The effect of blood brain barrier disruption on the cerebral blood flow measurement with dynamic susceptibility contrast MRI: Comparison study between SPION and Gd-DOTA
SEOKHA JIN1 and HyungJoon Cho2

1UNIST, Ulsan, Korea, Republic of, 2Ulsan, Korea, Republic of

Synopsis

Dynamic susceptibility contrast MRI (DSC MRI) is widely used for cerebral blood flow (CBF) measurement for diseases, such as stroke and cancer.1-2 Fundamental assumption of DSC-MRI based CBF measurement is that contrast agent is non-leaking with intact blood brain barrier (BBB).3 Here, we investigate the effect of BBB disruption on the CBF measurement, especially for stroke model utilizing serial dual acquisitions using DOTAREM and SPION. As SPION remains as intravascular agent, while DOTAREM becomes extravasating agent with BBB disruption, dual CBF acquisitions with both agents provide quantitative way to characterize the effect of BBB disruption on CBF measurements with DSC-MRI.

Purpose

To experimentally and theoretically investigate the effect of BBB disruptions on the CBF measurement with DSC-MRI acquisition, especially for stroke model with MCAO reperfusion, dual acquisitions using DOTAREM and SPION were sequentially acquired. Observed experimental temporal signal behavior of DSC-MRI were verified using Monte Carlo simulation of T1 and T2* effects in the presence of leaking contrast agent.

Method

Experimental study was performed at Bruker 7T scanner using two different contrast agents of DOTAREM and SPION for two groups of animals. Experimental group (n=4): For BBB disrupted model, SD rats went through 1h MCAO and 24h reperfusion.4 DOTAREM was injected via tail IV at the dose of 0.3 mmol/kg. After 4 hours later, MION was injected at the dose of 0.075 mmol/kg. Infarction area and BBB disruption was evaluated by ADC map and T1 difference map before and after DOTAREM injection, respectively. Control group (n=4): Normal SD rats were experimented to verify if CBF measurements with DOTAREM and SPION provide same information in the case of intact BBB. For DSC-MRI acquisitions, gradient echo EPI sequence was used with matrix size = 96×96, field of view = 30×30 mm2, repetition time (TR) = 300ms, echo time (TE) = 17ms. Theoretical study was also performed to understand the effect of leaking contrast on the signal behavior from DSC-MRI with varying degree of BBB disruption using Monte Carlo simulations.5

Result

Control group showed strong correlation (R2=0.9173) between SPION- and DOTAREM-derived CBF for normal brain as shown in Figure 1. For experimental group, CBF from SPION was ~1.3 times faster than that from DOTAREM for ipsilateral hemisphere with disrupted BBB, while similar CBF was measured for contralateral hemisphere as shown in Figure 2. Simulation shows the signal behavior of DSC-MRI with increasing BBB disruption for T1 (Figure 3a), T2* (Figure 3b), and combined effect (Figure 3c), respectively. It is observed that with increasing BBB disruption, i.e., increasing Ktrans values, both T1 and T2* effects contribute toward enhancing the signal of DCE-MRI, which will result in reducing the CBF values for the region of leaking contrast agent.

Conclusion and discussion

DSC-MRI is a powerful technique for evaluating CBF. However, we observed both from experiments and simulations that CBF values are underestimated when contrast agent starts to leak through disrupted BBB from combined T1 and T2* effects. It is interesting to notice that the level of underestimation is proportional to the value of Ktrans. Dual DSC-MRI acquisitions using DOTAREM and SPION may become more sensitive way to quantify the BBB integrity than conventional DCE-MRI, because the first-pass signal of DSC-MRI is more directly affected by BBB integrity (Ktrans), rather than by interstitial volume (Ve).

Acknowledgements

This work was supported by the National Research Foundation of Korea Grants funded by the Korean Government (No. 2010-0028684 and No. 2014 R1A1A1 008255)

References

1. Calamante, F., Thomas, D. L., Pell, G. S., Wiersma, J., & Turner, R. Measuring cerebral blood flow using magnetic resonance imaging techniques. Journal of cerebral blood flow & metabolism, 1999, 19.7: 701-735.

2. Cha, S., Knopp, E. A., Johnson, G., Wetzel, S. G., Litt, A. W., & Zagzag, D. Intracranial Mass Lesions: Dynamic Contrast-enhanced Susceptibility-weighted Echo-planar Perfusion MR Imaging 1. Radiology, 2002, 223.1: 11-29.

3. ZIERLER, Kenneth L. Theoretical basis of indicator-dilution methods for measuring flow and volume. Circ Res, 1962, 10.3: 393-407.

4. Dorsten, F. A. V., Hata, R., Maeda, K., Franke, C., Eis, M., Hossmann, K. A., & Hoehn, M. Diffusion-and perfusion-weighted MR imaging of transient focal cerebral ischaemia in mice. NMR in Biomedicine, 1999, 12.8: 525-534.

5. Pannetier, N. A., Debacker, C. S., Mauconduit, F., Christen, T., & Barbier, E. L. A simulation tool for dynamic contrast enhanced MRI. PLoS ONE, 2013, 8(3):e57636

Figures

Figure 1. Dual DSC-MRI results for normal brain. (a-b) SPION- and DOTAREM-derived CBF map. (c) Scatter plot for right hemisphere. (d) Scatter plot for left hemisphere.

Figure 2. Dual DSC-MRI results for BBB disrupted brain. (a-b) SPION- and DOTAREM-derived CBF map. (c) T1 difference map before and after DOTAREM injection. (d) Apparent diffusion coefficient (ADC) map. (c) Scatter plot for contralateral hemisphere (right hemisphere). (d) Scatter plot for BBB disruption region (left hemisphere). The BBB disruption region is defined by T1 difference map (ΔT1> 300 ms).

Figure 3. Simulation results for BBB disruption effect on DSC-MRI signal. (a) T1 effects depending on Ktrans. (b) T2* effects depending on Ktrans. (c) Combined effects behavior depending on Ktrans.



Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
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