Relative Regional Cerebral Blood Volume Research Articles

Effect of computed tomography perfusion post-processing algorithms on optimal threshold selection for final infarct volume prediction.

In acute ischemic stroke (AIS) patients, eligibility for endovascular intervention is commonly determined through computed tomography perfusion (CTP) analysis by quantifying ischemic tissue using perfusion parameter thresholds. However, thresholds are not uniform across all analysis methods due to dependencies on patient demographics and computational algorithms. This study aimed to investigate optimal perfusion thresholds for quantifying infarct and penumbra volumes using two post-processing CTP algorithms: Vitrea Bayesian and singular value decomposition plus (SVD+). We utilized 107 AIS patients (67 non-intervention patients and 40 successful reperfusion of thrombolysis in cerebral infarction (2b/3) patients). Infarct volumes were predicted for both post-processing algorithms through contralateral hemisphere comparisons using absolute time-to-peak (TTP) and relative regional cerebral blood volume (rCBV) thresholds ranging from +2.8 seconds to +9.3 seconds and -0.23 to -0.56 respectively. Optimal thresholds were determined by minimizing differences between predicted CTP and 24-hour fluid-attenuation inversion recovery magnetic resonance imaging infarct. Optimal thresholds were tested on 60 validation patients (30 intervention and 30 non-intervention) and compared using RAPID CTP software. Among the 67 non-intervention and 40 intervention patients, the following optimal thresholds were determined: intervention Bayesian: TTP = +4.8 seconds, rCBV = -0.29; intervention SVD+: TTP = +5.8 seconds, rCBV = -0.29; non-intervention Bayesian: TTP = +5.3 seconds, rCBV = -0.32; non-intervention SVD+: TTP = +6.3 seconds, rCBV = -0.26. When comparing SVD+ and Bayesian post-processing algorithms, optimal thresholds for TTP were significantly different for intervention and non-intervention patients. rCBV optimal thresholds were equal for intervention patients and significantly different for non-intervention patients. Comparison with commercially utilized software indicated similar performance.

Changes in the interictal and early postictal diffusion and perfusion magnetic resonance parameters in familial spontaneous epileptic cats

ObjectiveThe familial spontaneous epileptic cat (FSEC) is thought to be a good genetic model of mesial temporal lobe epilepsy. In the current study, cerebral diffusion and perfusion magnetic resonance imaging (MRI) were used to confirm the functional deficit zone in the FSEC and evaluate the effect of a single seizure on different brain regions. MethodsSix FSECs and six healthy control cats were used in this study. MRI was performed in the interictal state (resting state for control) and postictal state immediately after the vestibular stimulation-induced generalized epileptic seizure (control cats received the same stimulation as the FSECs). The apparent diffusion coefficient (ADC), fractional anisotropy and perfusion parameters (i.e., relative regional cerebral blood volume (rCBV), relative regional cerebral blood flow (rCBF), and relative regional mean transit time (rMTT)) were measured in the hippocampus, amygdala, thalamus, and gray and white matter. ResultsIn the interictal state, the rCBV and rMTT in the hippocampus was significantly decreased in FSECs, compared to the control. In the postictal state, FSECs had a significantly decreased ADC and an increased rCBV, rCBF, and rMTT in the hippocampus, and an increased rMTT in the amygdala, compared to the interictal state. ConclusionThis study showed that FSECs had interictal hypoperfusion in the hippocampus, and postictal hypodiffusion and hyperperfusion in the hippocampus and/or amygdala. These findings suggested that the hippocampus and/or amygdala act as the functional deficit and expanded seizure-onset zones in FSECs.

