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Oghabian MA, Fatemidokht A, Haririchian MH. Quantification of Blood-Brain-Barrier Permeability Dysregulation and Inflammatory Activity in MS Lesions by Dynamic-Contrast Enhanced MR Imaging. Basic Clin Neurosci 2022; 13:117-128. [PMID: 36589018 PMCID: PMC9790105 DOI: 10.32598/bcn.2022.575.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/08/2020] [Accepted: 09/09/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction Introduction: blood-brain-barrier perfusion characterization impaired in MS as some studies have shown recently but a comparison between perfusion parameters in contrast-enhanced and non-enhanced lesions not have been well documented. Pharmacokinetic quantitative parameters have obtained from dynamic contrast-enhanced in magnetic resonance imaging is a useful way to quantify blood-brain barrier permeability leakage. Methods MR examination was performed on 28 patients with Relapsing-remitted Multiple Sclerosis (RRMS) with (Mean±SD age: 34.7±9.28) which had multiple lesions in the brain.3D dynamic T1-weighted spoiled gradient echo was obtained and Perfusion parameters and its map assessed in enhanced and non-enhanced lesions after intravascular injection differences in parameters and map obtained by analyzing ROI in Extended Toft model. Results permeability as measured Krtans was a significantly higher value in CE to compare NE lesions. Ktrans and Kep have significant differences in NAWM and CE and NE lesions. Vb was slightly different in NE and CE lesions. Conclusion Permeability measured as Ktrans was the good parameter to show permeability impairment of BBB in CE lesions. Dysregulation in BBB is an acceptable sign to indicate existence inflammation in CE lesions. Highlights Multiple Sclerosis,Inflammation,Blood-brain-barrier dysregulation. Plain Language Summary Inflammation activity in MS patients has an important role to cause BBB dysfunction.in this article to achieve results to confirm the inflammation importance in MS patients with acute lesions. MRI modality have been used and with comparison between acute and chronic lesions and NAWM of MS patient's presence of inflammation have been proved.
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Affiliation(s)
- Mohammad Ali Oghabian
- Department of Neuroimaging and Analysis, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Asieh Fatemidokht
- Department of Biomedical Engineering and Medical Physics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Haririchian
- Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Arsiwala TA, Sprowls SA, Blethen KE, Adkins CE, Saralkar PA, Fladeland RA, Pentz W, Gabriele A, Kielkowski B, Mehta RI, Wang P, Carpenter JS, Ranjan M, Najib U, Rezai AR, Lockman PR. Ultrasound-mediated disruption of the blood tumor barrier for improved therapeutic delivery. Neoplasia 2021; 23:676-691. [PMID: 34139452 PMCID: PMC8208897 DOI: 10.1016/j.neo.2021.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 12/21/2022] Open
Abstract
The blood-brain barrier (BBB) is a major anatomical and physiological barrier limiting the passage of drugs into brain. Central nervous system tumors can impair the BBB by changing the tumor microenvironment leading to the formation of a leaky barrier, known as the blood-tumor barrier (BTB). Despite the change in integrity, the BTB remains effective in preventing delivery of chemotherapy into brain tumors. Focused ultrasound is a unique noninvasive technique that can transiently disrupt the BBB and increase accumulation of drugs within targeted areas of the brain. Herein, we summarize the current understanding of different types of targeted ultrasound mediated BBB/BTB disruption techniques. We also discuss influence of the tumor microenvironment on BBB opening, as well as the role of immunological response following disruption. Lastly, we highlight the gaps between evaluation of the parameters governing opening of the BBB/BTB. A deeper understanding of physical opening of the BBB/BTB and the biological effects following disruption can potentially enhance treatment strategies for patients with brain tumors.
