The Consistence of Dynamic Contrast‐Enhanced MRI and Filter‐Exchange Imaging in Measuring Water Exchange Across the Blood–Brain Barrier in High‐Grade Glioma

• Published in: Journal of magnetic resonance imaging Vol. 58; no. 6; pp. 1850 - 1860
• Main Authors: Wang, Zejun, Wang, Bao, Li, Zhaoqing, Han, Guangxu, Meng, Cheng, Jiao, Bingjie, Guo, Kaiyue, Hsu, Yi‐Cheng, Sun, Yi, Liu, Yingchao, Bai, Ruiliang
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.12.2023; Wiley Subscription Services, Inc
• Subjects: Algorithms; Biomarkers; Blood-brain barrier; brain; Correlation; dynamic contrast‐enhanced magnetic resonance imaging (MRI); Efflux; Evaluation; Field strength; Glioma; high‐grade glioma; Image segmentation; Magnetic resonance imaging; Medical imaging; Neuroimaging; Production methods; Statistical analysis; Statistical tests; Substantia alba; Substantia grisea; Tumors; vascular water‐exchange imaging; Water exchange; blood-brain barrier; dynamic contrast-enhanced magnetic resonance imaging (MRI); brain; high-grade glioma; vascular water-exchange imaging; water exchange
• ISSN: 1053-1807; 1522-2586; 1522-2586
• DOI: 10.1002/jmri.28729

Background Water exchange across blood–brain barrier (BBB) (WEXBBB) is an emerging biomarker of BBB dysfunction with potential applications in many brain diseases. Several MRI methods have been proposed to measure WEXBBB, but evidence remains scarce whether different methods can produce comparable WEXBBB. Purpose To explore whether dynamic contrast‐enhanced (DCE)‐MRI and vascular water exchange imaging (VEXI) could produce comparable WEXBBB in high‐grade glioma (HGG) patients. Study Type Prospective cross‐sectional. Subjects 13 HGG patients (58.4 ± 9.4 years, 9 females, 4 WHO III and 9 WHO IV). Field Strength/Sequence A 3 T, spoiled gradient‐recalled‐echo DCE‐MRI and VEXI containing two pulsed‐gradient spin‐echo blocks separated by a mixing block. Assessments The enhanced tumor and contralateral normal‐appearing white matter (cNAWM) volume‐of‐interests (VOIs) were drew by two neuroradiologists. And whole‐brain NAWM and normal‐appearing gray matter (NAGM) without tumor‐affected regions were segmented by automated segmentation algorithm in FSL. Statistical Tests Student's t‐test was used to evaluate parameters difference between cNAWM and tumor, NAGM and NAWM, respectively. The correlation between vascular water efflux rate constant (kbo) from DCE‐MRI and apparent exchange rate across BBB (AXRBBB) from VEXI was evaluated by Pearson correlation. P < 0.05 was considered statistically significant. Results Compared with cNAWM, both kbo and AXRBBB were significantly reduced in tumor (kbo = 3.50 ± 1.18 sec−1 vs. 1.03 ± 0.75 sec−1; AXRBBB = 3.54 ± 1.11 sec−1 vs. 1.94 ± 1.04 sec−1). Both kbo and AXRBBB showed significantly higher values in NAWM than NAGM (kbo = 3.50 ± 0.59 sec−1 vs. 2.10 ± 0.56 sec−1; AXRBBB = 3.35 ± 0.77 sec−1 vs. 2.07 ± 0.52 sec−1). The VOI‐averaged kbo and AXRBBB were also linearly correlated in tumor, NAWM, and NAGM (r = 0.59). Data Conclusion DCE‐MRI and VEXI showed comparable and correlated WEXBBB in HGG patients, suggesting that the consistence and reliability of these two MRI methods in measuring WEXBBB. Evidence Level 2. Technical Efficacy Stage 1.