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Journal of Neuro-Oncology

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01-12-2018 | Clinical Study

Repeatability of dynamic contrast enhanced v_p parameter in healthy subjects and patients with brain tumors

Authors: Moran Artzi, Gilad Liberman, Deborah T. Blumenthal, Felix Bokstein, Orna Aizenstein, Dafna Ben Bashat

Published in: Journal of Neuro-Oncology | Issue 3/2018

Abstract

Purpose

To study the repeatability of plasma volume (v_p) extracted from dynamic-contrast-enhanced (DCE) MRI in order to define threshold values for significant longitudinal changes, and to assess changes in patients with high-grade-glioma (HGG).

Methods

Twenty eight healthy subjects, of which eleven scanned twice, were used to assess the repeatability of v_p within the normal-appearing brain tissue and to define threshold values for significant changes based on least-detected-differences (LDD) of mean v_p values and histogram comparisons using earth-mover’s-distance (EMD). Sixteen patients with HGG were scanned longitudinally with eight patients scanned before and following bevacizumab therapy. Longitudinal changes were assessed based on defined threshold values in comparison to RANO criteria.

Results

The threshold values for significant changes were: LDD = 0.0024 (ml/100 ml, 21%) for mean v_p and EMD = 4.14. In patients, in 20/24 comparisons, no significant longitudinal changes were detected for v_p within the normal-appearing brain tissue. Concurring results were obtained between changes in lesion volume (RANO criteria) and LDD or EMD values in cases diagnosed with progressive-disease, yet in about 50% of cases diagnosed with partial-response preliminary results demonstrated significant increase in v_p despite significant reductions in lesion volume. In two patients, these changes preceded progression detected at follow-up scans. In general, a good concordance was obtained between LDD and EMD.

Conclusion

This study shows high repeatability of v_p and provides threshold values for significant changes in longitudinal assessment of patients with brain tumors. Preliminary results suggest the use of v_p-DCE parameter to improve assessment of therapy response in patients with high-grade-glioma.

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Title: Repeatability of dynamic contrast enhanced vp parameter in healthy subjects and patients with brain tumors
Authors: Moran Artzi
Gilad Liberman
Deborah T. Blumenthal
Felix Bokstein
Orna Aizenstein
Dafna Ben Bashat
Publication date: 01-12-2018
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 3/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-03006-w

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Springer Medicine

Repeatability of dynamic contrast enhanced v_p parameter in healthy subjects and patients with brain tumors

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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