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Ifergan G, Autret G, Del Giudice C, Lecler A, Lalot A, Marijon C, Casanova A, Perez-Liva M, Bellamy V, Bruneval P, Clement O, Sapoval M, Menasché P, Balvay D. Dynamic contrast enhanced - MRI efficiency in detecting embolization-induced perfusion defects in a rabbit model of critical-limb-ischemia. Magn Reson Imaging 2022; 87:88-96. [PMID: 35026346 DOI: 10.1016/j.mri.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/21/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
Critical limb ischemia (CLI) is a severe disease which affects about 2 million people in the US. Its prevalence is assessed at 800/100,000 population. However, no reliable tools are currently available to assess perfusion defects at the muscle tissue level. DCE-MRI is a technique that holds the potential to be effective in achieving this goal. However, preclinical studies performed with DCE-MRI have indicated low sensitivity assessing perfusion at resting state. To improve these previous results, in this work we propose new methodologies for data acquisition and analysis and we also revisit the biological model used for evaluation. Eleven rabbits underwent embolization of a lower limb. They were imaged at day 7 after embolization using DCE-MRI, performed on a 4.7 T small imaging device. Among them, n = 4 rabbits were used for MRI sequence optimization and n = 6 for data analysis after one exclusion. Normalized Areas under the curve (AUCn), and kinetic parameters such as Ktrans and Vd resulting from the Tofts-Kety modeling (KTM) were calculated on the embolized and contralateral limbs. Average and heterogeneity features, consisting on standard-deviation and quantiles, were calculated on muscle groups and whole limbs. The Wilcoxon and Fisher-tests were performed to compare embolized and contralateral regions of interests. The Wilcoxon test was also used to compare features of parametric maps. Quantiles of 5 and 95% in the contralateral side were used to define low and high outliers. A P-value <0.05 was considered statistically significant. Average features were inefficient to identify injured muscles, in agreement with the low sensitivity of the technique previously reported by the literature. However, these findings were dramatically improved by the use of additional heterogeneity features (97% of total accuracy for group muscles, P < 0.01 and 100% of total accuracy for the total limbs). The mapping analysis and automatic outlier detection quantification improvement was explained by the presence of local hyperemia that impair the average calculations. The analysis with KTM did not provide any additional information compared to AUCn. The DCE technique can be effective in detecting embolization-induced disorders of limb muscles in a CLI model when heterogeneity is taken into account in the data processing, even without vascular stimulation. The simultaneous presence of areas of ischemia and hyperemia appeared as a signature of the injured limbs. These areas seem to reflect the simultaneous presence of infarcted areas and viable peripheral areas, characterized by a vascular response that is visible in DCE.
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Affiliation(s)
- Gabriel Ifergan
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
| | - Gwennhael Autret
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
| | - Costantino Del Giudice
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Interventional Radiology / Radiology / Anatomy Pathology /horacic and cardiovascular surgery, Hôpital Européen Georges Pompidou, APHP, France.
| | - Augustin Lecler
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Fondation Ophtalmologique Adolphe de Rothschild, France.
| | - Adrien Lalot
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France
| | - Camille Marijon
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
| | - Amaury Casanova
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France
| | - Mailyn Perez-Liva
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
| | - Valérie Bellamy
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
| | - Patrick Bruneval
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Interventional Radiology / Radiology / Anatomy Pathology /horacic and cardiovascular surgery, Hôpital Européen Georges Pompidou, APHP, France.
| | - Olivier Clement
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Interventional Radiology / Radiology / Anatomy Pathology /horacic and cardiovascular surgery, Hôpital Européen Georges Pompidou, APHP, France.
| | - Marc Sapoval
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Interventional Radiology / Radiology / Anatomy Pathology /horacic and cardiovascular surgery, Hôpital Européen Georges Pompidou, APHP, France.
| | - Philippe Menasché
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Interventional Radiology / Radiology / Anatomy Pathology /horacic and cardiovascular surgery, Hôpital Européen Georges Pompidou, APHP, France.
