Abstract

Multi-parametric tissue characterisation is demonstrated using a 4-minute protocol based on diffusion trace acquisitions. Three diffusion regimes are covered simultaneously: pseudo-perfusion, Gaussian, and non-Gaussian diffusion. The clinical utility of this method for fast multi-parametric mapping for brain tumours is explored. A cohort of 17 brain tumour patients was measured on a 3T hybrid MR-PET scanner with a standard clinical MRI protocol, to which the proposed multi-parametric diffusion protocol was subsequently added. For comparison purposes, standard perfusion and a full diffusion kurtosis protocol were acquired. Simultaneous amino-acid (18F-FET) PET enabled the identification of active tumour tissue. The metrics derived from the proposed protocol included perfusion fraction, pseudo-diffusivity, apparent diffusivity, and apparent kurtosis. These metrics were compared to the corresponding metrics from the dedicated acquisitions: cerebral blood volume and flow, mean diffusivity and mean kurtosis. Simulations were carried out to assess the influence of fitting methods and noise levels on the estimation of the parameters. The diffusion and kurtosis metrics obtained from the proposed protocol show strong to very strong correlations with those derived from the conventional protocol. However, a bias towards lower values was observed. The pseudo-perfusion parameters showed very weak to weak correlations compared to their perfusion counterparts. In conclusion, we introduce a clinically applicable protocol for measuring multiple parameters and demonstrate its relevance to pathological tissue characterisation.

Highlights

  • The use of magnetic resonance imaging (MRI) is considered to be the standard clinical practice for non-invasive, in vivo brain tumour characterisation

  • In order to address these limitations, we propose a fast hybrid intravoxel incoherent motion (IVIM)/non-Gaussian diffusion (NG-diff) protocol with the goal of being able to derive all of the aforementioned parameters in a clinically acceptable measurement time

  • We present a protocol for joint IVIM/NG-diff acquisition

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Summary

Introduction

The use of magnetic resonance imaging (MRI) is considered to be the standard clinical practice for non-invasive, in vivo brain tumour characterisation. Fast Protocol for Multiparametric Diffusion contrast is based on the lengthened T2 relaxation time in the tumour and oedema regions. These parameters are seldom measured directly and the presence of these changes is only assessed qualitatively. Quantitative MRI (qMRI) enables the acquisition of parameters that do not depend on either the scanning protocol or the scanner, field strength notwithstanding. Applying such an approach to tumour lesion assessment results in more accurate evaluations and could, improve diagnosis [1]. QMRI facilitates a meta-analysis of results from different centres, enabling a greater breadth of research, i.e. larger cohort studies

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