Automatic brain tumour detection and neovasculature assessment with multiseries MRI analysis

In this paper a novel multi-stage automatic method for brain tumour detection and neovasculature assessment is presented. First, the brain symmetry is exploited to register the magnetic resonance (MR) series analysed. Then, the intracranial structures are found and the region of interest (ROI) is constrained within them to tumour and peritumoural areas using the Fluid Light Attenuation Inversion Recovery (FLAIR) series. Next, the contrast-enhanced lesions are detected on the basis of T1-weighted (T1W) differential images before and after contrast medium administration. Finally, their vascularisation is assessed based on the Regional Cerebral Blood Volume (RCBV) perfusion maps. The relative RCBV (rRCBV) map is calculated in relation to a healthy white matter, also found automatically, and visualised on the analysed series. Three main types of brain tumours, i.e. HG gliomas, metastases and meningiomas have been subjected to the analysis. The results of contrast enhanced lesions detection have been compared with manual delineations performed independently by two experts, yielding 64.84% sensitivity, 99.89% specificity and 71.83% Dice Similarity Coefficient (DSC) for twenty analysed studies of subjects with brain tumours diagnosed.

Integrating diffusion kurtosis imaging, dynamic susceptibility-weighted contrast-enhanced MRI, and short echo time chemical shift imaging for grading gliomas

We assessed the diagnostic accuracy of diffusion kurtosis imaging (DKI), dynamic susceptibility-weighted contrast-enhanced (DSC) MRI, and short echo time chemical shift imaging (CSI) for grading gliomas. In this prospective study, 35 patients with cerebral gliomas underwent DKI, DSC, and CSI on a 3 T MR scanner. Diffusion parameters were mean diffusivity (MD), fractional anisotropy, and mean kurtosis (MK). Perfusion parameters were mean relative regional cerebral blood volume (rrCBV), mean relative regional cerebral blood flow (rrCBF), mean transit time, and relative decrease ratio (rDR). The diffusion and perfusion parameters along with 12 CSI metabolite ratios were compared among 22 high-grade gliomas and 14 low-grade gliomas (Mann-Whitney U-test, P < .05). Classification accuracy was determined with a linear discriminant analysis for each MR modality independently. Furthermore, the performance of a multimodal analysis is reported, using a decision-tree rule combining the statistically significant DKI, DSC-MRI, and CSI parameters with the lowest P-value. The proposed classifiers were validated on a set of subsequently acquired data from 19 clinical patients. Statistically significant differences among tumor grades were shown for MK, MD, mean rrCBV, mean rrCBF, rDR, lipids over total choline, lipids over creatine, sum of myo-inositol, and sum of creatine. DSC-MRI proved to be the modality with the best performance when comparing modalities individually, while the multimodal decision tree proved to be most accurate in predicting tumor grade, with a performance of 86%. Combining information from DKI, DSC-MRI, and CSI increases diagnostic accuracy to differentiate low- from high-grade gliomas, possibly providing diagnosis for the individual patient.

Regional Cerebral Blood Volume Ratio on Perfusion MRI on the Growth of Infarct Size in Acute Ischemic Stroke

We hypothesized that the relative regional cerebral blood volume (rCBV) ratio could help predict the risk of infarct growth on follow-up magnetic resonance imaging (MRI) in patients with diffusion perfusion mismatch (DPM) on the time-to-peak (TTP) map. We recruited 60 patients with acute middle cerebral arterial (MCA) infarction who had been evaluated by perfusion MRI within 24 h of initial ischemic events, and assessed the predictive role of the rCBV ratio on infarct growth in patients with DPM. Among 60 patients with acute MCA ischemic stroke, 41 (68.3%) patients had DPM on the initial MRI. Follow-up MRI revealed ischemic lesion enlargement in 19 (31.7%) of these 41 patients. The presence of DPM had no effect on the rate of lesion enlargement. Patients with ischemic lesion growth in follow-up images had a significantly lower rCBV ratio than patients without (0.81 ± 0.22 vs. 1.08 ± 0.20, p < 0.01). In this study, the decreased rCBV ratio on perfusion MRI has a predictive value for the growth of ischemic lesions after acute ischemic stroke with DPM on the TTP map.

