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Mapping the vessel architecture of brain cancer by advanced perfusion MRI

Digernes, Ingrid
Doctoral thesis
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PhD-Digernes-2020.pdf (12.15Mb)
Year
2020
Permanent link
http://urn.nb.no/URN:NBN:no-76897

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  • Fysisk institutt [2360]
Abstract
An important part of our understanding of brain tumours relies on our ability to assess the vascular function of the tumours. Dynamic susceptibility contrast (DSC), and the novel method Vessel Architectural Imaging (VAI), are MRI techniques that potentially can provide valuable information about the vascular properties of the brain.

This thesis investigates the behaviour of DSC and VAI under a range of different conditions using an advanced simulation model. The simulations show that the derived parameters from DSC and VAI are dependent on a complex interaction between underlying vascular properties and the noise in the signal. Moreover, results from the simulations suggest that previous findings regarding these techniques are not always valid. This thesis also demonstrates a clinical application of DSC and VAI. By examining vascular function of brain tumours receiving high-dose radiotherapy, we found that brain tumours with poor vascular function were more prone to radiation-induced tissue damage than tumours with normal vascular function.

The results from this work suggest that DSC and VAI can be clinically valuable, but must be used with caution. In addition, the results are highly relevant for further use and development of these techniques.
List of papers
Paper I: A theoretical framework for determining cerebral vascular function and heterogeneity from dynamic susceptibility contrast MRI. Digernes I., Bjørnerud A., Vatnehol S.A.S., Løvland G., Courivaud F., Vik-Mo E., Meling T.R. and Emblem K.E. Journal of Cerebral Blood Flow and Metabolism, 2017; 37(6):2237-2248. DOI: 10.1177/0271678X17694187. The article is included in the thesis. Also available in DUO: http://urn.nb.no/URN:NBN:no-62746
Paper II: Noise dependency in vascular parameters from combined gradientecho spin-echo DSC MRI. Digernes I., Nilsen L.B., Grøvik E., Bjørnerud A., Løvland G., Vik-Mo E., Meling T.R., Saxhaug C., Helland Å., Jacobsen K.D., Geier O. and Emblem K.E. Submitted. To be published. The paper is not available in DUO awaiting publishing.
Paper III: Brain metastases with poor vascular function are susceptible to pseudoprogression after stereotactic radiosurgery. Digernes I., Grøvik E., Nilsen L.B., Saxhaug C., Geier O., Reitan E., Sætre D.O., Breivik B., Reese T., Jacobsen K.D., Helland Å. and Emblem K.E. Advances in Radiation Oncology, 2018; 3:559-567. DOI: 10.1016/j.adro.2018.05.005. The article is included in the thesis. Also available at: https://doi.org/10.1016/j.adro.2018.05.005
 
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