| | - Daniel Balvay
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
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Wang Y, Zhang R, Zhang B, Wang C, Wang H, Zhang X, Zhao K, Yang M, Wang X, Zhang J. Simultaneous R2, R2' and R2* measurement of skeletal muscle in a rabbit model of unilateral artery embolization. Magn Reson Imaging 2019; 61:149-157. [PMID: 31129281 DOI: 10.1016/j.mri.2019.05.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 05/20/2019] [Accepted: 05/20/2019] [Indexed: 01/27/2023]
Abstract
PURPOSE To demonstrate the feasibility of using a susceptibility-based MRI technique with multi-echo gradient and spin echo (MEGSE) sequence to achieve simultaneous R2, R2' and R2* measurement and assess skeletal muscle oxygenation alternations in a rabbit model of unilateral artery embolization. MATERIALS AND METHODS Approved by the local institutional review board for experimental animal studies, nine New Zealand White rabbits were included in this study. The MEGSE sequence consists of embedding a set of gradient echoes around the echo of a single spin-echo sequence using several gradient echoes to collect the magnetization intensity during the formation and attenuation of spin-echo simultaneously after 180° radio frequency pulse. Within-session and between-day tests were conducted to evaluate the reproducibility of this skeletal muscle oxygenation alternations measurement. Furthermore, all the MEGSE scans of skeletal muscle were conducted using a 3-T clinical MRI scanner during resting state (before unilateral artery embolization operation, pre), 1 h after unilateral artery embolization operation (post1) and 2 h after unilateral artery embolization operation (post2) model to verify the feasibility and sensitivity of this method. RESULTS The within-session coefficient of variations (CVs) of R2, R2' and R2* measurements were 1.57%, 3.33% and 2.57%, while the between-day CVs of were 1.42%, 5.85% and 2.85%. In all rabbits, the mean R2 decreased significantly from 36.46 ± 1.03 s-1 (pre) to 30.58 ± 2.11 s-1 (post1,**P < 0.01, relative to pre) and 28.62 ± 1.53 s-1 (post2, **P < 0.01, relative to post1), and the mean R2' went up markedly from 9.88 ± 2.14 s-1 (pre) to 16.10 ± 2.74 s-1 (post1, **P < 0.01) and 17.33 ± 2.25 s-1 (post2, **P < 0.05). The mean R2* increased from 43.27 ± 3.75 s-1 (pre) to 47.90 ± 5.08 s-1 (post1, *P < 0.05) and to 48.04 ± 4.42 s-1 (post2, NS, P > 0.05). CONCLUSION This study demonstrates the feasibility of simultaneous R2, R2' and R2* measurement method for the evaluation of skeletal muscle ischemia. Besides, this study indicates the sensitivity of the R2 and R2' compared with R2* and especially the necessity of R2 and R2' measurement for the further evaluation of skeletal muscle ischemia which always causes both edema and hypoxia in a rabbit model of unilateral artery embolization.
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Affiliation(s)
- Yao Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Rui Zhang
- College of Engineering, Peking University, Beijing, China
| | - Bihui Zhang
- Department of Interventional Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Chengyan Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Haochen Wang
- Department of Interventional Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Xiaodong Zhang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Kai Zhao
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Min Yang
- Department of Interventional Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Xiaoying Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; Department of Radiology, Peking University First Hospital, Beijing, China.
| | - Jue Zhang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; College of Engineering, Peking University, Beijing, China.
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Qi L, Xu L, Wang WT, Zhang YD, Zhang R, Zou YF, Shi HB. Dynamic contrast-enhanced magnetic resonance imaging in denervated skeletal muscle: Experimental study in rabbits. PLoS One 2019; 14:e0215069. [PMID: 30951550 PMCID: PMC6450635 DOI: 10.1371/journal.pone.0215069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/26/2019] [Indexed: 12/22/2022] Open
Abstract
Purpose To investigate the value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for evaluating denervated skeletal muscle in rabbits. Materials and methods 24 male rabbits were randomly divided into an irreversible neurotmesis group and a control group. In the experimental group, the sciatic nerves of rabbits were transected for irreversible neurotmesis model. A sham operation was performed in the control group. MRI of rabbit lower legs was performed before nerve surgery and 1 day, 3 days, 5 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, and 12 weeks after surgery. Results Signal intensity changes were seen in the left gastrocnemius muscle on the T2-weighted images. DCE-MRI derived parameters (Ktrans, Kep, and Vp) were measured in vivo. In the irreversible neurotmesis group, T2-weighted images showed increased signal intensity in the left gastrocnemius muscle. Ktrans, Vp values changes occur as early as 1 day after denervation, and increased gradually until 4 weeks after surgery. There are significant increases in both Ktrans and Vp values compared with those in the control group after surgery (P < 0.05). Kep values show no significant difference between the irreversible neurotmesis group and the control group. Conclusion DCE-MRI hold the promise of an early and sensitive diagnosis of denervated skeletal muscle.
