1
|
Tseng CH, Jaspers J, Romero AM, Wielopolski P, Smits M, van Osch MJP, Vos F. Improved reliability of perfusion estimation in dynamic susceptibility contrast MRI by using the arterial input function from dynamic contrast enhanced MRI. NMR IN BIOMEDICINE 2024; 37:e5038. [PMID: 37712359 DOI: 10.1002/nbm.5038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/02/2023] [Accepted: 08/23/2023] [Indexed: 09/16/2023]
Abstract
The arterial input function (AIF) plays a crucial role in estimating quantitative perfusion properties from dynamic susceptibility contrast (DSC) MRI. An important issue, however, is that measuring the AIF in absolute contrast-agent concentrations is challenging, due to uncertainty in relation to the measuredR 2 ∗ -weighted signal, signal depletion at high concentration, and partial-volume effects. A potential solution could be to derive the AIF from separately acquired dynamic contrast enhanced (DCE) MRI data. We aim to compare the AIF determined from DCE MRI with the AIF from DSC MRI, and estimated perfusion coefficients derived from DSC data using a DCE-driven AIF with perfusion coefficients determined using a DSC-based AIF. AIFs were manually selected in branches of the middle cerebral artery (MCA) in both DCE and DSC data in each patient. In addition, a semi-automatic AIF-selection algorithm was applied to the DSC data. The amplitude and full width at half-maximum of the AIFs were compared statistically using the Wilcoxon rank-sum test, applying a 0.05 significance level. Cerebral blood flow (CBF) was derived with different AIF approaches and compared further. The results showed that the AIFs extracted from DSC scans yielded highly variable peaks across arteries within the same patient. The semi-automatic DSC-AIF had significantly narrower width compared with the manual AIFs, and a significantly larger peak than the manual DSC-AIF. Additionally, the DCE-based AIF provided a more stable measurement of relative CBF and absolute CBF values estimated with DCE-AIFs that were compatible with previously reported values. In conclusion, DCE-based AIFs were reproduced significantly better across vessels, showed more realistic profiles, and delivered more stable and reasonable CBF measurements. The DCE-AIF can, therefore, be considered as an alternative AIF source for quantitative perfusion estimations in DSC MRI.
Collapse
Affiliation(s)
- Chih-Hsien Tseng
- Department of Imaging Physics, Delft University of Technology, Delft, the Netherlands
- Medical Delta, Delft, the Netherlands
- Holland Proton Therapy Center Consortium-Erasmus MC, Rotterdam, Holland Proton Therapy Centre, Delft, Leiden University Medical Center, Leiden and Delft University of Technology, Delft, the Netherlands
| | - Jaap Jaspers
- Holland Proton Therapy Center Consortium-Erasmus MC, Rotterdam, Holland Proton Therapy Centre, Delft, Leiden University Medical Center, Leiden and Delft University of Technology, Delft, the Netherlands
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Alejandra Mendez Romero
- Holland Proton Therapy Center Consortium-Erasmus MC, Rotterdam, Holland Proton Therapy Centre, Delft, Leiden University Medical Center, Leiden and Delft University of Technology, Delft, the Netherlands
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Piotr Wielopolski
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marion Smits
- Medical Delta, Delft, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Brain Tumour Center, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Matthias J P van Osch
- Medical Delta, Delft, the Netherlands
- Holland Proton Therapy Center Consortium-Erasmus MC, Rotterdam, Holland Proton Therapy Centre, Delft, Leiden University Medical Center, Leiden and Delft University of Technology, Delft, the Netherlands
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frans Vos
- Department of Imaging Physics, Delft University of Technology, Delft, the Netherlands
- Medical Delta, Delft, the Netherlands
- Holland Proton Therapy Center Consortium-Erasmus MC, Rotterdam, Holland Proton Therapy Centre, Delft, Leiden University Medical Center, Leiden and Delft University of Technology, Delft, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
2
|
Li R, Edalati M, Muccigrosso D, Lau JMC, Laforest R, Woodard PK, Zheng J. A simplified method to correct saturation of arterial input function for cardiac magnetic resonance first-pass perfusion imaging: validation with simultaneously acquired PET. J Cardiovasc Magn Reson 2023; 25:35. [PMID: 37344848 PMCID: PMC10286396 DOI: 10.1186/s12968-023-00945-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/06/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND First-pass perfusion imaging in magnetic resonance imaging (MRI) is an established method to measure myocardial blood flow (MBF). An obstacle for accurate quantification of MBF is the saturation of blood pool signal intensity used for arterial input function (AIF). The objective of this project was to validate a new simplified method for AIF estimation obtained from single-bolus and single sequence perfusion measurements. The reference MBF was measured simultaneously on 13N-ammonia positron emission tomography (PET). METHODS Sixteen patients with clinically confirmed myocardial ischemia were imaged in a clinical whole-body PET-MRI system. PET perfusion imaging was performed in a 10-min acquisition after the injection of 10 mCi of 13N-ammonia. The MRI perfusion acquisition started simultaneously with the start of the PET acquisition after the injection of a 0.075 mmol/kg gadolinium contrast agent. Cardiac stress imaging was initiated after the administration of regadenoson 20 s prior to PET-MRI scanning. The saturation part of the MRI AIF data was modeled as a gamma variate curve, which was then estimated for a true AIF by minimizing a cost function according to various boundary conditions. A standard AHA 16-segment model was used for comparative analysis of absolute MBF from PET and MRI. RESULTS Overall, there were 256 segments in 16 patients, mean resting perfusion for PET was 1.06 ± 0.34 ml/min/g and 1.04 ± 0.30 ml/min/g for MRI (P = 0.05), whereas mean stress perfusion for PET was 2.00 ± 0.74 ml/min/g and 2.12 ± 0.76 ml/min/g for MRI (P < 0.01). Linear regression analysis in MBF revealed strong correlation (r = 0.91, slope = 0.96, P < 0.001) between PET and MRI. Myocardial perfusion reserve, calculated from the ratio of stress MBF over resting MBF, also showed a strong correlation between MRI and PET measurements (r = 0.82, slope = 0.81, P < 0.001). CONCLUSION The results demonstrated the feasibility of the simplified AIF estimation method for the accurate quantification of MBF by MRI with single sequence and single contrast injection. The MRI MBF correlated strongly with PET MBF obtained simultaneously. This post-processing technique will allow easy transformation of clinical perfusion imaging data into quantitative information.
Collapse
Affiliation(s)
- Ran Li
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Ave, Room 3114, St. Louis, MO, USA
| | - Masoud Edalati
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Ave, Room 3114, St. Louis, MO, USA
| | - David Muccigrosso
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Ave, Room 3114, St. Louis, MO, USA
| | - Jeffrey M C Lau
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore
| | - Richard Laforest
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Ave, Room 3114, St. Louis, MO, USA
| | - Pamela K Woodard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Ave, Room 3114, St. Louis, MO, USA
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Ave, Room 3114, St. Louis, MO, USA.
