Subcompartmentalization of extracellular extravascular space (EES) into permeability and leaky space with local arterial input function (AIF) results in improved discrimination between high‐ and low‐grade glioma using dynamic contrast‐enhanced (DCE) MRI

Abstract

Purpose:To modify the generalized tracer kinetic model (GTKM) by introducing an additional tissue uptake leakage compartment in extracellular extravascular space (LTKM). In addition, an implicit determination of voxel‐wise local arterial input function (AIF) Cp(t) was performed to see whether these changes help in better discrimination between low‐ and high‐grade glioma using dynamic contrast‐enhanced (DCE) magnetic resonance imaging (MRI).Materials and Methods:The modified model (LTKM) was explored and fitted to the concentration–time curve C(t) of each voxel, in which the local AIF Cp(t) could be estimated by a time invariant convolution approximation based on a separately measured global AIF Ca(t). A comparative study of tracer kinetic analysis was performed on 184 glioma patients using DCE‐MRI data on 1.5T and 3T MRI systems.Results:The LTKM analysis provided more accurate pharmacokinetic parameters as evidenced by their relative constancy with respect to the length of concentration–time curve used. In addition, LTKM with local AIF resulted in improved discrimination between low‐grade and high‐grade gliomas.Conclusion:LTKM with local AIF provides more accurate estimation of physiological parameters and improves discrimination between low‐grade and high‐grade gliomas as compared with GTKM. J. Magn. Reson. Imaging 2013;38:677–688. © 2013 Wiley Periodicals, Inc.