Differentiation of Cerebral Neoplasms with Vessel Size Imaging (VSI)

Abstract

Purpose Cerebral neoplasms of various histological origins may show comparable appearances on conventional Magnetic Resonance Imaging (MRI). Vessel size imaging (VSI) is an MRI technique that enables noninvasive assessment of microvasculature by providing quantitative estimates of microvessel size and density. In this study, we evaluated the potential of VSI to differentiate between brain tumor types based on their microvascular morphology. Methods Using a clinical 3T MRI scanner, VSI was performed on 25 patients with cerebral neoplasms, 10 with glioblastoma multiforme (GBM), 8 with primary CNS lymphoma (PCNSL) and 7 with cerebral lung cancer metastasis (MLC). Following the postprocessing of VSI maps, mean vessel diameter (vessel size index, vsi) and microvessel density (Q) were compared across tumors, peritumoral areas, and healthy tissues. Results The MLC tumors have larger and less dense microvasculature compared to PCNSLs in terms of vsi and Q (p = 0.0004 and p < 0.0001, respectively). GBM tumors have higher yet non-significantly different vsi values than PCNSLs (p = 0.065) and non-significant differences in Q. No statistically significant differences in vsi or Q were present between GBMs and MLCs. GBM tumor volume was positively correlated with vsi (r = 0.502, p = 0.0017) and negatively correlated with Q (r = −0.531, p = 0.0007). Conclusion Conventional MRI parameters are helpful in differentiating between PCNSLs, GBMs, and MLCs. Additionally incorporating VSI parameters into the diagnostic protocol could help in further differentiating between PCNSLs and metastases and potentially between PCNSLs and GBMs. Future studies in larger patient cohorts are required to establish diagnostic cut-off values for VSI.

Tumor biomechanics as a novel imaging biomarker to assess response to immunotherapy in a murine glioma model

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Assessment of Microvascular Disease in Heart and Brain by MRI: Application in Heart Failure with Preserved Ejection Fraction and Cerebral Small Vessel Disease

“…Vessel size (and density) imaging is a research technique that can provide in vivo quantitative estimates of mean vessel diameter and density within a given voxel and is sensitive to large vessels and microvasculature <10 µm in diameter [ 110 ]. It exploits the difference in the ratio of relaxation rate changes as measured by gradient and spin echocardiography pulse sequences on T2- and T2*-weighted images during the passage of intravascular contrast, and if hybrid sequences combining both spins are employed, it can also estimate CBF, thereby making it an attractive combination sequence.…”

“…It exploits the difference in the ratio of relaxation rate changes as measured by gradient and spin echocardiography pulse sequences on T2- and T2*-weighted images during the passage of intravascular contrast, and if hybrid sequences combining both spins are employed, it can also estimate CBF, thereby making it an attractive combination sequence. Thus far, most of the research for vessel size imaging has been in the field of cerebral neoplasms [ 110 ]; however, initial study [ 111 ] in patients with CSVD detected a significantly increased mean vessel diameter when compared to matched controls. The finding of increased mean vessel diameter indicates that there is a potential reduction in the microvessels that increases the overall mean vessel diameter in the brain as the large vessels are preserved.…”