Session Item

Saturday
August 28
16:45 - 17:45
Online Stream 1
Poster Highlights 7: Quantitative functional and biological imaging
Petra van Houdt, The Netherlands
0520
Poster highlights
Physics
16:45 - 16:53
Optimization of intravoxel incoherent motion diffusion MRI for brain tumours biomarkers estimation
Chiara Paganelli, Italy
PH-0212

Abstract

Optimization of intravoxel incoherent motion diffusion MRI for brain tumours biomarkers estimation
Authors:

Giulia Buizza1, Marco Andrea Zampini1, Gioia Sablone1, Giulia Fontana2, Sara Imparato3, Giulia Riva4, Alberto Iannalfi4, Ester Orlandi4, Chiara Paganelli1, Guido Baroni1,2

1Politecnico di Milano, Department of Electronics, Information and Bioengineering (DEIB), Milan, Italy; 2National Center of Oncological Hadrontherapy (CNAO), Clinical Bioengineering Unit, Pavia, Italy; 3National Center of Oncological Hadrontherapy (CNAO), Radiology Unit, Pavia, Italy; 4National Center of Oncological Hadrontherapy (CNAO), Clinical Department, Pavia, Italy

Show Affiliations
Purpose or Objective
To provide a framework to optimize b-values sets for intravoxel incoherent motion (IVIM) parameters (diffusion D, perfusion fraction f, pseudo-diffusion D*) estimation in deriving accurate imaging biomarkers of brain tumors.
Material and Methods
Three sets of parameters were used to simulate noisy IVIM signals in different perfusion regimes (from literature {D,f,D*}-Low:{1e-3mm²/s, 0.05, 1e-2mm²/s}; Medium:{15e-4mm²/s, 0.30, 15e-3mm²/s}; High:{1e-3mm²/s, 0.30, 6e-2mm²/s}). A segmented fit was performed for b-low ([0 190]s/mm², step:10s/mm²) and b-high ([300 1400]s/mm², step:100s/mm²) b-values ranges. The optimal b-values set was found through an optimization procedure: from thousands of sets of 13 random b-values, estimates errors were computed (σₜₒₜ as the sum of relative errors of IVIM parameters: σD, σD*, σf) and candidate sets were chosen as those for which σD ≤ 0.25 for b-high and σₜₒₜ ≤ 0.80 for b-low. The 13 values of the optimal sets (b-opt₁₃, one for each regime) were found as the most frequent b-values in b-high and b-low. Optimized sets of 7 b-values (b-opt₇) were obtained via backward elimination: the least frequent b-values of b-opt₁₃ were iteratively eliminated in b-low and b-high ranges to minimize σₜₒₜ. 
Simulations were also performed using 7 b-values used in the clinical practice (b-im=[0 50 100 150 200 400 1000]s/mm²). Relative errors from different perfusion regimes and b-values sets (b-opt₁₃, b-opt₇ and b-im) were compared to evaluate differences between b-values configurations (Kruskall-Wallis test, α=0.05).
To evaluate the impact of optimization on patient data, IVIM maps were computed voxel wise through a segmented fit of diffusion MRI data acquired with b-im from patients affected by meningioma (n=9) and skull-base chordoma (n=11). The means of D, f and D* were computed over all patients in white matter (WM) and gross tumour volume (GTV) regions, and fed into simulations to compare b-opt to b-im (Wilcoxon tests, α=0.05) and characterize tissue perfusion regimes.
Results
Lower σₜₒₜ were obtained for b-opt₁₃ and b-opt₇ with respect to b-im for Medium and High regimes (Figure 1), suggesting that clinical protocols would benefit from an optimization if the expected perfusion regimes were high enough. As expected, σₜₒₜ was lower for b-opt₁₃ and estimates significantly differed in Medium and High regimes with respect to b-im and b-opt₇, showing that simplified protocols imply significantly different estimates. 
As for imaging biomarkers estimation, IVIM parameters from the GTV were comparable to Medium Perfusion, whereas those from WM to Low Perfusion, in both chordoma and meningioma patients (Figure 2).

Conclusion

The proposed framework showed that b-values optimization can aid the estimation of IVIM parameters to derive accurate brain tumours biomarkers with potential applications in personalized oncology. Nevertheless in-vivo IVIM measurements with optimal b-values are needed to validate these findings.