Abstract #3834

Comparing non-invasive blood-brain barrier mapping with dynamic susceptibility contrast MRI in patients with high-grade glioma and metastasis

Gabriel Hoffmann^1,2, Christine Preibisch^1,2,3, Matthias Günther^4,5,6, Amnah Mahroo⁴, Matthias JP van Osch^7,8, Lena Václavů⁷, Marie-Christin Metz¹, Kirsten Jung¹, Claus Zimmer^1,2, Benedikt Wiestler¹, and Stephan Kaczmarz^1,2,9

¹School of Medicine and Health, Department of Neuroradiology, Technical University of Munich, Munich, Germany, ²School of Medicine and Health, TUM-Neuroimaging Center, Technical University of Munich, Munich, Germany, ³School of Medicine and Health, Clinic of Neurology, Technical University of Munich, Munich, Germany, ⁴MR Physics, Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany, ⁵MR-Imaging and Spectroscopy, University of Bremen, Bremen, Germany, ⁶mediri GmbH, Heidelberg, Germany, ⁷C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, Netherlands, ⁸Leiden Institute of Brain and Cognition, Leiden University, Leiden, Netherlands, ⁹Philips GmbH Market DACH, Hamburg, Germany

Synopsis

Keywords: Tumors (Post-Treatment), Permeability, Blood Brain Barrier

Motivation: Glioma-induced blood-brain barrier (BBB) disruptions can be characterized by dynamic susceptibility contrast MRI via the leakage parameter K₂. However, it may lack sensitivity to subtle impairments. Recently, non-invasive ASL-based water-exchange measurements (T_ex) were proposed to measure even subtle BBB-impairments.

Goal(s): We hypothesized correlations of T_ex with K₂ in contrast-enhancing tissue (CET).

Approach: K₂ & T_ex were compared in 22 patients with brain tumors and 19 healthy controls.

Results: T_ex agreed well with K₂ in CET and was sensitive to pathophysiologically impaired BBB. Moreover, results indicate superior sensitivity to subtle impairments, which may improve therapy planning and progress monitoring.

Impact: ASL-based T_ex allows non-invasive detection of the pathophysiologically impaired blood-brain barrier in tumors. Whereas its sensitivity to subtle impairments may improve treatment planning in tumors, it could also impact diagnosis of neurodegenerative diseases such as Alzheimer's or Parkinson’s.

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