Role of diffusion- and perfusion-weighted MR imaging for brain tumour characterisation

This study was undertaken to correlate apparent diffusion coefficient (ADC) and relative regional cerebral blood volume (rrCBV) to histological findings in a large series of patients with primary or secondary brain tumours to evaluate diffusion-weighted (DWI) and perfusion-weighted (PWI) imaging in the characterisation of cerebral tumors. Ninety-eight patients with cerebral tumours, 46 of which were primary (seven grade 0-I, nine low-grade gliomas, two gliomatosis cerebri, nine lymphomas and 19 high-grade gliomas) and 52 secondary, underwent conventional magnetic resonance (MR) imaging completed with DWI and dynamic contrast susceptibility PWI. Both ADC and rrCBV were calculated on a workstation by using Functool 2 software. Student's t test was used to determine any statistically significant differences in the ADC and rrCBV values. Seventeen of 98 tumours were cystic or necrotic (12/17 hypointense and 5/17 hyperintense on DWI); the ADC value of hyperintense cystic areas was 0.97+/-0.23x10(-3) mm2/s. The ADC value of solid tumours varied between 0.64 and 3.5x10(-3) mm2/s. The rrCBV value was 1.4 (sigma 0.66) in low-grade gliomas; 1.22 (sigma 0.25) in lymphomas; 4.5 (sigma 0.85) in grade III gliomas; 3.18 (sigma 1.26) in grade IV gliomas and 2.53 (sigma 1.6) in metastases. DWI has an important role in the differential diagnosis of cystic cerebral masses but not in tumour characterisation. PWI is helpful in differentiating high-from low-grade gliomas and lymphomas from high-grade gliomas.

Perfusion Weighted MR Imaging May Differentiate Primary CNS Lymphoma from other Homogeneously Enhancing Brain Tumors

Primary central nervous system lymphoma (PCNSL), glioblastoma multiforme (GBM) and metastases may be difficult to differentiate based on conventional imaging alone. The aim of this study was to investigate the value of perfusion weighted imaging (PWI) in differentiating homogeneously enhancing PCNSL from homogeneously enhancing GBM and metastases. Seven consecutive patients presenting with homogeneously enhancing intraaxial tumors on MRI were retrospectively analyzed. All seven patients (three immunocompetent patients with PCNSL, three with GBM, and one with cerebral metastases) were examined with identical MR-sequences including PWI. The relative regional Cerebral Blood Volume (rrCBV) and the rrCBV ratio (rrCBVratio) were calculated. In lymphomas rrCBVratio was 0.93 ± 0.42 (mean ± SD) compared with 7.93 ± 1.44 in GBM and metastases. All lymphomas had rrCBVratio < 1.43 while all GBM and metastases had rrCBVratio > 1.43 (Fischer exact test; p < 0.001). PWI may be a valuable method in differentiating homogenously enhancing PCNSL from GBM and metastases.

Use of dynamic susceptibility-contrast MRI (DSC-MRI) to assess perfusion changes in the ipsilateral brain parenchyma from glioblastoma

We investigated the effect of increased tumor perfusion using dynamic susceptibility-contrast magnetic resonance imaging (DSC-MRI) in glioblastoma (GBM) patients on the surrounding ipsilateral brain tissue with respect to perfusion of the normal, unaffected contralateral brain and of the tumor. DSC-MRI was performed in 11 patients with glioblastoma using a multislice T2*-weighed EPI sequence (TR/TE = 2,000/62 ms; FOV 240 mm; matrix 128 x 128; slice thickness 6 mm) on a standard clinical 1.5 Tesla scanner during intravenous injection of 40 cc Gadolinium-DTPA at a flow rate of 5 cc/s. Maps for relative regional cerebral blood volume (rCBV) and relative regional cerebral blood flow (rCBF) were created and relative values analyzed in relation to the arterial input. Relative CBV and CBF were significantly higher in gray matter than in the respective white matter (paired t-test; P < 0.001) with a high correlation for both perfusion parameters between the gray and the white matter in both ipsilateral and contralateral brain (P < 0.001). The highest values for rCBV and rCBF were found in solid tumor tissue with a significant positive correlation between tumor and the adjacent gray matter (for both rCBV and rCBF; P < 0.001). In GBM patients there is increased metabolism and thus increased rCBV and rCBF within the tumor. This increased perfusion of the tumor is not at the expense of perfusion of the ipsilateral normal brain parenchyma and in fact, the rCBV and rCBF values are linked to tumor-induced changes in rCBV and rCBF.