| |
Collapse
|
3
|
Mazaheri Y, Kim N, Lakhman Y, Jafari R, Vargas A, Otazo R. Dynamic contrast-enhanced MRI parametric mapping using high spatiotemporal resolution Golden-angle RAdial Sparse Parallel MRI and iterative joint estimation of the arterial input function and pharmacokinetic parameters. NMR IN BIOMEDICINE 2022; 35:e4718. [PMID: 35226774 PMCID: PMC9203940 DOI: 10.1002/nbm.4718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
The aim of this work is to develop a data-driven quantitative dynamic contrast-enhanced (DCE) MRI technique using Golden-angle RAdial Sparse Parallel (GRASP) MRI with high spatial resolution and high flexible temporal resolution and pharmacokinetic (PK) analysis with an arterial input function (AIF) estimated directly from the data obtained from each patient. DCE-MRI was performed on 13 patients with gynecological malignancy using a 3-T MRI scanner with a single continuous golden-angle stack-of-stars acquisition and image reconstruction with two temporal resolutions, by exploiting a unique feature in GRASP that reconstructs acquired data with user-defined temporal resolution. Joint estimation of the AIF (both AIF shape and delay) and PK parameters was performed with an iterative algorithm that alternates between AIF and PK estimation. Computer simulations were performed to determine the accuracy (expressed as percentage error [PE]) and precision of the estimated parameters. PK parameters (volume transfer constant [Ktrans ], fractional volume of the extravascular extracellular space [ve ], and blood plasma volume fraction [vp ]) and normalized root-mean-square error [nRMSE] (%) of the fitting errors for the tumor contrast kinetic data were measured both with population-averaged and data-driven AIFs. On patient data, the Wilcoxon signed-rank test was performed to compare nRMSE. Simulations demonstrated that GRASP image reconstruction with a temporal resolution of 1 s/frame for AIF estimation and 5 s/frame for PK analysis resulted in an absolute PE of less than 5% in the estimation of Ktrans and ve , and less than 11% in the estimation of vp . The nRMSE (mean ± SD) for the dual temporal resolution image reconstruction and data-driven AIF was 0.16 ± 0.04 compared with 0.27 ± 0.10 (p < 0.001) with 1 s/frame using population-averaged AIF, and 0.23 ± 0.07 with 5 s/frame using population-averaged AIF (p < 0.001). We conclude that DCE-MRI data acquired and reconstructed with the GRASP technique at dual temporal resolution can successfully be applied to jointly estimate the AIF and PK parameters from a single acquisition resulting in data-driven AIFs and voxelwise PK parametric maps.
Collapse
Affiliation(s)
- Yousef Mazaheri
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nathanael Kim
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Yulia Lakhman
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ramin Jafari
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Alberto Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ricardo Otazo
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
4
|
Wang C, Padgett KR, Su MY, Mellon EA, Maziero D, Chang Z. Multi-parametric MRI (mpMRI) for treatment response assessment of radiation therapy. Med Phys 2021; 49:2794-2819. [PMID: 34374098 DOI: 10.1002/mp.15130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 11/11/2022] Open
Abstract
Magnetic resonance imaging (MRI) plays an important role in the modern radiation therapy (RT) workflow. In comparison with computed tomography (CT) imaging, which is the dominant imaging modality in RT, MRI possesses excellent soft-tissue contrast for radiographic evaluation. Based on quantitative models, MRI can be used to assess tissue functional and physiological information. With the developments of scanner design, acquisition strategy, advanced data analysis, and modeling, multiparametric MRI (mpMRI), a combination of morphologic and functional imaging modalities, has been increasingly adopted for disease detection, localization, and characterization. Integration of mpMRI techniques into RT enriches the opportunities to individualize RT. In particular, RT response assessment using mpMRI allows for accurate characterization of both tissue anatomical and biochemical changes to support decision-making in monotherapy of radiation treatment and/or systematic cancer management. In recent years, accumulating evidence have, indeed, demonstrated the potentials of mpMRI in RT response assessment regarding patient stratification, trial benchmarking, early treatment intervention, and outcome modeling. Clinical application of mpMRI for treatment response assessment in routine radiation oncology workflow, however, is more complex than implementing an additional imaging protocol; mpMRI requires additional focus on optimal study design, practice standardization, and unified statistical reporting strategy to realize its full potential in the context of RT. In this article, the mpMRI theories, including image mechanism, protocol design, and data analysis, will be reviewed with a focus on the radiation oncology field. Representative works will be discussed to demonstrate how mpMRI can be used for RT response assessment. Additionally, issues and limits of current works, as well as challenges and potential future research directions, will also be discussed.
Collapse
Affiliation(s)
- Chunhao Wang
- Department of Radiation Oncology, Duke University, Durham, North Carolina, USA
| | - Kyle R Padgett
- Department of Radiation Oncology, University of Miami, Miami, Florida, USA.,Department of Radiology, University of Miami, Miami, Florida, USA
| | - Min-Ying Su
- Department of Radiological Sciences, University of California, Irvine, California, USA.,Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Eric A Mellon
- Department of Radiation Oncology, University of Miami, Miami, Florida, USA
| | - Danilo Maziero
- Department of Radiation Oncology, University of Miami, Miami, Florida, USA
| | - Zheng Chang
- Department of Radiation Oncology, Duke University, Durham, North Carolina, USA
| |
Collapse
|
5
|
Wáng YXJ, Wang X, Wu P, Wang Y, Chen W, Chen H, Li J. Topics on quantitative liver magnetic resonance imaging. Quant Imaging Med Surg 2019; 9:1840-1890. [PMID: 31867237 DOI: 10.21037/qims.2019.09.18] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Liver magnetic resonance imaging (MRI) is subject to continuous technical innovations through advances in hardware, sequence and novel contrast agent development. In order to utilize the abilities of liver MR to its full extent and perform high-quality efficient exams, it is mandatory to use the best imaging protocol, to minimize artifacts and to select the most adequate type of contrast agent. In this article, we review the routine clinical MR techniques applied currently and some latest developments of liver imaging techniques to help radiologists and technologists to better understand how to choose and optimize liver MRI protocols that can be used in clinical practice. This article covers topics on (I) fat signal suppression; (II) diffusion weighted imaging (DWI) and intravoxel incoherent motion (IVIM) analysis; (III) dynamic contrast-enhanced (DCE) MR imaging; (IV) liver fat quantification; (V) liver iron quantification; and (VI) scan speed acceleration.
Collapse
Affiliation(s)
- Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | | | - Peng Wu
- Philips Healthcare (Suzhou) Co., Ltd., Suzhou 215024, China
| | - Yajie Wang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Weibo Chen
- Philips Healthcare, Shanghai 200072, China.,Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai 200062, China
| | - Huijun Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai 200062, China
| |
Collapse
|
6
|
Ahmed Z, Levesque IR. Pharmacokinetic modeling of dynamic contrast-enhanced MRI using a reference region and input function tail. Magn Reson Med 2019; 83:286-298. [PMID: 31393033 DOI: 10.1002/mrm.27913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/18/2019] [Accepted: 06/18/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE Quantitative analysis of dynamic contrast-enhanced MRI (DCE-MRI) requires an arterial input function (AIF) which is difficult to measure. We propose the reference region and input function tail (RRIFT) approach which uses a reference tissue and the washout portion of the AIF. METHODS RRIFT was evaluated in simulations with 100 parameter combinations at various temporal resolutions (5-30 s) and noise levels (σ = 0.01-0.05 mM). RRIFT was compared against the extended Tofts model (ETM) in 8 studies from patients with glioblastoma multiforme. Two versions of RRIFT were evaluated: one using measured patient-specific AIF tails, and another assuming a literature-based AIF tail. RESULTS RRIFT estimated the transfer constant K trans and interstitial volume v e with median errors within 20% across all simulations. RRIFT was more accurate and precise than the ETM at temporal resolutions slower than 10 s. The percentage error of K trans had a median and interquartile range of -9 ± 45% with the ETM and -2 ± 17% with RRIFT at a temporal resolution of 30 s under noiseless conditions. RRIFT was in excellent agreement with the ETM in vivo, with concordance correlation coefficients (CCC) of 0.95 for K trans , 0.96 for v e , and 0.73 for the plasma volume v p using a measured AIF tail. With the literature-based AIF tail, the CCC was 0.89 for K trans , 0.93 for v e and 0.78 for v p . CONCLUSIONS Quantitative DCE-MRI analysis using the input function tail and a reference tissue yields absolute kinetic parameters with the RRIFT method. This approach was viable in simulation and in vivo for temporal resolutions as low as 30 s.