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Affiliation(s)
- Liang Qi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Lei Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Wen-Tao Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yu-Dong Zhang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Rui Zhang
- Department of Neurosurgery, Nanjing Children’s Hospital, Nanjing, PR China
| | - Yue-Fen Zou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hai-Bin Shi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
- * E-mail:
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Zhang B, Wang Y, Wang C, Wang H, Kong H, Zhang J, Zou Y, Yang M. Comparison of blood oxygen level-dependent imaging and diffusion-weighted imaging in early diagnosis of acute kidney injury in animal models. J Magn Reson Imaging 2019; 50:719-724. [PMID: 30635951 DOI: 10.1002/jmri.26617] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Early diagnosis of acute kidney injury (AKI) has clinical importance. Current methods are neither adequately sensitive nor specific. Blood oxygen level-dependent (BOLD) imaging and diffusion-weighted imaging (DWI) may help to assess AKI in the early phase. PURPOSE To investigate the feasibility of BOLD imaging and DWI in the assessment of AKI and compare the sensitivities of both techniques in early detection of renal damage. STUDY TYPE Prospective animal study. ANIMAL MODEL Thirty New Zealand white rabbits. FIELD STRENGTH/SEQUENCE 3 T clinical MRI/BOLD and DWI. ASSESSMENT Thirty rabbits were divided into three groups (severe AKI group, mild AKI group, and control group). Transarterial renal embolization with different doses of microspheres was performed to create severe and mild AKI disease models. All the MRI scans of kidneys were conducted within 2 hours after the embolization procedure. Histological examinations with hematoxylin and eosin staining were performed to validate renal damage. STATISTICAL TESTS Analysis of variance (ANOVA) for comparisons between groups, and paired t-test for tests within the same group. P < 0.05 was considered statistically significant. RESULTS Both R2* and apparent diffusion coefficient (ADC) showed significant differences between the severe AKI group (56.34 ± 3.45 s-1 for R2*, 1.14 ± 0.23 mm2 /s for ADC) and the control group (28.24 ± 2.26 s-1 for R2*, 1.94 ± 0.33 mm2 /s for ADC, both P < 0.01). However, the ADC values did not show significant differences (P = 0.41) between mild AKI group (1.88 ± 0.31 mm2 /s for ADC) and the control group (1.94 ± 0.33 mm2 /s for ADC), while R2* was still useful in differentiating the two groups (52.32 ± 4.1 s-1 vs. 28.24 ± 2.26 s-1 for R2*, P < 0.01). The histopathologic results were found to be correlated with MRI findings. DATA CONCLUSION BOLD contrast and DW images are both effective in detecting AKI noninvasively, but BOLD imaging is more sensitive in early detection of mild ischemia than DWI. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:719-724.