A Prospective Cohort Study on Sustained Effects of Low-Dose Ecstasy Use on the Brain in New Ecstasy Users

It is debated whether ecstasy use has neurotoxic effects on the human brain and what the effects are of a low dose of ecstasy use. We prospectively studied sustained effects (>2 weeks abstinence) of a low dose of ecstasy on the brain in ecstasy-naive volunteers using a combination of advanced MR techniques and self-report questionnaires on psychopathology as part of the NeXT (Netherlands XTC Toxicity) study. Outcomes of proton magnetic resonance spectroscopy (1H-MRS), diffusion tensor imaging (DTI), perfusion-weighted imaging (PWI), and questionnaires on depression, impulsivity, and sensation seeking were compared in 30 subjects (12M, 21.8+/-3.1 years) in two sessions before and after first ecstasy use (1.8+/-1.3 tablets). Interval between baseline and follow-up was on average 8.1+/-6.5 months and time between last ecstasy use and follow-up was 7.7+/-4.4 weeks. Using 1H-MRS, no significant changes were observed in metabolite concentrations of N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI), and creatine (Cr), nor in ratios of NAA, Cho, and mI relative to Cr. However, ecstasy use was followed by a sustained 0.9% increase in fractional anisotropy (FA) in frontoparietal white matter, a 3.4% decrease in apparent diffusion (ADC) in the thalamus and a sustained decrease in relative regional cerebral blood volume (rrCBV) in the thalamus (-6.2%), dorsolateral frontal cortex (-4.0%), and superior parietal cortex (-3.0%) (all significant at p<0.05, paired t-tests). After correction for multiple comparisons, only the rrCBV decrease in the dorsolateral frontal cortex remained significant. We also observed increased impulsivity (+3.7% on the Barratt Impulsiveness Scale) and decreased depression (-28.0% on the Beck Depression Inventory) in novel ecstasy users, although effect sizes were limited and clinical relevance questionable. As no indications were found for structural neuronal damage with the currently used techniques, our data do not support the concern that incidental ecstasy use leads to extensive axonal damage. However, sustained decreases in rrCBV and ADC values may indicate that even low ecstasy doses can induce prolonged vasoconstriction in some brain areas, although it is not known whether this effect is permanent. Additional studies are needed to replicate these findings.

Retrograde cerebral perfusion with intermittent pressure augmentation provides adequate neuroprotection: Diffusion- and perfusion-weighted magnetic resonance imaging study in an experimental canine model