Collapse
Affiliation(s)
- Zaki Ahmed
- Medical Physics Unit, McGill University, Montreal, Canada.,Department of Physics, McGill University, Montreal, Canada
| | - Ives R Levesque
- Medical Physics Unit, McGill University, Montreal, Canada.,Department of Physics, McGill University, Montreal, Canada.,Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada.,Cancer Research Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| |
Collapse
|
7
|
Thibodeau-Antonacci A, Petitclerc L, Gilbert G, Bilodeau L, Olivié D, Cerny M, Castel H, Turcotte S, Huet C, Perreault P, Soulez G, Chagnon M, Kadoury S, Tang A. Dynamic contrast-enhanced MRI to assess hepatocellular carcinoma response to Transarterial chemoembolization using LI-RADS criteria: A pilot study. Magn Reson Imaging 2019; 62:78-86. [PMID: 31247250 DOI: 10.1016/j.mri.2019.06.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/05/2019] [Accepted: 06/23/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To identify quantitative dynamic contrast-enhanced (DCE)-MRI perfusion parameters indicating tumor response of hepatocellular carcinoma (HCC) to transarterial chemoembolization (TACE). MATERIALS AND METHODS This prospective pilot study was approved by our institutional review board; written and informed consent was obtained for each participant. Patients underwent DCE-MRI examinations before and after TACE. A variable flip-angle unenhanced 3D mDixon sequence was performed for T1 mapping. A dynamic 4D mDixon sequence was performed after contrast injection for assessing dynamic signal enhancement. Nonparametric analysis was conducted on the time-intensity curves. Parametric analysis was performed on the time-concentration curves using a dual-input single-compartment model. Treatment response according to Liver Reporting and Data System (LI-RADS) v2018 was used as the reference standard. The comparisons within groups (before vs. after treatment) and between groups (nonviable vs. equivocal or viable tumor) were performed using nonparametric bootstrap taking into account the clustering effect of lesions in patients. RESULTS Twenty-eight patients with 52 HCCs (size: 10-104 mm) were evaluated. For nonviable tumors (n = 27), time to peak increased from 62.5 ± 18.2 s before to 83.3 ± 12.8 s after treatment (P< 0.01). For equivocal or viable tumors (n = 25), time to peak and mean transit time significantly increased (from 54.4 ± 24.1 s to 69.5 ± 18.9 s, P < 0.01 and from 14.2 ± 11.8 s to 33.9 ± 36.8 s, P= 0.01, respectively) and the transfer constant from the extracellular and extravascular space to the central vein significantly decreased from 14.8 ± 14.1 to 8.1 ± 9.1 s-1 after treatment (P= 0.01). CONCLUSION This prospective pilot DCE-MRI study showed that time to peak significantly changed after TACE treatment for both groups (nonviable tumors and equivocal or viable tumors). In our cohort, several perfusion parameters may provide an objective marker for differentiation of treatment response after TACE in HCC patients.
Collapse
Affiliation(s)
- Alana Thibodeau-Antonacci
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Léonie Petitclerc
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | | | - Laurent Bilodeau
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Damien Olivié
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Milena Cerny
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Hélène Castel
- Department of Hepatology and Liver transplantation, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Simon Turcotte
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada; Department of Surgery, Hepatopancreatobiliary and Liver Transplantation Service, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Catherine Huet
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Pierre Perreault
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Gilles Soulez
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Miguel Chagnon
- Department of Mathematics and Statistics, Université de Montréal, QC, Canada
| | - Samuel Kadoury
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada; École Polytechnique, Montréal, Québec, Canada
| | - An Tang
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.
| |
Collapse
|
8
|
Ippoliti M, Lukas M, Brenner W, Schaeffter T, Makowski MR, Kolbitsch C. 3D nonrigid motion correction for quantitative assessment of hepatic lesions in DCE-MRI. Magn Reson Med 2019; 82:1753-1766. [PMID: 31228296 PMCID: PMC6771884 DOI: 10.1002/mrm.27867] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/03/2019] [Accepted: 05/24/2019] [Indexed: 12/27/2022]
Abstract
Purpose To provide nonrigid respiratory motion‐corrected DCE‐MRI images with isotropic resolution of 1.5 mm, full coverage of abdomen, and covering the entire uptake curve with a temporal resolution of 6 seconds, for the quantitative assessment of hepatic lesions. Methods 3D DCE‐MRI data were acquired at 3 T during free breathing for 5 minutes using a 3D T1‐weighted golden‐angle radial phase‐encoding sequence. Nonrigid respiratory motion information was extracted and used in motion‐corrected image reconstruction to obtain high‐quality DCE‐MRI images with temporal resolution of 6 seconds and isotropic resolution of 1.5 mm. An extended Tofts model was fitted to the dynamic data sets, yielding quantitative parametric maps of endothelial permeability using the hepatic artery as input function. The proposed approach was evaluated in 11 patients (52 ± 17 years, 5 men) with and without known hepatic lesions, undergoing DCE‐MRI. Results Respiratory motion produced artifacts and misalignment between dynamic volumes (lesion average motion amplitude of 3.82 ± 1.11 mm). Motion correction minimized artifacts and improved average contrast‐to‐noise ratio of hepatic lesions in late phase by 47% (p < .01). Quantitative endothelial permeability maps of motion‐corrected data demonstrated enhanced visibility of different pathologies (e.g., metastases, hemangiomas, cysts, necrotic tumor substructure) and showed improved contrast‐to‐noise ratio by 62% (p < .01) compared with uncorrected data. Conclusion 3D nonrigid motion correction in DCE‐MRI improves both visual and quantitative assessment of hepatic lesions by ensuring accurate alignment between 3D DCE images and reducing motion blurring. This approach does not require breath‐holds and minimizes scan planning by using a large FOV with isotropic resolution.
Collapse
Affiliation(s)
- Matteo Ippoliti
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Mathias Lukas
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Winfried Brenner
- Department of Nuclear Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Schaeffter
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Marcus R Makowski
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Kolbitsch
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| |
Collapse
|
9
|
Shukla-Dave A, Obuchowski NA, Chenevert TL, Jambawalikar S, Schwartz LH, Malyarenko D, Huang W, Noworolski SM, Young RJ, Shiroishi MS, Kim H, Coolens C, Laue H, Chung C, Rosen M, Boss M, Jackson EF. Quantitative imaging biomarkers alliance (QIBA) recommendations for improved precision of DWI and DCE-MRI derived biomarkers in multicenter oncology trials. J Magn Reson Imaging 2018; 49:e101-e121. [PMID: 30451345 DOI: 10.1002/jmri.26518] [Citation(s) in RCA: 221] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 12/14/2022] Open
Abstract
Physiological properties of tumors can be measured both in vivo and noninvasively by diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging. Although these techniques have been used for more than two decades to study tumor diffusion, perfusion, and/or permeability, the methods and studies on how to reduce measurement error and bias in the derived imaging metrics is still lacking in the literature. This is of paramount importance because the objective is to translate these quantitative imaging biomarkers (QIBs) into clinical trials, and ultimately in clinical practice. Standardization of the image acquisition using appropriate phantoms is the first step from a technical performance standpoint. The next step is to assess whether the imaging metrics have clinical value and meet the requirements for being a QIB as defined by the Radiological Society of North America's Quantitative Imaging Biomarkers Alliance (QIBA). The goal and mission of QIBA and the National Cancer Institute Quantitative Imaging Network (QIN) initiatives are to provide technical performance standards (QIBA profiles) and QIN tools for producing reliable QIBs for use in the clinical imaging community. Some of QIBA's development of quantitative diffusion-weighted imaging and dynamic contrast-enhanced QIB profiles has been hampered by the lack of literature for repeatability and reproducibility of the derived QIBs. The available research on this topic is scant and is not in sync with improvements or upgrades in MRI technology over the years. This review focuses on the need for QIBs in oncology applications and emphasizes the importance of the assessment of their reproducibility and repeatability. Level of Evidence: 5 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019;49:e101-e121.
