With cellular ensembles featuring stochastic geometries, Monte Carlo random walk simulated DWI b-space decays exhibit sensitivity to cell biology parameters measuring membrane Na+,K+‑ATPase [NKA] activity, cell density, ρ, and voxel average cell volume, <V>. Furthermore, the simulation matching the experimental in vivo human cerebral cortex b‑space decay has parameters [cellular water efflux rate constant <kio> = 2 s-1, ρ = 98,000 cells/μL, and <V> = 8.2 pL] in near absolute agreement with the most pertinent literature. Inspecting the common, empirical early decay measure, ADC, of these simulations provides insights into acute and chronic tissue property changes in vivo.
We choose quality awake human cerebral cortex experimental data18 (3.3 mL ROI; Fig. 2, points) also because the only rigorous, absolute model and ex vivo kio and ρ values are cortical.1 One simulation (red in each panel) matches the data remarkably well. More gratifying, its parameters, <kio> = 2.0 s-1, ρ = 98,000 cells/μL, and <V> = 8.2 pL, are in excellent agreement with literature cortical <kio> = 2 s-1, ρ = 88,000 cells/mL, and <V> values:1 and we have not conducted a formal fitting. Also, the Fig. 2,middle pure water, ρ = 0, black [Gaussian] line agrees with that for living human brain ventricular, acellular water [ADC, 3 μm2/ms].1 Fig. 2 suggests the probabilities of encountering and of permeating cell membranes are the major diffusion determinants, not “viscosity” considerations. It seems <kio>, ρ, and <V> are sufficient to characterize tissue water diffusion.
The ultimate goal is fitting entire experimental voxel b decays to produce absolute <kio>, ρ, and <V> parametric maps [during iterations, the variables will interact]. However, we can appraise clinical implications with the empirical ADC values as commonly employed, from only the initial decay. We use the conventional b = 1 [Fig. 2 vertical dashed lines] to determine the asymptotic {ln[S(b)/S0]/b} slope [-ADC], for each Fig. 2 curve. Figure 3,left shows ADC = f<kio>ρ,V; Fig.3,middle, ADC = f(ρ)kio,V; and Fig. 3,right, ADC = f<V>kio,ρ [i.e., f<V>kio,ρ is the ADC <V>-dependence at constant <kio> and ρ]. In Fig. 3,left, the ADC value increases rather linearly with <kio>. Since kio reflects a fast metabolic rate [cMRNKA],1 this suggests acute ADC changes1 are dominated by fast cMRNKA changes. Most Fig. 1 kio changes are acute. Fast literature ADC changes1 are often attributed to <V> changes (e.g., “swelling”), but Fig. 3,right indicates ADC has very weak <V>‑sensitivity, for a large <V> change. Figure 3,middle shows ADC decreases rather linearly with ρ. However, large cellularity changes, > 1000 cells/μL, are required. Thus, ρ effects could dominate chronic ADC changes: cancer cell bed ρ can exceed 106 cells/μL, with very small <V>.1 Effective therapy increases the small malignant tumor ADC.1 But, we expect <kio> should give a faster response. Fig. 3 is also in general agreement with literature values reported for in vivo human brain cortex, ADC = 0.83 (μm)2/ms.1 For our Fig. 2,left kio = 2 s-1 (red) curve, ADC is 0.73 (μm)2/ms. This is quite gratifying: an actual fitting of the cortical data might return an awake human brain <kio> ~5 s‑1; the value suggested by ADC ~0.83 (μm)2/ms in Fig. 3,left. Furthermore, our DWI approach is complementary to those focusing on the tissue water anisotropic D tensor nature.