Diffusion- and perfusion-weighted magnetic resonance imaging can identify ischemic brain injury in the hyperacute stage. For neuroprotection during thoracic aortic surgery, we developed a novel retrograde cerebral perfusion with intermittent pressure augmentation. The purpose of this study was to assess the efficiency of this novel method for neuroprotection in real time by using diffusion- and perfusion-weighted magnetic resonance imaging. Sixteen beagle dogs were randomly divided into 4 groups: the antegrade selective cerebral perfusion group (n = 4; antegrade selective cerebral perfusion at a flow rate of 10 mL x kg(-1) x min(-1)); the intermittent retrograde cerebral perfusion group (n = 4; retrograde cerebral perfusion at a baseline pressure of 15 mm Hg with intermittent pressure augmentation to 45 mm Hg every 30 seconds); the conventional retrograde cerebral perfusion group (n = 4; conventional retrograde cerebral perfusion at a fixed pressure of 25 mm Hg); and the circulatory arrest group (n = 4; only circulatory arrest). Diffusion- and perfusion-weighted magnetic resonance images were acquired during each session of cerebral perfusion. Regions of interest were defined, and the apparent diffusion coefficient and relative regional cerebral blood volume were calculated in these regions of interest. Finally, the brain was evaluated for its histopathologic damage score. The best apparent diffusion coefficient values were observed in the intermittent retrograde cerebral perfusion group in all the regions of interest, although the relative regional cerebral blood volume values were mostly lower than those in the antegrade selective cerebral perfusion group. The total Histopathologic Damage Score (0, normal; 32, worst) in the intermittent retrograde cerebral perfusion group (8.0 +/- 0.6) was significantly lower than that in the conventional retrograde cerebral perfusion (17.5 +/- 1.7; P < .01) and circulatory arrest (25 +/- 1.0; P < 0.01) groups and was equivalent to that in the antegrade selective cerebral perfusion group (7.8 +/- 0.8; P = .9). Intermittent retrograde cerebral perfusion provides adequate neuroprotection by allowing high apparent diffusion coefficient values to be maintained.

Neuroprotective effect of hyperbaric oxygen therapy monitored by MR-imaging after embolic stroke in rats

The potential neuroprotective effects of hyperbaric oxygen (HBO) were tested in an embolic model of focal cerebral ischemia with partially spontaneous reperfusion. Rats ( n = 10) were subjected to embolic middle cerebral artery occlusion (MCAO) and diffusion weighted MRI (DWI) was performed at baseline, 1, 3, and 6 h after MCAO to determine the ADC viability threshold yielding the lesion volumes that best approximated the 2,3,5-triphenyltetrazolium chloride (TTC) infarct volumes at 24 h (experiment 1). For assessment of neuroprotective effects, rats were treated with 100% oxygen at 2.5 atmospheres absolute (ATA, n = 15) or normobaric room air ( n = 15) for 60 min beginning 180 min after MCAO (experiment 2). DWI-, perfusion (PWI)- and T2-weighted MRI (T2WI) started within 0.5 h after MCAO and was continued 5 h, 24 h (PWI and T2WI only), and 168 h (T2WI only). Infarct volume was calculated based on TTC-staining at 24 h (experiment 1) or 168 h (experiment 2) post-MCAO. ADC-lesion evolution was maximal between 3 and 6 h. In experiment 2, the relative regional cerebral blood volume (rCBV) of both groups showed similar incomplete spontaneous reperfusion in the ischemic core. HBO reduced infarct volume to 145.3 ± 39.6 mm 3 vs. 202.5 ± 58.3 mm 3 (control, P = 0.029). As shown by MRI and TTC, HBO treatment demonstrated significant neuroprotection at 5 h after embolic focal cerebral ischemia that lasted for 168 h.

Effect of brain tumor neovasculature defined by rCBV on BOLD fMRI activation volume in the primary motor cortex

We utilized blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) and MR perfusion imaging methods to study the influence of brain tumor neovascularity on the BOLD fMRI activation volume in the primary motor cortex (PMC). The results from 57 brain tumor cases demonstrated that, for grade IV gliomas only, decreases in the BOLD fMRI activation volumes within the ipsilateral PMC, when compared with that observed in the contralateral PMC, correlated with increases in the relative regional cerebral blood volume (rCBV) in the PMC. In addition, relative increases in the activation volumes, corresponding to decreases in the rCBV, exhibited a linear dependence on the distance between the grade IV glioma and PMC. These findings lend support to the hypothesis that decreases in the fMRI activation volumes adjacent to a GBM may, in part, be due to the increased contribution of aberrant tumor neovascularity, with the resultant de-coupling of blood flow from neuronal activity. The nature of the relationship between the resulting activation volumes and adjacent tumor characteristics is complex, but is found to be dependent on the tumor grade and type, as well as the distance of the tumor to the PMC.

