were observed. When the venous blood contribution was minimized, the ADC change was higher at the middle cortical layer than at the cortical surface, which is mainly attributed to a functional elevation in arterial blood volume. At TE = 16 ms, the highest ADC changes occurred at the cortical surface with its large draining veins, which can mainly be explained by an additional contribution from the venous blood oxygenation changes. Our TE-dependent ADC results agree with computer simulations based on a three-compartment model. The contribution of arterial blood volume changes in ADC fMRI offers an improvement in spatial localization for SE-BOLD fMRI studies.     

The evolution of the apparent diffusion coefficient in the pediatric brain at low and high diffusion weightings

PURPOSE: To evaluate the evolution of the apparent diffusion coefficient (ADC) with age for different degrees of diffusion weighting using a clinically feasible approach. MATERIALS AND METHODS: Data was acquired using separate scans with b values in the range typically used for clinical studies (100-900 seconds/mm(2)) and higher b values (1800-3000 seconds/mm(2)). The ADC was calculated for each of the data sets by fitting the data to a monoexponential function. RESULTS: The results from 50 children aged three years and less showed some deviations from literature values derived using a full biexponential fit, with these differences reflecting the approximations inherent in this approach. The values obtained with this technique appear to be reproducible but the resulting "institutional values" are comparable to those from other centers only if identical measurement criteria are used. CONCLUSION: A significant decline in both components of the ADC during the first few months of life was observed; in addition, the attenuated slow ADC values seen in adult white matter were only present at birth in early myelinating regions. The subsequent development of the slow ADC in white matter suggests that it is associated with myelination or processes associated with axonal development.     

Simultaneous temperature and regional blood volume measurements in human muscle using an MRI fast diffusion technique

The thermal dependence of the translational diffusion coefficient and of the regional blood volume was investigated in vivo by using a special MR pulsed gradient technique with reduced sensitivity to bulk tissue motion. Measurements were done at 0.5 T, using a small gradient insert. The diffusion coefficient of muscle water was calibrated against thermocouple-measured temperature in vitro, both with the muscle fibers parallel and perpendicular to the diffusion gradient. The maximum muscle temperature variation obtained by percutaneous conduction was ?8.8 ± 1.6°C under cooling and +3.7 ± 1.6°C under heating, from basal state. Simultaneously the fractional regional blood volume decreased by a factor of 3.5 under cooling and increased by a factor of 2.7 under heating. Due to the interdependence of microcirculation and tissue temperature, this technique may be used to follow heat production or deposition in living tissue (muscle exercise, electromagnetic irradiation, etc.).     

A quantitative interpretation of IVIM measurements of vascular perfusion in the rat brain

Pulsed gradient spin echo (PGSE) sequences have been used to measure the signal loss of ¹⁹F in perfluorinated hydrocarbon blood substitutes moving within the vasculature of the rat brain in the experimental conditions of the study. The signal loss is not characterized by a single apparent pseudodiffusion coefficient. A simple vascular network model based on self-similarity hss been used to calculate the shape of the signal loss. Excellent agreement with the experiment has been obtained showing that the IVlM measurements are sensitive to flow over a wide range of vessel diameters and flow rates. This model of vascular structure may serve well for other MR measurements that are sensitive to perfusion.