Evaluating the Role of Leakage Correction of Hemodynamic Parameters derived from Dynamic Contrast Enhanced MRI for Glioma Grading

Abstract

To the Editor:Quantitative dynamic-contrast-enhanced (DCE)-MRI technique is being used for brain tumor characterization. 1,2 Traditionally, kinetic parameters derived from DCE-MRI such as the volumetransfer-constant (K trans ) and volume fraction of extracellular-extravascular-space are used to quantify blood-brain-barrier breakdown in brain tumors. However, recent developments have expanded our understanding by enabling the simultaneous measurement of hemodynamic parameters cerebral-blood-flow (CBF) and cerebralblood-volume (CBV), alongside the conventional kinetic parameters obtained from DCE-MRI data. 3,4 Early attempts by Singh et al and Li et al utilized first-pass analysis as a model-free approach to quantify CBV and CBF from DCE-MRI data. 3,5 Nonetheless, these initial efforts faced challenges, as CBV and CBF exhibited leakage profiles attributed to contributions from the extracellular-extravascular leakage space. To address this limitation, Sourbron et al introduced a two-compartmental-tissue-uptake-model (CTUM) for the simultaneous and absolute quantification of leakage-corrected CBV and CBF along with K trans . 4 Despite these advancements, the clinical importance of leakage-corrected CBV and CBF in characterizing brain tumors remains uncertain. This study aims to evaluate the influence of leakage correction on hemodynamic parameters in glioma grading.