Identification of intratumour low frequency microvascular components via BOLD signal fractal dimension mapping

Typical clinical evaluation of the tumour microvascular environment is performed by dynamic contrast enhanced MRI (dceMRI). However, this approach has been defined by numerous mathematical models each with their own physiologic assumptions which often leads to inconclusive results in the assessment of microstructure. Alternatively, Blood Oxygen Level Dependent (BOLD) Magnetic Resonance Imaging (MRI) is already known to be sensitive to the microvascular environment through fluctuation in the oxyhemoglobin to deoxyhemoglobin ratio. Consequently, quantification of the BOLD signal's temporal complexity using a fractal dimension index allows maps to be generated that are physiologically distinctive in nature and allow potential insight into tumour microvasculature with no a priori assumptions as in dceMRI. Here, using rectal carcinoma as an example, we present this novel approach to tumour microvascular evaluation using fractal dimension parametric mapping.