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Affiliation(s)
- Bihui Zhang
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Yao Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Chengyan Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Haochen Wang
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Hanjing Kong
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Jue Zhang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Yinghua Zou
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Min Yang
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
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Yoon MA, Hong SJ, Ku MC, Kang CH, Ahn KS, Kim BH. Multiparametric MR Imaging of Age-related Changes in Healthy Thigh Muscles. Radiology 2018; 287:235-246. [DOI: 10.1148/radiol.2017171316] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Min A Yoon
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
| | - Suk-Joo Hong
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
| | - Min Cheol Ku
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
| | - Chang Ho Kang
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
| | - Kyung-Sik Ahn
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
| | - Baek Hyun Kim
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
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Identification of the S100 fused-type protein hornerin as a regulator of tumor vascularity. Nat Commun 2017; 8:552. [PMID: 28916756 PMCID: PMC5601918 DOI: 10.1038/s41467-017-00488-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/04/2017] [Indexed: 02/03/2023] Open
Abstract
Sustained angiogenesis is essential for the development of solid tumors and metastatic disease. Disruption of signaling pathways that govern tumor vascularity provide a potential avenue to thwart cancer progression. Through phage display-based functional proteomics, immunohistochemical analysis of human pancreatic ductal carcinoma (PDAC) specimens, and in vitro validation, we reveal that hornerin, an S100 fused-type protein, is highly expressed on pancreatic tumor endothelium in a vascular endothelial growth factor (VEGF)-independent manner. Murine-specific hornerin knockdown in PDAC xenografts results in tumor vessels with decreased radii and tortuosity. Hornerin knockdown tumors have significantly reduced leakiness, increased oxygenation, and greater apoptosis. Additionally, these tumors show a significant reduction in growth, a response that is further heightened when therapeutic inhibition of VEGF receptor 2 (VEGFR2) is utilized in combination with hornerin knockdown. These results indicate that hornerin is highly expressed in pancreatic tumor endothelium and alters tumor vessel parameters through a VEGF-independent mechanism.Angiogenesis is essential for solid tumor progression. Here, the authors interrogate the proteome of pancreatic cancer endothelium via phage display and identify hornerin as a critical protein whose expression is essential to maintain the pancreatic cancer vasculature through a VEGF-independent mechanism.
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Turco S, Wijkstra H, Mischi M. Mathematical Models of Contrast Transport Kinetics for Cancer Diagnostic Imaging: A Review. IEEE Rev Biomed Eng 2016; 9:121-47. [PMID: 27337725 DOI: 10.1109/rbme.2016.2583541] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Angiogenesis plays a fundamental role in cancer growth and the formation of metastasis. Novel cancer therapies aimed at inhibiting angiogenic processes and/or disrupting angiogenic tumor vasculature are currently being developed and clinically tested. The need for earlier and improved cancer diagnosis, and for early evaluation and monitoring of therapeutic response to angiogenic treatment, have led to the development of several imaging methods for in vivo noninvasive assessment of angiogenesis. The combination of dynamic contrast-enhanced imaging with mathematical modeling of the contrast agent kinetics enables quantitative assessment of the structural and functional changes in the microvasculature that are associated with tumor angiogenesis. In this paper, we review quantitative imaging of angiogenesis with dynamic contrast-enhanced magnetic resonance imaging, computed tomography, and ultrasound.
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Nguyen A, Ledoux JB, Omoumi P, Becce F, Forget J, Federau C. Application of intravoxel incoherent motion perfusion imaging to shoulder muscles after a lift-off test of varying duration. NMR IN BIOMEDICINE 2016; 29:66-73. [PMID: 26684052 DOI: 10.1002/nbm.3449] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 10/06/2015] [Accepted: 10/26/2015] [Indexed: 06/05/2023]
Abstract
Intravoxel incoherent motion (IVIM) MRI is a method to extract microvascular blood flow information out of diffusion-weighted images acquired at multiple b-values. We hypothesized that IVIM can identify the muscles selectively involved in a specific task, by measuring changes in activity-induced local muscular perfusion after exercise. We tested this hypothesis using a widely used clinical maneuver, the lift-off test, which is known to assess specifically the subscapularis muscle functional integrity. Twelve shoulders from six healthy male volunteers were imaged at 3 T, at rest, as well as after a lift-off test hold against resistance for 30 s, 1 and 2 min respectively, in three independent sessions. IVIM parameters, consisting of perfusion fraction (f), diffusion coefficient (D), pseudo-diffusion coefficient D* and blood flow-related fD*, were estimated within outlined muscles of the rotator cuff and the deltoid bundles. The mean values at rest and after the lift-off tests were compared in each muscle using a one-way ANOVA. A statistically significant increase in fD* was measured in the subscapularis, after a lift-off test of any duration, as well as in D. A fD* increase was the most marked (30 s, +103%; 1 min, +130%; 2 min, +156%) and was gradual with the duration of the test (in 10(-3) mm(2) /s: rest, 1.41 ± 0.50; 30 s, 2.86 ± 1.17; 1 min, 3.23 ± 1.22; 2 min, 3.60 ± 1.21). A significant increase in fD* and D was also visible in the posterior bundle of the deltoid. No significant change was consistently visible in the other investigated muscles of the rotator cuff and the other bundles of the deltoid. In conclusion, IVIM fD* allows the demonstration of a task-related microvascular perfusion increase after a specific task and suggests a direct relationship between microvascular perfusion and the duration of the effort. It is a promising method to investigate non-invasively skeletal muscle physiology and clinical perfusion-related muscular disorders.