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Affiliation(s)
- T A Arsiwala
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, HSC, Morgantown, WV
| | - S A Sprowls
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, HSC, Morgantown, WV
| | - K E Blethen
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, HSC, Morgantown, WV
| | - C E Adkins
- School of Pharmacy, South University, Savannah, GA
| | - P A Saralkar
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, HSC, Morgantown, WV
| | - R A Fladeland
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, HSC, Morgantown, WV
| | - W Pentz
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, HSC, Morgantown, WV
| | - A Gabriele
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, HSC, Morgantown, WV
| | - B Kielkowski
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, HSC, Morgantown, WV
| | - R I Mehta
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV; Department of Neuroradiology, West Virginia University, Morgantown, WV; Department of Neuroscience, West Virginia University, Morgantown, WV
| | - P Wang
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV; Department of Neuroradiology, West Virginia University, Morgantown, WV
| | - J S Carpenter
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV; Department of Neuroradiology, West Virginia University, Morgantown, WV
| | - M Ranjan
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV; Departments of Neuroscience and Neurosurgery, West Virginia University, Morgantown, WV
| | - U Najib
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV; Department of Neurology, West Virginia University, Morgantown, WV
| | - A R Rezai
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV; Departments of Neuroscience and Neurosurgery, West Virginia University, Morgantown, WV
| | - P R Lockman
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, HSC, Morgantown, WV.
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Choi S, Spini M, Hua J, Harrison DM. Blood-brain barrier breakdown in non-enhancing multiple sclerosis lesions detected by 7-Tesla MP2RAGE ΔT1 mapping. PLoS One 2021; 16:e0249973. [PMID: 33901207 PMCID: PMC8075220 DOI: 10.1371/journal.pone.0249973] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/28/2021] [Indexed: 11/19/2022] Open
Abstract
Although the blood-brain barrier (BBB) is altered in most multiple sclerosis (MS) lesions, gadolinium enhancement is seen only in acute lesions. In this study, we aimed to investigate gadolinium-induced changes in T1 relaxation time in MS lesions on 7-tesla (7T) MRI as a means to quantify BBB breakdown in non-enhancing MS lesions. Forty-seven participants with MS underwent 7T MRI of the brain with a magnitude-prepared rapid acquisition of 2 gradient echoes (MP2RAGE) sequence before and after contrast. Subtraction of pre- and post-contrast T1 maps was used to measure T1 relaxation time change (ΔT1) from gadolinium. ΔT1 values were interrogated in enhancing white matter lesions (ELs), non-enhancing white matter lesions (NELs), and normal appearing white matter (NAWM) and metrics were compared to clinical data. ΔT1 was measurable in NELs (median: -0.139 (-0.304, 0.174) seconds; p < 0.001) and was negligible in NAWM (median: -0.001 (-0.036, 0.155) seconds; p = 0.516). Median ΔT1 in NELs correlated with disability as measured by Expanded Disability Status Scale (EDSS) (rho = -0.331, p = 0.026). Multiple measures of NEL ΔT1 variability also correlated with EDSS. NEL ΔT1 values were greater and more variable in patients with progressive forms of MS and greater in those not on MS treatment. Measurement of the changes in T1 relaxation time caused by contrast on 7T MP2RAGE reveals clinically relevant evidence of BBB breakdown in NELs in MS. This data suggests that NEL ΔT1 should be evaluated further as a potential biomarker of persistently disrupted BBB in MS.
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Affiliation(s)
- Seongjin Choi
- Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Margaret Spini
- University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Jun Hua
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United Stated of America
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States of America
| | - Daniel M. Harrison
- Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
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Fan X, Chatterjee A, Medved M, Oto A, Karczmar GS. Signal intensity form of the Tofts model for quantitative analysis of prostate dynamic contrast enhanced MRI data. Phys Med Biol 2021; 66:025002. [PMID: 33181487 DOI: 10.1088/1361-6560/abca02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this study is to develop a signal intensity (S(t)) form of the standard Tofts pharmacokinetic model that avoids the need to calculate tissue contrast agent concentration (C(t)) as function of time (t). We refer to this as 'SI-Tofts' model. Physiological parameters (K trans and v e) calculated using the SI-Tofts and standard Tofts models were compared by using simulations and human prostate dynamic contrast enhanced (DCE) MRI data. This approach was also applied to the Patlak model to compare K trans values calculated from C(t) and S(t). Simulations were performed on DCE-MRI data from the quantitative imaging biomarkers alliance to validate SI-Tofts model. In addition, ultrafast DCE-MRI data were acquired from 18 prostate cancer patients on a Philips Achieva 3T-TX scanner. Regions-of-interest (ROIs) for prostate cancer, normal tissue, gluteal muscle, and iliac artery were manually traced. The C(t) was calculated for each ROI using the standard model with measured pre-contrast tissue T 1 values. Both the simulation and clinical results showed strong correlation (r = 0.87-0.99, p < 0.001) for K trans and v e calculated from the SI-Tofts and standard Tofts models. The SI-Tofts model with a correction factor using the T 1 ratio of blood to tissue significantly improved the K trans estimates. The correlation of K trans obtained from the Patlak model with C(t) vs S(t) was also strong (r = 0.95-0.99, p < 0.001). These preliminary results suggest that physiological parameters from DCE-MRI can be reliably estimated from the SI-Tofts model without contrast agent concentration calculation.