Collapse
Affiliation(s)
- Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nancy A Obuchowski
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Thomas L Chenevert
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Sachin Jambawalikar
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Lawrence H Schwartz
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Dariya Malyarenko
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Wei Huang
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Susan M Noworolski
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Robert J Young
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mark S Shiroishi
- Division of Neuroradiology, Department of Radiology, University of Southern California, Los Angeles, California, USA
| | - Harrison Kim
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Catherine Coolens
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | | | - Caroline Chung
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Mark Rosen
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael Boss
- Applied Physics Division, National Institute of Standards and Technology, Boulder, Colorado, USA
| | - Edward F Jackson
- Departments of Medical Physics, Radiology, and Human Oncology, University of Wisconsin School of Medicine, Madison, Wisconsin, USA
| |
Collapse
|
10
|
Multiparametric FDG-PET/MRI of Hepatocellular Carcinoma: Initial Experience. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:5638283. [PMID: 30402045 PMCID: PMC6192124 DOI: 10.1155/2018/5638283] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/30/2018] [Accepted: 09/06/2018] [Indexed: 12/16/2022]
Abstract
Purpose To compare multiparametric (mp)FDG-PET/MRI metrics between hepatocellular carcinoma (HCC) and liver parenchyma and to assess the correlation between mpMRI and FDG-PET standard uptake values (SUVs) in liver parenchyma and HCC. Methods This prospective, institutional review board-approved study enrolled 15 patients (M/F 12/3; mean age 61 y) with HCC. mpMRI including blood-oxygen-level-dependent (BOLD) MRI, intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), and dynamic contrast-enhanced-(DCE-) MRI was performed simultaneously with 18F-FDG-PET on a 3T PET/MRI hybrid system. Quantitative BOLD, IVIM and DCE-MRI parameters (Tofts model (TM) and shutter-speed model (SSM)), and PET parameters (SUVmean and SUVmax) were quantified and compared between HCC lesions and liver parenchyma using Wilcoxon signed-rank tests. SUV ratios between HCCs and liver were also calculated (SUVmean T/L and SUVmax T/L). Diagnostic performance of (combined) mp-PET/MRI parameters for characterization of HCC was assessed using ROC analysis. Spearman correlations between PET and mpMRI parameters in HCC tumors and liver parenchyma were evaluated. Results 21 HCC lesions (mean size 4.0 ± 2.4 cm; range 2-13 cm) were analyzed. HCCs exhibited significantly higher arterial fraction (from DCE-MRI) and lower R 2 ∗ pre-O2 and post-O2 (from BOLD-MRI) versus liver parenchyma (P < 0.032). The highest diagnostic performance for differentiation between HCC and liver parenchyma was achieved for combined ART SSM and R 2 ∗ post-O2 (AUC = 0.91). SUVmax showed reasonable performance for differentiation of HCC versus liver (AUC = 0.75). In HCC, DCE-MRI parameters K trans (TM and SSM) and v e TM exhibited significant negative correlations with SUVmax T/L (r ranges from -0.624 to -0.566; FDR-adjusted P < 0.050). Conclusions Despite the observed reasonable diagnostic performance of FDG-PET SUVmax for HCC detection and several significant correlations between FDG-PET SUV and DCE-MRI parameters, FDG-PET did not provide clear additional value for HCC characterization compared to mpMRI in this pilot study.
Collapse
|
11
|
Hundshammer C, Braeuer M, Müller CA, Hansen AE, Schillmaier M, Düwel S, Feuerecker B, Glaser SJ, Haase A, Weichert W, Steiger K, Cabello J, Schilling F, Hövener JB, Kjær A, Nekolla SG, Schwaiger M. Simultaneous characterization of tumor cellularity and the Warburg effect with PET, MRI and hyperpolarized 13C-MRSI. Am J Cancer Res 2018; 8:4765-4780. [PMID: 30279736 PMCID: PMC6160766 DOI: 10.7150/thno.25162] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/26/2018] [Indexed: 02/07/2023] Open
Abstract
Modern oncology aims at patient-specific therapy approaches, which triggered the development of biomedical imaging techniques to synergistically address tumor biology at the cellular and molecular level. PET/MR is a new hybrid modality that allows acquisition of high-resolution anatomic images and quantification of functional and metabolic information at the same time. Key steps of the Warburg effect-one of the hallmarks of tumors-can be measured non-invasively with this emerging technique. The aim of this study was to quantify and compare simultaneously imaged augmented glucose uptake and LDH activity in a subcutaneous breast cancer model in rats (MAT-B-III) and to study the effect of varying tumor cellularity on image-derived metabolic information. Methods: For this purpose, we established and validated a multimodal imaging workflow for a clinical PET/MR system including proton magnetic resonance (MR) imaging to acquire accurate morphologic information and diffusion-weighted imaging (DWI) to address tumor cellularity. Metabolic data were measured with dynamic [18F]FDG-PET and hyperpolarized (HP) 13C-pyruvate MR spectroscopic imaging (MRSI). We applied our workflow in a longitudinal study and analyzed the effect of growth dependent variations of cellular density on glycolytic parameters. Results: Tumors of similar cellularity with similar apparent diffusion coefficients (ADC) showed a significant positive correlation of FDG uptake and pyruvate-to-lactate exchange. Longitudinal DWI data indicated a decreasing tumor cellularity with tumor growth, while ADCs exhibited a significant inverse correlation with PET standard uptake values (SUV). Similar but not significant trends were observed with HP-13C-MRSI, but we found that partial volume effects and point spread function artifacts are major confounders for the quantification of 13C-data when the spatial resolution is limited and major blood vessels are close to the tumor. Nevertheless, analysis of longitudinal data with varying tumor cellularity further detected a positive correlation between quantitative PET and 13C-data. Conclusions: Our workflow allows the quantification of simultaneously acquired PET, MRSI and DWI data in rodents on a clinical PET/MR scanner. The correlations and findings suggest that a major portion of consumed glucose is metabolized by aerobic glycolysis in the investigated tumor model. Furthermore, we conclude that variations in cell density affect PET and 13C-data in a similar manner and correlations of longitudinal metabolic data appear to reflect both biochemical processes and tumor cellularity.
Collapse
|
12
|
Ahmed Z, Levesque IR. An extended reference region model for DCE-MRI that accounts for plasma volume. NMR IN BIOMEDICINE 2018; 31:e3924. [PMID: 29745982 DOI: 10.1002/nbm.3924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 02/20/2018] [Accepted: 02/27/2018] [Indexed: 06/08/2023]
Abstract
The reference region model (RRM) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) provides pharmacokinetic parameters without requiring the arterial input function. A limitation of the RRM is that it assumes that the blood plasma volume in the tissue of interest is zero, but this is often not true in highly vascularized tissues, such as some tumours. This study proposes an extended reference region model (ERRM) to account for tissue plasma volume. Furthermore, ERRM was combined with a two-fit approach to reduce the number of fitting parameters, and this was named the constrained ERRM (CERRM). The accuracy and precision of RRM, ERRM and CERRM were evaluated in simulations covering a range of parameters, noise and temporal resolutions. These models were also compared with the extended Tofts model (ETM) on in vivo glioblastoma multiforme data. In simulations, RRM overestimated Ktrans by over 10% at vp = 0.01 under noiseless conditions. In comparison, ERRM and CERRM were both accurate, with CERRM showing better precision when noise was included. On in vivo data, CERRM provided maps that had the highest agreement with ETM, whilst also being robust at temporal resolutions as poor as 30 s. ERRM can provide pharmacokinetic parameters without an arterial input function in tissues with non-negligible vp where RRM provides inaccurate estimates. The two-fit approach, named CERRM, further improves on the accuracy and precision of ERRM.
Collapse
Affiliation(s)
- Zaki Ahmed
- Medical Physics Unit, McGill University, Montreal, QC, Canada
- Department of Physics, McGill University, Montreal, QC, Canada
| | - Ives R Levesque
- Medical Physics Unit, McGill University, Montreal, QC, Canada
- Department of Physics, McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| |
Collapse
|
13
|
Wang S, Lu Z, Fan X, Medved M, Jiang X, Sammet S, Yousuf A, Pineda F, Oto A, Karczmar GS. Comparison of arterial input functions measured from ultra-fast dynamic contrast enhanced MRI and dynamic contrast enhanced computed tomography in prostate cancer patients. Phys Med Biol 2018; 63:03NT01. [PMID: 29300175 PMCID: PMC6040820 DOI: 10.1088/1361-6560/aaa51b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The purpose of this study was to evaluate the accuracy of arterial input functions (AIFs) measured from dynamic contrast enhanced (DCE) MRI following a low dose of contrast media injection. The AIFs measured from DCE computed tomography (CT) were used as 'gold standard'. A total of twenty patients received CT and MRI scans on the same day. Patients received 120 ml Iohexol in DCE-CT and a low dose of (0.015 mM kg-1) of gadobenate dimeglumine in DCE-MRI. The AIFs were measured in the iliac artery and normalized to the CT and MRI contrast agent doses. To correct for different temporal resolution and sampling periods of CT and MRI, an empirical mathematical model (EMM) was used to fit the AIFs first. Then numerical AIFs (AIFCT and AIFMRI) were calculated based on fitting parameters. The AIFMRI was convolved with a 'contrast agent injection' function ([Formula: see text]) to correct for the difference between MRI and CT contrast agent injection times (~1.5 s versus 30 s). The results show that the EMMs accurately fitted AIFs measured from CT and MRI. There was no significant difference (p > 0.05) between the maximum peak amplitude of AIFs from CT (22.1 ± 4.1 mM/dose) and MRI after convolution (22.3 ± 5.2 mM/dose). The shapes of the AIFCT and [Formula: see text] were very similar. Our results demonstrated that AIFs can be accurately measured by MRI following low dose contrast agent injection.
