Abstract

Background: Dynamic susceptibility contrast (DSC) MR perfusion is a frequently-used technique for neurovascular imaging. The progress of a bolus of contrast agent through the tissue of the brain is imaged via a series of T2*-weighted MRI scans. Clinically relevant parameters such as blood flow and Tmax can be calculated by deconvolving the contrast-time curves with the bolus shape (arterial input function). In acute stroke, for instance, these parameters may help distinguish between the likely salvageable tissue and irreversibly damaged infarct core. Deconvolution typically relies on singular value decomposition (SVD): however, studies have shown that these algorithms are very sensitive to noise and artifacts present in the image and therefore may introduce distortions that influence the estimated output parameters.Methods: In this work, we present a machine learning approach to the estimation of perfusion parameters in DSC-MRI. Various machine learning models using as input the raw MR source data were trained to reproduce the output of an FDA approved commercial implementation of the SVD deconvolution algorithm. Experiments were conducted to determine the effect of training set size, optimal patch size, and the effect of using different machine-learning models for regression.Results: Model performance increased with training set size, but after 5,000 samples (voxels) this effect was minimal. Models inferring perfusion maps from a 5 by 5 voxel patch outperformed models able to use the information in a single voxel, but larger patches led to worse performance. Random Forest models produced had the lowest root mean squared error, with neural networks performing second best: however, a phantom study revealed that the random forest was highly susceptible to noise levels, while the neural network was more robust.Conclusion: The machine learning-based approach produces estimates of the perfusion parameters invariant to the noise and artifacts that commonly occur as part of MR acquisition. As a result, better robustness to noise is obtained, when evaluated against the FDA approved software on acute stroke patients and simulated phantom data.

Highlights

  • Perfusion imaging is a vital tool in clinical neuroimaging, and in particular in the imaging of acute stroke patients

  • Dynamic Susceptibility Contrast (DSC) MR Perfusion imaging is a modality in which a bolus of contrast agent that reduces the signal intensity of T2− and T2∗− weighted images is allowed to perfuse through neural tissue while a series of consecutive MRIs is taken

  • The models are trained on a large number of voxels from perfusion imaging in ischemic stroke cases: the variability of these cases allows our models to disregard erroneous measurements and produce better estimates of perfusion parameters, as we demonstrate by synthetically adding noise to both perfusion cases and phantom data

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Summary

Introduction

Perfusion imaging is a vital tool in clinical neuroimaging, and in particular in the imaging of acute stroke patients. The signal attenuation resulting from the contrast agent can be used to infer the concentration of contrast agent in the volume over time [1] These concentrationtime curves on their own cannot be directly interpreted, but clinically relevant measures such as cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), timeto-peak (TTP), and time-to-maximum (Tmax) can be inferred by deconvolving the arterial input function to obtain the residue function: a curve characterizing blood flow through that volume element. The progress of a bolus of contrast agent through the tissue of the brain is imaged via a series of T2*-weighted MRI scans Relevant parameters such as blood flow and Tmax can be calculated by deconvolving the contrast-time curves with the bolus shape (arterial input function). Deconvolution typically relies on singular value decomposition (SVD): studies have shown that these algorithms are very sensitive to noise and artifacts present in the image and may introduce distortions that influence the estimated output parameters

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