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

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 (Tex) were proposed to measure even subtle BBB-impairments. Goal(s): We hypothesized correlations of Tex with K2 in contrast-enhancing tissue (CET). Approach: K2 & Tex were compared in 22 patients with brain tumors and 19 healthy controls. Results: Tex 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 Tex 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.