'Royal College of Obstetricians & Gynaecologists (RCOG)'
Abstract
PURPOSE:
To evaluate potential modeling paradigms and the impact of relaxation time effects on human blood-brain barrier (BBB) water exchange measurements using FEXI (BBB-FEXI), and to quantify the accuracy, precision, and
repeatability of BBB-FEXI exchange rate estimates at 3 T.
METHODS:
Three modeling paradigms were evaluated: (i) the apparent
exchange rate (AXR) model; (ii) a two-compartment model (2CM) explicitly representing intra- and extravascular signal components, and (iii) a
two-compartment model additionally accounting for finite compartmental T1
and T2 relaxation times (2CMr). Each model had three free parameters. Simulations quantified biases introduced by the assumption of infinite relaxation times
in the AXR and 2CM models, as well as the accuracy and precision of all three
models. The scan–rescan repeatability of all paradigms was quantified for the
first time in vivo in 10 healthy volunteers (age range 23–52 years; five female)
RESULTS:
The assumption of infinite relaxation times yielded exchange rate
errors in simulations up to 42%/14% in the AXR/2CM models, respectively.
Accuracy was highest in the compartmental models; precision was best in the
AXR model. Scan–rescan repeatability in vivo was good for all models, with negligible bias and repeatability coefficients in grey matter of RCAXR = 0.43 s −1,
RC2CM = 0.51 s −1, and RC2CMr = 0.61 s −1.
CONCLUSION: Compartmental modelling of BBB-FEXI signals can provide accurate and repeatable measurements of BBB water exchange; however, relaxation time and partial volume effects may cause model-dependent biases