Collapse
|
14
|
van Schie JJN, Lavini C, van Vliet LJ, Kramer G, Pieters-van den Bos I, Marcus JT, Stoker J, Vos FM. Estimating the arterial input function from dynamic contrast-enhanced MRI data with compensation for flow enhancement (II): Applications in spine diagnostics and assessment of crohn's disease. J Magn Reson Imaging 2017; 47:1197-1204. [PMID: 29193469 DOI: 10.1002/jmri.25905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/16/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Pharmacokinetic (PK) models can describe microvascular density and integrity. An essential component of PK models is the arterial input function (AIF) representing the time-dependent concentration of contrast agent (CA) in the blood plasma supplied to a tissue. PURPOSE/HYPOTHESIS To evaluate a novel method for subject-specific AIF estimation that takes inflow effects into account. STUDY TYPE Retrospective study. SUBJECTS Thirteen clinical patients referred for spine-related complaints; 21 patients from a study into luminal Crohn's disease with known Crohn's Disease Endoscopic Index of Severity (CDEIS). FIELD STRENGTH/SEQUENCE Dynamic fast spoiled gradient echo (FSPGR) at 3T. ASSESSMENT A population-averaged AIF, AIFs derived from distally placed regions of interest (ROIs), and the new AIF method were applied. Tofts' PK model parameters (including vp and Ktrans ) obtained with the three AIFs were compared. In the Crohn's patients Ktrans was correlated to CDEIS. STATISTICAL TESTS The median values of the PK model parameters from the three methods were compared using a Mann-Whitney U-test. The associated variances were statistically assessed by the Brown-Forsythe test. Spearman's rank correlation coefficient was computed to test the correlation of Ktrans to CDEIS. RESULTS The median vp was significantly larger when using the distal ROI approach, compared to the two other methods (P < 0.05 for both comparisons, in both applications). Also, the variances in vp were significantly larger with the ROI approach (P < 0.05 for all comparisons). In the Crohn's disease study, the estimated Ktrans parameter correlated better with the CDEIS (r = 0.733, P < 0.001) when the proposed AIF was used, compared to AIFs from the distal ROI method (r = 0.429, P = 0.067) or the population-averaged AIF (r = 0.567, P = 0.011). DATA CONCLUSION The proposed method yielded realistic PK model parameters and improved the correlation of the Ktrans parameter with CDEIS, compared to existing approaches. LEVEL OF EVIDENCE 3 Technical Efficacy Stage 1 J. Magn. Reson. Imaging 2018;47:1197-1204.
Collapse
Affiliation(s)
- Jeroen J N van Schie
- Quantitative Imaging Group, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Cristina Lavini
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Lucas J van Vliet
- Quantitative Imaging Group, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Gem Kramer
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Indra Pieters-van den Bos
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - J T Marcus
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Jaap Stoker
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Frans M Vos
- Quantitative Imaging Group, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands.,Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
15
|
van Schie JJN, Lavini C, van Vliet LJ, Vos FM. Estimating the arterial input function from dynamic contrast-enhanced MRI data with compensation for flow enhancement (I): Theory, method, and phantom experiments. J Magn Reson Imaging 2017; 47:1190-1196. [PMID: 29193415 DOI: 10.1002/jmri.25906] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/03/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The arterial input function (AIF) represents the time-dependent arterial contrast agent (CA) concentration that is used in pharmacokinetic modeling. PURPOSE To develop a novel method for estimating the AIF from dynamic contrast-enhanced (DCE-) MRI data, while compensating for flow enhancement. STUDY TYPE Signal simulation and phantom measurements. PHANTOM MODEL Time-intensity curves (TICs) were simulated for different numbers of excitation pulses modeling flow effects. A phantom experiment was performed in which a solution (without CA) was passed through a straight tube, at constant flow velocity. FIELD STRENGTH/SEQUENCE Dynamic fast spoiled gradient echo (FSPGRs) at 3T MRI, both in the simulations and in the phantom experiment. TICs were generated for a duration of 373 seconds and sampled at intervals of 1.247 seconds (300 timepoints). ASSESSMENT The proposed method first estimates the number of pulses that spins have received, and then uses this knowledge to accurately estimate the CA concentration. STATISTICAL TESTS The difference between the median of the estimated number of pulses and the true value was determined, as well as the interquartile range (IQR) of the estimations. The estimated CA concentrations were evaluated in the same way. The estimated number of pulses was also used to calculate flow velocity. RESULTS The difference between the median estimated and reference number of pulses varied from -0.005 to -1.371 (corresponding IQRs: 0.853 and 48.377) at true values of 10 and 180 pulses, respectively. The difference between the median estimated CA concentration and the reference value varied from -0.00015 to 0.00306 mmol/L (corresponding IQRs: 0.01989 and 1.51013 mmol/L) at true values of 0.5 and 8.0 mmol/l, respectively, at an intermediate value of 100 pulses. The estimated flow velocities in the phantom were within 10% of the reference value. DATA CONCLUSION The proposed method accurately corrects the MRI signal affected by the inflow effect. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1190-1196.