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Affiliation(s)
- Xiaobing Fan
- Department of Radiology, University of Chicago, Chicago, IL 60637, United States of America
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Kontopodis E, Marias K, Manikis GC, Nikiforaki K, Venianaki M, Maris TG, Mastorodemos V, Papadakis GZ, Papadaki E. Extended perfusion protocol for MS lesion quantification. Open Med (Wars) 2020; 15:520-530. [PMID: 33336007 PMCID: PMC7711864 DOI: 10.1515/med-2020-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/09/2020] [Accepted: 03/13/2020] [Indexed: 11/15/2022] Open
Abstract
This study aims to examine a time-extended dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) protocol and report a comparative study with three different pharmacokinetic (PK) models, for accurate determination of subtle blood-brain barrier (BBB) disruption in patients with multiple sclerosis (MS). This time-extended DCE-MRI perfusion protocol, called Snaps, was applied on 24 active demyelinating lesions of 12 MS patients. Statistical analysis was performed for both protocols through three different PK models. The Snaps protocol achieved triple the window time of perfusion observation by extending the magnetic resonance acquisition time by less than 2 min on average for all patients. In addition, the statistical analysis in terms of adj-R 2 goodness of fit demonstrated that the Snaps protocol outperformed the conventional DCE-MRI protocol by detecting 49% more pixels on average. The exclusive pixels identified from the Snaps protocol lie in the low k trans range, potentially reflecting areas with subtle BBB disruption. Finally, the extended Tofts model was found to have the highest fitting accuracy for both analyzed protocols. The previously proposed time-extended DCE protocol, called Snaps, provides additional temporal perfusion information at the expense of a minimal extension of the conventional DCE acquisition time.
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Affiliation(s)
- Eleftherios Kontopodis
- Foundation for Research and Technology - Hellas, Institute of Computer Science, Computational Bio-Medicine Laboratory, N. Plastira 100, Vassilika Vouton, GR-700 13 Heraklion, Crete, Greece.,Department of Radiology, Medical School, University of Crete, P. O. Box 2208, Heraklion, Crete, Greece
| | - Kostas Marias
- Technological Educational Institute of Crete, Department of Informatics Engineering, Heraklion , Crete, Estavromenos, TK 71410, Greece
| | - Georgios C Manikis
- Foundation for Research and Technology - Hellas, Institute of Computer Science, Computational Bio-Medicine Laboratory, N. Plastira 100, Vassilika Vouton, GR-700 13 Heraklion, Crete, Greece.,Department of Radiology, Medical School, University of Crete, P. O. Box 2208, Heraklion, Crete, Greece
| | - Katerina Nikiforaki
- Foundation for Research and Technology - Hellas, Institute of Computer Science, Computational Bio-Medicine Laboratory, N. Plastira 100, Vassilika Vouton, GR-700 13 Heraklion, Crete, Greece.,Department of Radiology, Medical School, University of Crete, P. O. Box 2208, Heraklion, Crete, Greece
| | - Maria Venianaki
- Science and Technology Park of Crete, Gnosis Data Analysis, N. Plastira 100, Vassilika Vouton, GR-700 13, Heraklion, Greece
| | - Thomas G Maris
- Foundation for Research and Technology - Hellas, Institute of Computer Science, Computational Bio-Medicine Laboratory, N. Plastira 100, Vassilika Vouton, GR-700 13 Heraklion, Crete, Greece.,Department of Radiology, Medical School, University of Crete, P. O. Box 2208, Heraklion, Crete, Greece
| | - Vasileios Mastorodemos
- Department of Neurology, Medical School, University of Crete, P. O. Box 2208, Heraklion, Crete, Greece
| | - Georgios Z Papadakis
- Foundation for Research and Technology - Hellas, Institute of Computer Science, Computational Bio-Medicine Laboratory, N. Plastira 100, Vassilika Vouton, GR-700 13 Heraklion, Crete, Greece.,Department of Radiology, Medical School, University of Crete, P. O. Box 2208, Heraklion, Crete, Greece
| | - Efrosini Papadaki
- Foundation for Research and Technology - Hellas, Institute of Computer Science, Computational Bio-Medicine Laboratory, N. Plastira 100, Vassilika Vouton, GR-700 13 Heraklion, Crete, Greece.,Department of Radiology, Medical School, University of Crete, P. O. Box 2208, Heraklion, Crete, Greece