Dexamethasone and Enhancing Solitary Cerebral Mass Lesions: Alterations in Perfusion and Blood-tumor Barrier Kinetics Shown by Magnetic Resonance Imaging

Glucocorticoid analogues are often administered to patients with intracranial space-occupying lesions. Clinical response can be dramatic, but the neurophysiological response is not well documented. This study sought to investigate the blood-lesion barrier, blood-brain barrier, and cerebral perfusion characteristics of patients who have undergone such therapy using magnetic resonance imaging. Seventeen patients with intracranial mass-enhancing lesions underwent magnetic resonance imaging before and after 3 days of high-dose dexamethasone therapy. Assessments of blood-lesion barrier and blood-brain barrier integrity were based on a dynamic T1-weighted exogenous contrast technique that yielded the normalized maximal change in contrast uptake (T1-uptake). Perfusion was assessed using a dynamic T2*-weighted exogenous contrast technique to yield relative regional cerebral blood volume and first-moment mean transit time. Comparisons were made in T1-uptake, regional cerebral blood volume, and first-moment mean transit time of both enhancing lesion and contralateral normal-appearing white matter (CNAWM) obtained before and after dexamethasone. Significant reduction in T1-uptake was observed (19% decrease, P < 0.005) within enhancing pathological tissue, whereas no significant alteration was detected in CNAWM. Regional cerebral blood volume was significantly reduced in both enhancing tissue (28% decrease, P < 0.005) and in CNAWM (20% decrease, P < 0.001). Bolus first-moment mean transit time significantly increased (2.0 s prolongation, P < 0.05) in CNAWM, whereas there was no significant change (1.4 s prolongation, P > 0.05) within enhancing tissue. Glucocorticoid-analogue therapy not only affects the permeability of the blood-lesion barrier and lesion blood volume but also affects blood flow within normal-appearing contralateral parenchyma. There is a need for controls in steroid therapy in magnetic resonance imaging studies, which involve assessments of cerebrovascular function.

Comparison of contrast agents with high molarity and with weak protein binding in cerebral perfusion imaging at 3 T

To examine and compare properties of high-molarity contrast agent gadobutrol (Gadovist) and weakly protein-binding agent gadobenate-dimeglumine (MultiHance in dynamic susceptibility contrast (DSC) perfusion imaging at 3 T. Sixteen healthy volunteers underwent three separate examinations with contrast agent doses of 0.1 and 0.2 mmol/kg body weight (bw) gadobutrol and 0.1 mmol/kg bw gadobenate-dimeglumine. Maps of relative regional cerebral blood volume (rCBV) and blood flow (rCBF) were calculated using deconvolution based on singular value decomposition. Signal and concentration time curves, the concentration-to-noise ratio (SNR(c)), and gray matter (GM)-to-white matter (WM) rCBV and rCBF contrast and ratios were evaluated in a region of interest (ROI)-based analysis. Image quality of calculated parametric maps was assessed in direct visual comparison and with respect to suitability for diagnostic purposes. The contrast agents displayed very similar results in the 0.1 mmol/kg examinations, both with respect to the quantitative evaluation parameters and in the qualitative assessment of the calculated parametric maps. Maps from 0.2 mmol/kg examinations were rated as being superior in quality, but with respect to diagnostic suitability all contrast agents and doses yielded images of sufficient quality. At 3 T, a gadobutrol or gadobenate-dimeglumine dose of 0.1 mmol/kg is sufficient for DSC magnetic resonance imaging (MRI) perfusion assessment. At the used small injection volumes, the tissue concentration curve was determined only by the gadolinium (Gd) dosage in mmol/kg, and the T2* relaxation effects of the two agents can be considered to be nearly identical in the applied gradient-echo (GRE) sequence.