Collapse
Affiliation(s)
| | - Cristina Lavini
- Department of Radiology and Nuclear Medicine, Academic Medical Center Amsterdam, The Netherlands
| | - Lucas J van Vliet
- Quantitative Imaging Group, University of Technology Delft, The Netherlands
| | - Frans M Vos
- Quantitative Imaging Group, University of Technology Delft, The Netherlands.,Department of Radiology and Nuclear Medicine, Academic Medical Center Amsterdam, The Netherlands
| |
Collapse
|
16
|
Ning J, Schubert T, Johnson KM, Roldán-Alzate A, Chen H, Yuan C, Reeder SB. Vascular input function correction of inflow enhancement for improved pharmacokinetic modeling of liver DCE-MRI. Magn Reson Med 2017; 79:3093-3102. [PMID: 29124781 DOI: 10.1002/mrm.26988] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/08/2017] [Accepted: 10/09/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE To propose a simple method to correct vascular input function (VIF) due to inflow effects and to test whether the proposed method can provide more accurate VIFs for improved pharmacokinetic modeling. METHODS A spoiled gradient echo sequence-based inflow quantification and contrast agent concentration correction method was proposed. Simulations were conducted to illustrate improvement in the accuracy of VIF estimation and pharmacokinetic fitting. Animal studies with dynamic contrast-enhanced MR scans were conducted before, 1 week after, and 2 weeks after portal vein embolization (PVE) was performed in the left portal circulation of pigs. The proposed method was applied to correct the VIFs for model fitting. Pharmacokinetic parameters fitted using corrected and uncorrected VIFs were compared between different lobes and visits. RESULTS Simulation results demonstrated that the proposed method can improve accuracy of VIF estimation and pharmacokinetic fitting. In animal study results, pharmacokinetic fitting using corrected VIFs demonstrated changes in perfusion consistent with changes expected after PVE, whereas the perfusion estimates derived by uncorrected VIFs showed no significant changes. CONCLUSION The proposed correction method improves accuracy of VIFs and therefore provides more precise pharmacokinetic fitting. This method may be promising in improving the reliability of perfusion quantification. Magn Reson Med 79:3093-3102, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
Collapse
Affiliation(s)
- Jia Ning
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, People's Republic of China.,Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Tilman Schubert
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Clinic for Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Huijun Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, People's Republic of China
| | - Chun Yuan
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, People's Republic of China.,Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| |
Collapse
|
17
|
Ahmed Z, Levesque IR. Increased robustness in reference region model analysis of DCE MRI using two-step constrained approaches. Magn Reson Med 2016; 78:1547-1557. [PMID: 27797110 DOI: 10.1002/mrm.26530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/25/2016] [Accepted: 10/06/2016] [Indexed: 12/23/2022]
Abstract
PURPOSE Reference region models (RRMs) can quantify tumor perfusion in dynamic contrast-enhanced MRI without an arterial input function. Inspection of the RRM reveals that one of the free parameters in the fit is uniquely linked to the reference region and is common to all voxels. A two-step approach is proposed that takes this constraint into account. METHODS Three constrained RRM (CRRM) approaches were devised and evaluated. Simulations were performed to compare their accuracy and precision over a range of noise and temporal resolutions. The CRRM was also applied on a virtual phantom that simulates different perfusion values. In vivo evaluation was performed on data from breast cancer and soft tissue sarcoma. RESULTS In simulations, the CRRM consistently improved precision and had better accuracy at low signal-to-noise ratio (SNR). In virtual phantom, the CRRMs were able to fit voxels that had similar kinetics to the reference tissue, whereas the unconstrained models failed to accurately fit these voxels. In the in vivo data, the constrained approaches produced parameter maps that had less variability and were in better agreement with the Tofts model. CONCLUSION These findings indicate that the two-step fitting approach of the CRRM can reduce the variability of perfusion estimates for quantifying perfusion with dynamic contrast-enhanced (DCE) MRI. Magn Reson Med 78:1547-1557, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
Collapse
Affiliation(s)
- Zaki Ahmed
- Medical Physics Unit, McGill University, Montreal, QC, Canada
| | - Ives R Levesque
- Medical Physics Unit, McGill University, Montreal, QC, Canada.,Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| |
Collapse
|
18
|
Ter Voert EEGW, Heijmen L, Punt CJA, de Wilt JHW, van Laarhoven HWM, Heerschap A. Reduced respiratory motion artifacts using structural similarity in fast 2D dynamic contrast enhanced MRI of liver lesions. NMR IN BIOMEDICINE 2016; 29:1526-1535. [PMID: 27598946 DOI: 10.1002/nbm.3606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 07/21/2016] [Accepted: 07/25/2016] [Indexed: 06/06/2023]
Abstract
The purpose of this work was to improve dynamic contrast enhanced MRI (DCE-MRI) of liver lesions by removing motion corrupted images as identified by a structural similarity (SSIM) algorithm, and to assess the effect of this correction on the pharmacokinetic parameter Ktrans using automatically determined arterial input functions (AIFs). Fifteen patients with colorectal liver metastases were measured twice with a T1 weighted multislice 2D FLASH sequence for DCE-MRI (time resolution 1.2 s). AIFs were automatically derived from contrast inflow in the aorta of each patient. Thereafter, SSIM identified motion corrupted images of the liver were removed from the DCE dataset. From this corrected data set Ktrans and its reproducibility were determined. Using the SSIM algorithm a median fraction of 46% (range 37-50%) of the liver images in DCE time series was labeled as motion distorted. Rejection of these images resulted in a significantly lower median Ktrans (p < 0.05) and lower coefficient of repeatability of Ktrans in liver metastases compared with an analysis without correction. SSIM correction improves the reproducibility of the DCE-MRI parameter Ktrans in liver metastasis and reduces contamination of Ktrans values of lesions by that of surrounding normal liver tissue.
Collapse
Affiliation(s)
- Edwin E G W Ter Voert
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Linda Heijmen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Cornelis J A Punt
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes H W de Wilt
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Arend Heerschap
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
19
|
Chouhan MD, Lythgoe MF, Mookerjee RP, Taylor SA. Vascular assessment of liver disease-towards a new frontier in MRI. Br J Radiol 2016; 89:20150675. [PMID: 27115318 PMCID: PMC5124867 DOI: 10.1259/bjr.20150675] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Complex haemodynamic phenomena underpin the pathophysiology of chronic liver disease. Non-invasive MRI-based assessment of hepatic vascular parameters therefore has the potential to yield meaningful biomarkers for chronic liver disease. In this review, we provide an overview of vascular sequelae of chronic liver disease amenable to imaging evaluation and describe the current supportive evidence, strengths and the limitations of MRI methodologies, including dynamic contrast-enhanced, dynamic hepatocyte-specific contrast-enhanced, phase-contrast, arterial spin labelling and MR elastography in the assessment of hepatic vascular parameters. We review the broader challenges of quantitative hepatic vascular MRI, including the difficulties of motion artefact, complex post-processing, long acquisition times, validation and limitations of pharmacokinetic models, alongside the potential solutions that will shape the future of MRI and deliver this new frontier to the patient bedside.
Collapse
Affiliation(s)
- Manil D Chouhan
- 1 University College London (UCL) Centre for Medical Imaging, Division of Medicine, UCL, London, UK
| | - Mark F Lythgoe
- 2 University College London (UCL) Centre for Advanced Biomedical Imaging, Division of Medicine, UCL, London, UK
| | - Rajeshwar P Mookerjee
- 3 University College London (UCL) Institute for Liver and Digestive Health, Division of Medicine, UCL, London, UK
| | - Stuart A Taylor
- 1 University College London (UCL) Centre for Medical Imaging, Division of Medicine, UCL, London, UK
| |
Collapse
|
20
|
Bevilacqua A, Barone D, Malavasi S, Gavelli G. Automatic detection of misleading blood flow values in CT perfusion studies of lung cancer. Biomed Signal Process Control 2016. [DOI: 10.1016/j.bspc.2016.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
21
|
Pan X, Qian T, Fernandez-Seara MA, Smith RX, Li K, Ying K, Sung K, Wang DJJ. Quantification of liver perfusion using multidelay pseudocontinuous arterial spin labeling. J Magn Reson Imaging 2015; 43:1046-54. [PMID: 26445928 DOI: 10.1002/jmri.25070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 09/24/2015] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To develop a free-breathing multidelay pseudocontinuous arterial spin labeling (pCASL) technique for quantitative measurement of liver perfusion of the hepatic artery and portal vein, respectively. MATERIALS AND METHODS A navigator-gated pCASL sequence with balanced steady-state free precession (bSSFP) readout was developed and applied on five healthy young volunteers at 3T. Two labeling schemes were performed with the labeling plane applied on the descending aorta above the liver, and perpendicular to the portal vein before its entry to liver to label the hepatic artery and portal vein, respectively. For each labeling scheme, pCASL scans were performed at five or six postlabeling delays between 200 and 2000 msec or 2500 msec with an interval of 400 or 500 msec. Multidelay pCASL images were processed offline with nonrigid motion correction, outlier removal, and fitted for estimation of liver perfusion and transit time. RESULTS Estimated liver perfusion of the hepatic artery and hepatic portal vein were 21.8 ± 1.9 and 95.1 ± 8.9 mL/100g/min, with the corresponding transit time of 1227.3 ± 355.5 and 667.2 ± 85.0 msec, respectively. The estimated liver perfusion and transit time without motion correction were less reliable with greater residual variance compared to those processed with motion correction (P < 0.05). CONCLUSION The liver perfusion measurement using multidelay pCASL showed good correspondence with values noted in the literature. The capability to noninvasively and selectively label the hepatic artery and portal vein is a unique strength of pCASL as compared to other liver perfusion imaging techniques, such as computed tomography perfusion and dynamic contrast-enhanced MRI.
