A cross-sectional study to test equivalence of low- versus intermediate-flip angle dynamic susceptibility contrast MRI measures of relative cerebral blood volume in patients with high-grade gliomas at 1.5 Tesla field strength

Mark S Shiroishi; Dane Weinert; Steven Y Cen; Bino Varghese; Timothy Dondlinger; Melissa Prah; Jesse Mendoza; Sina Nazemi; Nima Ameli; Negin Amini; Salman Shohas; Shannon Chen; Bavrina Bigjahan; Gabriel Zada; Thomas Chen; Josh Neman-Ebrahim; Eric L Chang; Frances E Chow; Zhaoyang Fan; Wensha Yang; Frank J Attenello; Jason Ye; Paul E Kim; Vishal N Patel; Alexander Lerner; Jay Acharya; Leland S Hu; C Chad Quarles; Jerrold L Boxerman; Ona Wu; Kathleen M Schmainda

doi:10.3389/fonc.2023.1156843

A cross-sectional study to test equivalence of low- versus intermediate-flip angle dynamic susceptibility contrast MRI measures of relative cerebral blood volume in patients with high-grade gliomas at 1.5 Tesla field strength

Front Oncol. 2023 Sep 20:13:1156843. doi: 10.3389/fonc.2023.1156843. eCollection 2023.

Authors

Mark S Shiroishi^{1

2

3}, Dane Weinert¹, Steven Y Cen¹, Bino Varghese¹, Timothy Dondlinger⁴, Melissa Prah⁵, Jesse Mendoza¹, Sina Nazemi¹, Nima Ameli¹, Negin Amini¹, Salman Shohas¹, Shannon Chen¹, Bavrina Bigjahan¹, Gabriel Zada⁶, Thomas Chen⁶, Josh Neman-Ebrahim⁶, Eric L Chang⁷, Frances E Chow⁶, Zhaoyang Fan^{1

7}, Wensha Yang⁷, Frank J Attenello⁶, Jason Ye⁷, Paul E Kim¹, Vishal N Patel⁸, Alexander Lerner¹, Jay Acharya¹, Leland S Hu⁹, C Chad Quarles¹⁰, Jerrold L Boxerman¹¹, Ona Wu¹², Kathleen M Schmainda⁵

Affiliations

¹ Department of Radiology, Keck School of Medicine of the University of Southern California (USC), Los Angeles, CA, United States.
² Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Marina del Rey, CA, United States.
³ Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States.
⁴ Imaging Biometrics, Elm Grove, WI, United States.
⁵ Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, United States.
⁶ Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, United States.
⁷ Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, United States.
⁸ Department of Radiology, Mayo Clinic, Jacksonville, FL, United States.
⁹ Department of Radiology, Mayo Clinic, Phoenix, AZ, United States.
¹⁰ Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
¹¹ Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Providence, RI, United States.
¹² Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.

Abstract

Introduction: 1.5 Tesla (1.5T) remain a significant field strength for brain imaging worldwide. Recent computer simulations and clinical studies at 3T MRI have suggested that dynamic susceptibility contrast (DSC) MRI using a 30° flip angle ("low-FA") with model-based leakage correction and no gadolinium-based contrast agent (GBCA) preload provides equivalent relative cerebral blood volume (rCBV) measurements to the reference-standard acquisition using a single-dose GBCA preload with a 60° flip angle ("intermediate-FA") and model-based leakage correction. However, it remains unclear whether this holds true at 1.5T. The purpose of this study was to test this at 1.5T in human high-grade glioma (HGG) patients.

Methods: This was a single-institution cross-sectional study of patients who had undergone 1.5T MRI for HGG. DSC-MRI consisted of gradient-echo echo-planar imaging (GRE-EPI) with a low-FA without preload (30°/P-); this then subsequently served as a preload for the standard intermediate-FA acquisition (60°/P+). Both normalized (nrCBV) and standardized relative cerebral blood volumes (srCBV) were calculated using model-based leakage correction (C+) with IBNeuro™ software. Whole-enhancing lesion mean and median nrCBV and srCBV from the low- and intermediate-FA methods were compared using the Pearson's, Spearman's and intraclass correlation coefficients (ICC).

Results: Twenty-three HGG patients composing a total of 31 scans were analyzed. The Pearson and Spearman correlations and ICCs between the 30°/P-/C+ and 60°/P+/C+ acquisitions demonstrated high correlations for both mean and median nrCBV and srCBV.

Conclusion: Our study provides preliminary evidence that for HGG patients at 1.5T MRI, a low FA, no preload DSC-MRI acquisition can be an appealing alternative to the reference standard higher FA acquisition that utilizes a preload.

Keywords: 1.5 Tesla; dynamic susceptibility contrast MRI (DSC-MRI); flip angle; glioma; standardization.

Copyright © 2023 Shiroishi, Weinert, Cen, Varghese, Dondlinger, Prah, Mendoza, Nazemi, Ameli, Amini, Shohas, Chen, Bigjahan, Zada, Chen, Neman-Ebrahim, Chang, Chow, Fan, Yang, Attenello, Ye, Kim, Patel, Lerner, Acharya, Hu, Quarles, Boxerman, Wu and Schmainda.

Abstract

Grants and funding