For example, while providing a relatively fast measurement,

the two flip angle T10 measurement procedure used in this work overestimated T10 at greater values, most notably in CSF. This overestimation only results in a modest underestimation of Ct, but if accurate CSF measurements are required, the T1 measurement procedure should be improved, PTC124 datasheet while still maintaining a clinically acceptable imaging time. Reliable estimation of r1 is even more challenging, and a significant weakness of current DCE-MRI methodologies is the reliance on an assumed in vitro value for the r1 relaxivity. This is despite relaxivity measurements being known to vary significantly between (ex vivo) tissue samples measured thus far, although at least the relaxivity appears to consistently

describe a linear relationship between reciprocal T1 change and contrast agent concentration at all but the most extreme concentrations [33], [34], [35], [36] and [37]. However, as a feasible method for direct measurement of contrast agent concentration in living human tissue remains elusive, relaxivity properties check details of in vivo brain tissues (whether normal or diseased) remain largely unknown. While the influence of T10 and r1 on the interpretation of signal enhancement curves is potentially significant, their effects are frequently ignored, particularly in the case of r1. This has been accepted in the community because traditional applications of DCE-MRI in tumors and MS produce very large signal enhancement,

compared to normal tissues or subtle BBB disorders. Therefore, it is likely that such changes do arise from significant contrast agent uptake rather than from T10 or r1 alterations which would have to change by unfeasibly large amounts. Furthermore, when the enhancement is so great, there is a lesser requirement to measure T10 or r1 to such a high degree of accuracy, as small errors are unlikely to alter the overall conclusion, even though Urease more subtle differences may be lost. In contrast, for subtle BBB disorders exhibiting small enhancement differences, relatively small differences in T10 or r1 could radically alter the conclusions drawn. As a result, T10 or r1 really needs to be known with a high degree of accuracy and accounted for when interpreting DCE-MRI results in subtle BBB disorders. This work has described the limitations of directly inferring contrast agent concentration from signal enhancement curves in the context of subtle BBB disorders. However, it should be noted that even if a reliable estimation of contrast agent concentration profiles in each tissue is obtained, it is only a first step towards obtaining a quantitative estimate of BBB disruption.