Collapse
Affiliation(s)
- Xinlei Pan
- Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Tianyi Qian
- Siemens Healthcare, MR Collaboration NE Asia, Beijing, China
| | - Maria A Fernandez-Seara
- Neuroimaging Laboratory, Division of Neuroscience, Center for Applied Medical Research, University of Navarra, Spain
| | - Robert X Smith
- Laboratory of Functional MRI Technology (LOFT), Department of Neurology, University of California Los Angeles, Los Angeles, California, USA
| | - Kuncheng Li
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Kui Ying
- Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Kyunghyun Sung
- Department of Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Danny J J Wang
- Laboratory of Functional MRI Technology (LOFT), Department of Neurology, University of California Los Angeles, Los Angeles, California, USA.,Department of Radiology, University of California Los Angeles, Los Angeles, California, USA
| |
Collapse
|
22
|
DCE-MRI of the liver: reconstruction of the arterial input function using a low dose pre-bolus contrast injection. PLoS One 2014; 9:e115667. [PMID: 25546176 PMCID: PMC4278725 DOI: 10.1371/journal.pone.0115667] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 11/26/2014] [Indexed: 11/26/2022] Open
Abstract
Purpose To assess the quality of the arterial input function (AIF) reconstructed using a dedicated pre-bolus low-dose contrast material injection imaged with a high temporal resolution and the resulting estimated liver perfusion parameters. Materials and Methods In this IRB–approved prospective study, 24 DCE-MRI examinations were performed in 21 patients with liver disease (M/F 17/4, mean age 56 y). The examination consisted of 1.3 mL and 0.05 mmol/kg of gadobenate dimeglumine for pre-bolus and main bolus acquisitions, respectively. The concentration-curve of the abdominal aorta in the pre-bolus acquisition was used to reconstruct the AIF. AIF quality and shape parameters obtained with pre-bolus and main bolus acquisitions and the resulting estimated hepatic perfusion parameters obtained with a dual-input single compartment model were compared between the 2 methods. Test–retest reproducibility of perfusion parameters were assessed in three patients. Results The quality of the pre-bolus AIF curve was significantly better than that of main bolus AIF. Shape parameters peak concentration, area under the time activity curve of gadolinium contrast at 60 s and upslope of pre-bolus AIF were all significantly higher, while full width at half maximum was significantly lower than shape parameters of main bolus AIF. Improved liver perfusion parameter reproducibility was observed using pre-bolus acquisition [coefficient of variation (CV) of 4.2%–38.7% for pre-bolus vs. 12.1–71.4% for main bolus] with the exception of distribution volume (CV of 23.6% for pre-bolus vs. 15.8% for main bolus). The CVs between pre-bolus and main bolus for the perfusion parameters were lower than 14%. Conclusion The AIF reconstructed with pre-bolus low dose contrast injection displays better quality and shape parameters and enables improved liver perfusion parameter reproducibility, although the resulting liver perfusion parameters demonstrated no clinically significant differences between pre-bolus and main bolus acquisitions.
Collapse
|
23
|
Geisel D, Lüdemann L, Fröling V, Malinowski M, Stockmann M, Baron A, Gebauer B, Seehofer D, Prasad V, Denecke T. Imaging-based evaluation of liver function: comparison of ⁹⁹mTc-mebrofenin hepatobiliary scintigraphy and Gd-EOB-DTPA-enhanced MRI. Eur Radiol 2014; 25:1384-91. [PMID: 25447973 DOI: 10.1007/s00330-014-3536-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 11/14/2014] [Accepted: 11/20/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To compare Gd-EOB-enhanced MRI and (99m)Tc-mebrofenin hepatobiliary scintigraphy (HBS) as imaging-based liver function tests for separate evaluation of right (RLL) and left liver lobe (LLL) function. METHODS Fourteen patients underwent Gd-EOB-enhanced MRI and (99m)Tc-mebrofenin HBS after portal vein embolization within 24 h. Relative enhancement (RE) and hepatic uptake index (HUI) were determined from MRI; and T max, T 1/2 and mebrofenin uptake were determined from HBS, all values separately for RLL and LLL. RESULTS Mebrofenin uptake correlated significantly with HUI and RE for both liver lobes. There was strong correlation of mebrofenin uptake with HUI for RLL (r (2) = 0.802, p = 0.001) and RE for LLL (r (2) = 0.704, p = 0.005) and moderate correlation with HUI for LLL (r (2) = 0.560, p = 0.037) and RE for RLL (r (2) = 0.620, p = 0.018). Correlating the percentage share of RLL function derived from MRI (with HUI) with the percentage of RLL function derived from mebrofenin uptake revealed a strong correlation (r (2) = 0.775, p = 0.002). CONCLUSIONS Both RE and HUI correlate with mebrofenin uptake in HBS. The results suggest that Gd-EOB-enhanced MRI and (99m)Tc-mebrofenin HBS may equally be used to separately determine right and left liver lobe function. KEY POINTS • Information about liver function can be acquired with routine Gd-EOB-MRI. • Gd-EOB-MRI and (99m) Tc-mebrofenin HBS show elevated function of non-embolized lobe. • Gd-EOB-MRI and (99m) Tc-mebrofenin HBS can determine lobar liver function.
Collapse
Affiliation(s)
- Dominik Geisel
- Department of Diagnostic and Interventional Radiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Bultman EM, Brodsky EK, Horng DK, Irarrazaval P, Schelman WR, Block WF, Reeder SB. Quantitative hepatic perfusion modeling using DCE-MRI with sequential breathholds. J Magn Reson Imaging 2014; 39:853-65. [PMID: 24395144 PMCID: PMC3962525 DOI: 10.1002/jmri.24238] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 05/01/2013] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To develop and demonstrate the feasibility of a new formulation for quantitative perfusion modeling in the liver using interrupted DCE-MRI data acquired during multiple sequential breathholds. MATERIALS AND METHODS A new mathematical formulation to estimate quantitative perfusion parameters using interrupted data was developed. Using this method, we investigated whether a second degree-of-freedom in the tissue residue function (TRF) improves quality-of-fit criteria when applied to a dual-input single-compartment perfusion model. We subsequently estimated hepatic perfusion parameters using DCE-MRI data from 12 healthy volunteers and 9 cirrhotic patients with a history of hepatocellular carcinoma (HCC); and examined the utility of these estimates in differentiating between healthy liver, cirrhotic liver, and HCC. RESULTS Quality-of-fit criteria in all groups were improved using a Weibull TRF (2 degrees-of-freedom) versus an exponential TRF (1 degree-of-freedom), indicating nearer concordance of source DCE-MRI data with the Weibull model. Using the Weibull TRF, arterial fraction was greater in cirrhotic versus normal liver (39 ± 23% versus 15 ± 14%, P = 0.07). Mean transit time (20.6 ± 4.1 s versus 9.8 ± 3.5 s, P = 0.01) and arterial fraction (39 ± 23% versus 73 ± 14%, P = 0.04) were both significantly different between cirrhotic liver and HCC, while differences in total perfusion approached significance. CONCLUSION This work demonstrates the feasibility of estimating hepatic perfusion parameters using interrupted data acquired during sequential breathholds.
Collapse
Affiliation(s)
- Eric M. Bultman
- Dept. of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
| | - Ethan K. Brodsky
- Dept. of Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Debra K. Horng
- Dept. of Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Pablo Irarrazaval
- Dept. of Electrical Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | | | - Walter F. Block
- Dept. of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- Dept. of Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Scott B. Reeder
- Dept. of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- Dept. of Medical Physics, University of Wisconsin, Madison, WI, USA
- Dept. of Medicine, University of Wisconsin, Madison, WI, USA
- Dept. of Radiology, University of Wisconsin, Madison, WI, USA
| |
Collapse
|
25
|
Geisel D, Lüdemann L, Wagner C, Stelter L, Grieser C, Malinowski M, Stockmann M, Seehofer D, Hamm B, Gebauer B, Denecke T. Evaluation of gadolinium-EOB-DTPA uptake after portal vein embolization: value of an increased flip angle. Acta Radiol 2014; 55:149-54. [PMID: 23908244 DOI: 10.1177/0284185113495833] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The optimal sequence for Gd-EOB-DTPA uptake measurement in the liver with the purpose of liver function measurement is still not defined. PURPOSE To prospectively evaluate the effect of an increased flip angle (FA) of a T1-weighted fat-saturated 3D sequence for the measurement of hepatocyte uptake of Gd-EOB-DTPA magnetic resonance imaging (MRI) after right portal vein embolization (PVE). MATERIAL AND METHODS Ten patients who received a PVE prior to an extended hemihepatectomy were examined 14 days after PVE using Gd-EOB-DTPA enhanced MRI of the liver using the standard FA of 10° and the increased FA of 30°. RESULTS Relative enhancement of the right liver lobe (RLL) was 0.52 ± 0.12 for 10° and 1.41 ± 0.39 for 30°. Relative enhancement of the left liver lobe (LLL) was 0.58 ± 0.11 for 10° and 2.05 ± 0.61 for 30°. Relative enhancement of the RLL was significantly higher for 30° than for 10° (P = 0.009) and significantly higher in the 30° than in the 10° sequences (P = 0.005) for the LLL. CONCLUSION A flip angle of 30° increases the contrast between liver partitions with and without portal venous embolization. Thereby, the sensitivity for differences in uptake intensity is increased. This could be of value for a more exact determination of differences in regional liver function and, consequently, the estimation of the future remnant liver function.
