Journal Article DKFZ-2026-00050

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A novel vascular model yields increased MR perfusion metrics compared to conventional dynamic susceptibility contrast algorithms in untreated glioblastoma.

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2025
Oxford University Press Oxford

Neuro-oncology advances 7(1), vdaf212 () [10.1093/noajnl/vdaf212]
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Abstract: Malignant gliomas are heterogeneous brain tumors with extensive neovascularization. Conventional gradient-echo dynamic susceptibility contrast (GRE-DSC) perfusion MRI may underestimate microvascular alterations. We hypothesized that a novel vascular model (NVM), based on Bayesian voxel-wise transit time distribution analysis, could yield higher perfusion metrics in untreated isocitrate dehydrogenase (IDH)-wild-type glioblastoma compared to standard vendor GRE-DSC algorithms.In this retrospective, single-center study, 89 patients with neuropathologically confirmed glioblastoma underwent pretherapeutic GRE-DSC perfusion MRI at 1.5 or 3.0 T. Perfusion maps were generated using both the NVM and default vendor algorithms. Using co-registered T1-post-contrast and T2/FLAIR images, two neuroradiologists independently assessed perfusion conspicuity of color-coded maps for each algorithm and manually performed region-of-interest analyses within visually identified tumor hotspots for quantification. Relative values of cerebral blood flow (rCBF), cerebral blood volume (rCBV), and mean transit time (rMTT) were normalized to contralateral normal-appearing white matter. Nonparametric tests evaluated group differences.The NVM yielded enhanced hotspot delineation and significantly higher median normalized perfusion values than vendor algorithms (all P < .001), with excellent inter-rater reliability (Cohen's κ and intraclass correlation coefficients ≥0.86). At 3.0 T, NVM-derived rCBV was significantly higher than at 1.5 T (P = .008).NVM post-processing yielded higher normalized CBF, CBV, and MTT values within tumor hotspots than vendor pipelines, suggesting that Bayesian model-based perfusion analysis may enhance the detection of microvascular changes in glioblastoma. As validation against a gold standard is missing, prospective multicenter studies are warranted to confirm our findings, particularly with regard to treatment monitoring and clinical decision-making.

Keyword(s): Bayesian modeling ; glioblastoma ; gradient echo dynamic susceptibility contrast perfusion ; magnet resonance imaging ; neoangiogenesis

Classification:

Note: Published:30 September 2025

Contributing Institute(s):
  1. DKTK Koordinierungsstelle München (MU01)
Research Program(s):
  1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2025
Database coverage:
Medline ; DOAJ ; Article Processing Charges ; Clarivate Analytics Master Journal List ; DOAJ Seal ; Emerging Sources Citation Index ; Fees ; IF < 5 ; JCR ; SCOPUS ; Web of Science Core Collection
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 Record created 2026-01-07, last modified 2026-01-08


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