Sci‐YIS Fri ‐ 08: Regional change in brain perfusion after fractionated stereotactic radiotherapy (FSRT) at 4 months and 3 years follow‐up

Purpose: The change in hemodynamic parameters, such as mean transit time and cerebral blood volume, reflect the damage to vasculature. A relationship between the change in hemodynamic parameters and radiation dose delivered would help predict the degree and nature of damage, and would be most beneficial for patients with a long life‐expectancy who are at risk of long‐term radiation‐induced injury. Method and Materials: We applied the relative perfusion weighted MRI technique, currently used in stroke imaging, to calculate the relative regional mean transit time (rrMTT) and relative regional cerebral blood volume (rrCBV). We acquired data for one patient. We used a 3.0 T magnet at the Seaman Family MRI Centre in Calgary and a single‐shot echo‐planar imaging (EPI) sequence following the injection of a paramagnetic contrast agent (Gd‐DTPA‐Magnevist; Berlex, Wayne, NJ). These images have been processed to yield rrMTT and rrCBV. The patient had previously been treated with surgery, but had received no chemotherapy. The percentage change in rrMTT and rrCBV was correlated to the spatial distribution of radiation dose delivered using the Pinnacle® radiation treatment planning system. Results: Our preliminary results show that with a follow‐up time of 4 months and 3 years after receiving approximately 5000 cGy/25 fractions, rrMTT and rrCBV change significantly in normal tissue and tumour. The most important normal tissue changes occur in the near‐target area. Conclusion: The change in rrMTT and rrCBV indicates response to treatment. Perfusion weighted MRI can be used to assess the change in hemodynamic measures after radiotherapy.

SU‐EE‐A4‐01: Regional Change in Brain Perfusion, in Irradiated Normal Tissue: Correlation Study Between Perfusion MRI and Spatial Distribution of Radiation Dose Delivered

Purpose: When irradiating the normal brain, one of the principal causes of complications is damage to the cerebral vasculature, particularly the micro‐vasculature. This is of particular concern when treating diseases which are slow‐growing or are not malignant. While there is some data relating loss of perfusion to radiation dose in other tissues such as lung, there is very little data for the brain. We intend to determine the relationship between the change due to irradiation in hemodynamic measures, such as relative regional Mean Transit Time (rrMTT) and relative regional Cerebral Blood Volume (rrCBV), and the radiation dose delivered to the normal brain tissue. Method and Materials: We acquired data in the form of perfusion weighted images (PWI) for two patients. We used a 3.0 T magnet at the Seaman Family MRI Centre at the Foothills Medical Centre and a single‐shot echo‐planar imaging (EPI) sequence following the injection of a paramagnetic contrast agent (Gd‐DTPA‐Magnevist; Berlex, Wayne, NJ). These images have been processed to yield rrCBV and rrMTT. The patients had previously been treated with surgery, but had received no chemotherapy. Results: Our preliminary results show that with a follow‐up time of 4 months after receiving approximately 5000 cGy/25 fractions, in normal brain tissue the rrMTT is reduced by approximately 2% (1.8 ± 0.5) and the rrCBV is reduced by almost 12% (11.8 ± 2.2). The tumor showed reductions in both rrMTT (1.2 ± 1.5)% and rrCBV (19.9 ± 3.5)%. It is expected that these changes will increase with longer term follow‐up. Conclusion: Perfusion Weighted MR Imaging can be used to assess the change in hemodynamic measures in the normal brain tissue after radiotherapy.

Human immunodeficiency virus 1-associated minor motor disorders: perfusion-weighted MR imaging and H MR spectroscopy.