Collapse
Affiliation(s)
- Dominik Geisel
- Department of Diagnostic and Interventional Radiology, Charité, Campus Virchow-Klinikum, Berlin, Germany
| | - Lutz Lüdemann
- Department of Medical Physics, Essen University Hospital, Essen, Germany
| | - Clemens Wagner
- Department of General, Visceral and Transplantation Surgery, Charité, Campus Virchow-Klinikum, Berlin, Germany
| | - Lars Stelter
- Department of Diagnostic and Interventional Radiology, Charité, Campus Virchow-Klinikum, Berlin, Germany
| | - Christian Grieser
- Department of Diagnostic and Interventional Radiology, Charité, Campus Virchow-Klinikum, Berlin, Germany
| | - Maciej Malinowski
- Department of General, Visceral and Transplantation Surgery, Charité, Campus Virchow-Klinikum, Berlin, Germany
| | - Martin Stockmann
- Department of General, Visceral and Transplantation Surgery, Charité, Campus Virchow-Klinikum, Berlin, Germany
| | - Daniel Seehofer
- Department of General, Visceral and Transplantation Surgery, Charité, Campus Virchow-Klinikum, Berlin, Germany
| | - Bernd Hamm
- Department of Diagnostic and Interventional Radiology, Charité, Campus Virchow-Klinikum, Berlin, Germany
| | - Bernhard Gebauer
- Department of Diagnostic and Interventional Radiology, Charité, Campus Virchow-Klinikum, Berlin, Germany
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, Charité, Campus Virchow-Klinikum, Berlin, Germany
| |
Collapse
|
26
|
Kleppestø M, Larsson C, Groote I, Salo R, Vardal J, Courivaud F, Bjørnerud A. T2*-correction in dynamic contrast-enhanced MRI from double-echo acquisitions. J Magn Reson Imaging 2013; 39:1314-9. [PMID: 24123598 DOI: 10.1002/jmri.24268] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 05/16/2013] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To evaluate the importance of T2*-effects on the arterial input function (AIF) and on the resulting dynamic parameter estimation in dynamic contrast-enhanced (DCE) MRI of high-grade gliomas. MATERIALS AND METHODS Seven patients with high-grade gliomas were imaged in total 50 times using a double-echo DCE sequence. Kinetic analysis using the extended Tofts model was performed using AIFs with and without correction for T2*-effects, and the resulting estimates of the transfer constant (K(trans) ), blood plasma volume (vp ), and the rate constant (kep ) were compared. Numerical simulations were done for comparison with clinical results as well as to further investigate the dependency of parameter values on the magnitude of T2*-induced errors. RESULTS All kinetic parameters were found to be overestimated if T2*-effects in the AIF were not accounted for; with vp being most severely affected. The relative error in each parameter was dependent on the absolute parameter magnitude, resulting in incorrect parametric tumor distributions in the presence of uncorrected AIF T2*-effects. CONCLUSION In DCE, a sufficiently short echo time should be used or corrections for T2*-effects based on double-echo acquisition should be made for correct quantification of kinetic parameters.
Collapse
Affiliation(s)
- Magne Kleppestø
- The Intervention Centre, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | | | | | | | | | | |
Collapse
|
27
|
|
28
|
Geisel D, Lüdemann L, Keuchel T, Malinowski M, Seehofer D, Stockmann M, Hamm B, Gebauer B, Denecke T. Increase in left liver lobe function after preoperative right portal vein embolisation assessed with gadolinium-EOB-DTPA MRI. Eur Radiol 2013; 23:2555-60. [PMID: 23652847 DOI: 10.1007/s00330-013-2859-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 03/06/2013] [Accepted: 03/08/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To prospectively evaluate the early development of regional liver function after right portal vein embolisation (PVE) with Gd-EOB-DTPA-enhanced MRI in patients scheduled for extended right hemihepatectomy. METHODS Ten patients who received a PVE before an extended hemihepatectomy were examined before and 14 days after PVE using Gd-EOB-DTPA-enhanced MRI of the liver. In these sequences representative region of interest measurements were performed in the embolised right (RLL) and the non-embolised left liver lobe (LLL). The volume as well as hepatic uptake index (HUI) was calculated independently for each lobe. RESULTS Relative enhancement 14 days after PVE decreased in the RLL and increased significantly in the LLL (P < 0.05). Average hepatic uptake index (HUI) for RLL was significantly lower 14 days after PVE than before PVE (P < 0.05) and significantly higher for LLL (P < 0.05). CONCLUSIONS A significant shift of contrast uptake from the right to the left liver lobe can be depicted as early as 14 days after right PVE by using Gd-EOB-DTPA-enhanced MRI, which could reflect the redirected portal venous blood flow and the rapid utilisation of a hepatic functional reserve. KEY POINTS • Preoperative portal vein embolisation (PVE) is widely performed before right-sided hepatic resection. • PVE increases intravenous contrast medium uptake in the left lobe of liver. • The hepatic uptake index for the left liver lobe increases rapidly after PVE. • Left liver lobe function increase may be visualised by Gd-EOB-DTPA-enhanced MRI.
Collapse
Affiliation(s)
- Dominik Geisel
- Department of Diagnostic and Interventional Radiology, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Cao Y, Wang H, Johnson TD, Pan C, Hussain H, Balter JM, Normolle D, Ben-Josef E, Ten Haken RK, Lawrence TS, Feng M. Prediction of liver function by using magnetic resonance-based portal venous perfusion imaging. Int J Radiat Oncol Biol Phys 2012; 85:258-63. [PMID: 22520476 DOI: 10.1016/j.ijrobp.2012.02.037] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 02/14/2012] [Accepted: 02/16/2012] [Indexed: 12/21/2022]
Abstract
PURPOSE To evaluate whether liver function can be assessed globally and spatially by using volumetric dynamic contrast-enhanced magnetic resonance imaging MRI (DCE-MRI) to potentially aid in adaptive treatment planning. METHODS AND MATERIALS Seventeen patients with intrahepatic cancer undergoing focal radiation therapy (RT) were enrolled in institution review board-approved prospective studies to obtain DCE-MRI (to measure regional perfusion) and indocyanine green (ICG) clearance rates (to measure overall liver function) prior to, during, and at 1 and 2 months after treatment. The volumetric distribution of portal venous perfusion in the whole liver was estimated for each scan. We assessed the correlation between mean portal venous perfusion in the nontumor volume of the liver and overall liver function measured by ICG before, during, and after RT. The dose response for regional portal venous perfusion to RT was determined using a linear mixed effects model. RESULTS There was a significant correlation between the ICG clearance rate and mean portal venous perfusion in the functioning liver parenchyma, suggesting that portal venous perfusion could be used as a surrogate for function. Reduction in regional venous perfusion 1 month after RT was predicted by the locally accumulated biologically corrected dose at the end of RT (P<.0007). Regional portal venous perfusion measured during RT was a significant predictor for regional venous perfusion assessed 1 month after RT (P<.00001). Global hypovenous perfusion pre-RT was observed in 4 patients (3 patients with hepatocellular carcinoma and cirrhosis), 3 of whom had recovered from hypoperfusion, except in the highest dose regions, post-RT. In addition, 3 patients who had normal perfusion pre-RT had marked hypervenous perfusion or reperfusion in low-dose regions post-RT. CONCLUSIONS This study suggests that MR-based volumetric hepatic perfusion imaging may be a biomarker for spatial distribution of liver function, which could aid in individualizing therapy, particularly for patients at risk for liver injury after RT.
Collapse
Affiliation(s)
- Yue Cao
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan 48109, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|