Perfusion linearity and its applications in perfusion algorithm analysis

A Novel Statistical Optimization Algorithm for Estimating Perfusion Curves in Susceptibility Contrast-Enhanced MRI

Dynamic susceptibility contrast-enhanced magnetic resonance imaging is an important tool for evaluating intravascular indicator dynamics, which in turn is valuable for understanding brain physiology and pathophysiology. This procedure usually involves fitting a gamma-variate function to observed concentration-time curves in order to eliminate undesired effects of recirculation and the leakage of contrast agents. Several conventional curve-fitting approaches are routinely applied. The nonlinear optimization methods typically are computationally expensive and require reliable initial values to guarantee success, whereas a logarithmic linear least-squares (LL-LS) method is more stable and efficient, and does not suffer from the initial-value problem, but it can show degraded performance, especially when a few data or outliers are present. In this paper, we demonstrate, that the original perfusion curve-fitting problem can be transformed into a gamma-distribution-fitting problem by treating the concentration-time curves as a random sample from a gamma distribution with time as the random variable. A robust maximum-likelihood estimation (MLE) algorithm can then be readily adopted to solve this problem. The performance of the proposed method is compared with the nonlinear Levenberg-Marquardt (L-M) method and the LL-LS method using both synthetic and real data. The results show that the performance of the proposed approach is far superior to those of the other two methods, while keeping the advantages of the LL-LS method, such as easy implementation, low computational load, and dispensing with the need to guess the initial values. We argue that the proposed method represents an attractive alternative option for assessing intravascular indicator dynamics in clinical applications. Moreover, we also provide valuable suggestions on how to select valid data points and set the initial values in the two traditional approaches (LL-LS and nonlinear L-M methods) to achieve more reliable estimations.

Digital perfusion phantoms for visual perfusion validation

OBJECTIVE

Despite the increasingly broad use of perfusion applications, we still have no generally accessible means for their verification: The common sense of perfusion maps and "bona fides" of perfusion software vendors remain the only grounds for acceptance. Thus, perfusion applications are one of a very few clinical tools considerably lacking practical objective hands-on validation.

MATERIALS AND METHODS

To solve this problem, we introduce digital perfusion phantoms (DPPs)--numerically simulated DICOM image sequences specifically designed to have known perfusion maps with simple visual patterns. Processing DPP perfusion sequences with any perfusion algorithm or software of choice and comparing the results with the expected DPP patterns provide a robust and straightforward way to control the quality of perfusion analysis, software, and protocols.

RESULTS

The deviations from the expected DPP maps, observed in each perfusion software, provided clear visualization of processing differences and possible perfusion implementation errors.

CONCLUSION

Perfusion implementation errors, often hidden behind real-data anatomy and noise, become very visible with DPPs. We strongly recommend using DPPs to verify the quality of perfusion applications.