%0 Journal Article
%A Reis, Jonas
%A Stahl, Robert
%A Müller, Katharina J
%A Karschnia, Philipp
%A Teske, Nico
%A Neubauer, Antonia
%A von Baumgarten, Louisa
%A Thon, Niklas
%A Ringel, Florian
%A Liebig, Thomas
%A Albert, Nathalie L
%A Harter, Patrick
%A Forbrig, Robert
%T A novel vascular model yields increased MR perfusion metrics compared to conventional dynamic susceptibility contrast algorithms in untreated glioblastoma.
%J Neuro-oncology advances
%V 7
%N 1
%@ 2632-2498
%C Oxford
%I Oxford University Press
%M DKFZ-2026-00050
%P vdaf212
%D 2025
%Z Published:30 September 2025
%X 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.
%K Bayesian modeling (Other)
%K glioblastoma (Other)
%K gradient echo dynamic susceptibility contrast perfusion (Other)
%K magnet resonance imaging (Other)
%K neoangiogenesis (Other)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:41497452
%2 pmc:PMC12768504
%R 10.1093/noajnl/vdaf212
%U https://inrepo02.dkfz.de/record/307553