TY  - JOUR
AU  - Reis, Jonas
AU  - Stahl, Robert
AU  - Müller, Katharina J
AU  - Karschnia, Philipp
AU  - Teske, Nico
AU  - Neubauer, Antonia
AU  - von Baumgarten, Louisa
AU  - Thon, Niklas
AU  - Ringel, Florian
AU  - Liebig, Thomas
AU  - Albert, Nathalie L
AU  - Harter, Patrick
AU  - Forbrig, Robert
TI  - A novel vascular model yields increased MR perfusion metrics compared to conventional dynamic susceptibility contrast algorithms in untreated glioblastoma.
JO  - Neuro-oncology advances
VL  - 7
IS  - 1
SN  - 2632-2498
CY  - Oxford
PB  - Oxford University Press
M1  - DKFZ-2026-00050
SP  - vdaf212
PY  - 2025
N1  - Published:30 September 2025
AB  - 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.
KW  - Bayesian modeling (Other)
KW  - glioblastoma (Other)
KW  - gradient echo dynamic susceptibility contrast perfusion (Other)
KW  - magnet resonance imaging (Other)
KW  - neoangiogenesis (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:41497452
C2  - pmc:PMC12768504
DO  - DOI:10.1093/noajnl/vdaf212
UR  - https://inrepo02.dkfz.de/record/307553
ER  -