Review of tracer kinetic models in evaluation of gliomas using dynamic contrast-enhanced imaging

TL;DR

This paper reviews how dynamic contrast-enhanced imaging and tracer kinetic models can improve the evaluation and management of gliomas, a type of brain tumor.

Contribution

The paper provides a critical review of conventional and advanced tracer kinetic models used in DCE imaging for glioma assessment.

Findings

Conventional tracer kinetic models like Tofts and ETM have yielded ambiguous results in glioma studies.

Advanced models such as Brix, TH, and DP offer better insights but are underutilized in clinical trials.

DCE imaging techniques can provide valuable information on tumor vascular characteristics.

Abstract

Glioma is the most common type of primary malignant tumor of the central nervous system (CNS), and is characterized by high malignancy, high recurrence rate and poor survival. Conventional imaging techniques only provide information regarding the anatomical location, morphological characteristics, and enhancement patterns. In contrast, advanced imaging techniques such as dynamic contrast-enhanced (DCE) MRI or DCE CT can reflect tissue microcirculation, including tumor vascular hyperplasia and vessel permeability. Although several studies have used DCE imaging to evaluate gliomas, the results of data analysis using conventional tracer kinetic models (TKMs) such as Tofts or extended-Tofts model (ETM) have been ambiguous. More advanced models such as Brix’s conventional two-compartment model (Brix), tissue homogeneity model (TH) and distributed parameter (DP) model have been developed, but their application in clinical trials has been limited. This review attempts to appraise issues on glioma studies using conventional TKMs, such as Tofts or ETM model, highlight advancement of DCE imaging techniques and provides insights on the clinical value of glioma management using more advanced TKMs.

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