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Huber, Thomas; Rotkopf, Lukas; Wiestler, Benedikt; Kunz, Wolfgang G.; Bette, Stefanie; Gempt, Jens; Preibisch, Christine; Ricke, Jens; Zimmer, Claus; Kirschke, Jan S.; Sommer, Wieland H. and Thierfelder, Kolja M. (2019): Wavelet-based reconstruction of dynamic susceptibility MR-perfusion: a new method to visualize hypervascular brain tumors. In: European Radiology, Vol. 29, No. 5: pp. 2669-2676

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ObjectivesParameter maps based on wavelet-transform post-processing of dynamic perfusion data offer an innovative way of visualizing blood vessels in a fully automated, user-independent way. The aims of this study were (i) a proof of concept regarding wavelet-based analysis of dynamic susceptibility contrast (DSC) MRI data and (ii) to demonstrate advantages of wavelet-based measures compared to standard cerebral blood volume (CBV) maps in patients with the initial diagnosis of glioblastoma (GBM).MethodsConsecutive 3-T DSC MRI datasets of 46 subjects with GBM (mean age 63.013.1years, 28 m) were retrospectively included in this feasibility study. Vessel-specific wavelet magnetic resonance perfusion (wavelet-MRP) maps were calculated using the wavelet transform (Paul wavelet, order 1) of each voxel time course. Five different aspects of image quality and tumor delineation were each qualitatively rated on a 5-point Likert scale. Quantitative analysis included image contrast and contrast-to-noise ratio.ResultsVessel-specific wavelet-MRP maps could be calculated within a mean time of 2:27min. Wavelet-MRP achieved higher scores compared to CBV in all qualitative ratings: tumor depiction (4.02 vs. 2.33), contrast enhancement (3.93 vs. 2.23), central necrosis (3.86 vs. 2.40), morphologic correlation (3.87 vs. 2.24), and overall impression (4.00 vs. 2.41);all p<.001. Quantitative image analysis showed a better image contrast and higher contrast-to-noise ratios for wavelet-MRP compared to conventional perfusion maps (all p<.001).Conclusionswavelet-MRP is a fast and fully automated post-processing technique that yields reproducible perfusion maps with a clearer vascular depiction of GBM compared to standard CBV maps.

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