To investigate whether advanced magnetic resonance (MR) imaging techniques such as diffusion-weighted (DW) and perfusion-weighted (PW) MR imaging and hydrogen 1 (1H) MR spectroscopy can depict functional and pathophysiologic mechanisms in patients who have minor motor deficits (MMDs) associated with human immunodeficiency virus 1 (HIV-1). Thirty-two patients with results seropositive for HIV-1 and different degrees of HIV-1-related MMD underwent conventional brain MR imaging, as well as DW and PW MR imaging and 1H MR spectroscopy of the basal ganglia. PW MR imaging data were computed pixel by pixel for creation of time-to-peak, relative regional cerebral blood volume, and bolus amplitude parameter maps. In addition, quantitative regional cerebral blood flow (rCBF) maps were calculated with respect to the arterial input function by using the singular value decomposition algorithm. For 1H MR spectroscopy, a stimulated echo acquisition mode 20, or STEAM 20, sequence was used. Spectra were fit for determination of the signal intensities of the different metabolites. According to psychomotor testing results, patients were divided into three groups: group 1, 10 patients with normal motor function; group 2, eight patients with psychomotor slowing for the first time; and group 3, 14 patients who had had sustained pathologic psychomotor slowing for at least 6 months before the MR imaging examination. No patients had an abnormality at either conventional or DW MR imaging. PW MR imaging depicted significantly elevated rCBF in group 2 patients (P =.039, analysis of variance [ANOVA]) and significantly elevated myo-inositol-to-creatine ratio levels in group 3 patients (P =.020, ANOVA). Quantitative PW MR imaging and 1H MR spectroscopy can depict pathologic changes in patients who have HIV-1-related MMD but normal clinical examination and conventional MR imaging findings.

High-resolution in vivo CBV mapping with MRI in wild-type mice.

NMR microimaging has the potential to elucidate cerebrovascular abnormalities in mouse models. In this study, the relative regional cerebral blood volume (CBV) map is presented for C57BL6/J wild-type mice. The CBV mapping was based on changes in the steady-state NMR transverse relaxation rate (DeltaR(2)) associated with the presence of a superparamagnetic intravascular contrast agent (MION) with a long blood halflife. The experiments were performed at 9.4 T at a voxel size of 100 microm x 100 microm x 600 microm. Fine details, such as the hippocampal and olfactory bulb area, were visualized in the CBV map. The relative regional CBV values of various brain regions were measured. The DeltaR(2) dosage dependency and MION tissue clearance in mouse are also reported.

Multispectral magnetic resonance image analysis using principal component and linear discriminant analysis.

To explore the possibilities of combining multispectral magnetic resonance (MR) images of different patients within one data matrix. Principal component and linear discriminant analysis was applied to multispectral MR images of 12 patients with different brain tumors. Each multispectral image consisted of T1-weighted, T2-weighted, proton-density-weighted, and gadolinium-enhanced T1-weighted MR images, and a calculated relative regional cerebral blood volume map. Similar multispectral image regions were clustered, while dissimilar multispectral image regions were scattered in a single plot. Both principal component and linear discriminant analysis allowed discrimination between healthy and tumor regions on the image. In addition, linear discriminant analysis allowed discrimination between oligodendrogliomas and astrocytomas. However, the discriminant analysis method was partially capable of recognizing the tumor identity in unknown multispectral images. The proposed method may help the radiologist in comparing multispectral MR images of different patients in a more easy and objective way.

Distinguishing of primary cerebral lymphoma from high-grade glioma with perfusion-weighted magnetic resonance imaging

To assess the usefulness of perfusion-weighted echo-planar magnetic resonance imaging in the differential diagnosis of primary supratentorial lymphoma (PCNSL) and glioblastoma (GBM), 12 patients with a PCNSL and 12 with a GBM were examined using a 1.5 T magnetic resonance (MR) imager. With dynamic-susceptibility contrast MR imaging the intensity-time curves of each tumor were analyzed, and we determined the relative regional cerebral blood volume ratios (rrCBV [tumor/contralateral white matter (WM)]) to find out whether these parameters could be used to separate PCNSL from GBM. The maximum rrCBV ratio in the PCNSL was significantly lower than that of the GBM ( P<0.0001). Comparing the intensity-time curves for the two tumor groups, the PCNSL showed a characteristic type of curve with a significant increase in signal intensity above the baseline due to massive leakage of contrast media into the interstitial space. PCNSL tend to have low maximum CBV ratios and typical intensity-time curves. These two parameters may be useful in distinguishing PCNSL from GBM.