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Fatemidokht A, Harirchian MH, Faghihzadeh E, Tafakhori A, Oghabian MA. Assessment of the Characteristics of Different Kinds of MS Lesions Using Multi-Parametric MRI. ARCHIVES OF NEUROSCIENCE 2020; 7. [DOI: 10.5812/ans.102911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/06/2020] [Accepted: 07/12/2020] [Indexed: 08/30/2023]
Abstract
Background: Studying different pathological aspects of lesions in multiple sclerosis (MS) patients could be useful to modify the diagnosis and treatment of this neurological disorder. Magnetic resonance imaging (MRI) modalities have the potential to investigate variations in brain tissue because of inflammatory and neurodegenerative processes in various types of MS-related lesions. Objectives: This study was done to investigate the quantitative changes in MRI-based parameters, like perfusion and magnetization transfer ratio (MTR) of different types of brain lesions, to demonstrate the ability of MRI to detect structural and pathological differences in MS lesions. Methods: Quantitative MRI modalities were performed on 18 patients with five different kinds of lesions (T1 holes, acute and chronic white matter (WM), and acute and chronic gray matter (GM) lesions) using a 3 T MRI scanner. The following protocols were used to characterize the pathology of lesions: (I) fluid-attenuated inversion recovery (FLAIR); (II) pre- and post-contrast T1-weighted; (III) dynamic contrast-enhanced (DCE); and (IV) MTR imaging. Quantitative comparison of Ktrans, cerebral blood volume (CBV), cerebral blood flow (CBF), and MTR was done to find the best parameter to distinguish different lesions. Finally, a multivariate classifier was applied to introduce the best parameter to indicate differences in lesions. Results: Five lesions were characterized by perfusion and MTR parameters. The pathological changes were measured, including: (I) the highest value of parameters in both acute WM and GM lesions; (II) the lowest value of four parameters in both chronic WM and GM lesions; (III) MTR had the highest rank among parameters using the classifier. Conclusions: The degree of pathological alterations due to inflammatory and neurodegenerative processes in MS-related lesions was indicated through the used parameters in different kinds of lesions. Inflammation was the dominant process in acute lesions, while neurodegeneration and tissue loss were observed mostly in chronic lesions. Both inflammation and neurodegeneration were detected in T1 holes. Perfusion parameters and MTR were reasonable parameters to describe differences in brain lesions. Thus, it could be confirmed that magnetization transfer imaging (MTI) and DCE-MRI are high-sensitivity methods to detect microstructural changes in the brain and subtle changes in the blood-brain-barrier. Classification of the parameters indicated that MTR was the best biomarker than others to show variations in lesions pathology.
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Abstract
The blood-brain barrier (BBB) is the interface between the blood and brain tissue, which regulates the maintenance of homeostasis within the brain. Impaired BBB integrity is increasingly associated with various neurological diseases. To gain a better understanding of the underlying processes involved in BBB breakdown, magnetic resonance imaging (MRI) techniques are highly suitable for noninvasive BBB assessment. Commonly used MRI techniques to assess BBB integrity are dynamic contrast-enhanced and dynamic susceptibility contrast MRI, both relying on leakage of gadolinium-based contrast agents. A number of conceptually different methods exist that target other aspects of the BBB. These alternative techniques make use of endogenous markers, such as water and glucose, as contrast media. A comprehensive overview of currently available MRI techniques to assess the BBB condition is provided from a scientific point of view, including potential applications in disease. Improvements that are required to make these techniques clinically more easily applicable will also be discussed.
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Monitoring tumour microenvironment changes during anti-angiogenesis therapy using functional MRI. Angiogenesis 2019; 22:457-470. [DOI: 10.1007/s10456-019-09670-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/16/2019] [Indexed: 12/11/2022]
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