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Affiliation(s)
- Audrey Nguyen
- Faculty of Biology and Medicine, University of Lausanne, Switzerland
| | - Jean-Baptiste Ledoux
- Department of Diagnostic and Interventional Radiology, University Hospital Center and University of Lausanne (CHUV-UNIL), Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, University Hospital Center and University of Lausanne (CHUV-UNIL), Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, University Hospital Center and University of Lausanne (CHUV-UNIL), Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Joachim Forget
- Department of Diagnostic and Interventional Radiology, University Hospital Center and University of Lausanne (CHUV-UNIL), Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Christian Federau
- Department of Diagnostic and Interventional Radiology, University Hospital Center and University of Lausanne (CHUV-UNIL), Rue du Bugnon 46, 1011, Lausanne, Switzerland
- Department of Radiology, Division of Neuroradiology, Stanford University, 300 Pasteur Drive, Room S039, Stanford, CA, 94305-5105, United States
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Khalifa F, Soliman A, El-Baz A, Abou El-Ghar M, El-Diasty T, Gimel'farb G, Ouseph R, Dwyer AC. Models and methods for analyzing DCE-MRI: a review. Med Phys 2015; 41:124301. [PMID: 25471985 DOI: 10.1118/1.4898202] [Citation(s) in RCA: 199] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To present a review of most commonly used techniques to analyze dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), discusses their strengths and weaknesses, and outlines recent clinical applications of findings from these approaches. METHODS DCE-MRI allows for noninvasive quantitative analysis of contrast agent (CA) transient in soft tissues. Thus, it is an important and well-established tool to reveal microvasculature and perfusion in various clinical applications. In the last three decades, a host of nonparametric and parametric models and methods have been developed in order to quantify the CA's perfusion into tissue and estimate perfusion-related parameters (indexes) from signal- or concentration-time curves. These indexes are widely used in various clinical applications for the detection, characterization, and therapy monitoring of different diseases. RESULTS Promising theoretical findings and experimental results for the reviewed models and techniques in a variety of clinical applications suggest that DCE-MRI is a clinically relevant imaging modality, which can be used for early diagnosis of different diseases, such as breast and prostate cancer, renal rejection, and liver tumors. CONCLUSIONS Both nonparametric and parametric approaches for DCE-MRI analysis possess the ability to quantify tissue perfusion.
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Affiliation(s)
- Fahmi Khalifa
- BioImaging Laboratory, Department of Bioengineering, University of Louisville, Louisville, Kentucky 40292 and Electronics and Communication Engineering Department, Mansoura University, Mansoura 35516, Egypt
| | - Ahmed Soliman
- BioImaging Laboratory, Department of Bioengineering, University of Louisville, Louisville, Kentucky 40292
| | - Ayman El-Baz
- BioImaging Laboratory, Department of Bioengineering, University of Louisville, Louisville, Kentucky 40292
| | - Mohamed Abou El-Ghar
- Radiology Department, Urology and Nephrology Center, Mansoura University, Mansoura 35516, Egypt
| | - Tarek El-Diasty
- Radiology Department, Urology and Nephrology Center, Mansoura University, Mansoura 35516, Egypt
| | - Georgy Gimel'farb
- Department of Computer Science, University of Auckland, Auckland 1142, New Zealand
| | - Rosemary Ouseph
- Kidney Transplantation-Kidney Disease Center, University of Louisville, Louisville, Kentucky 40202
| | - Amy C Dwyer
- Kidney Transplantation-Kidney Disease Center, University of Louisville, Louisville, Kentucky 40202
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Gordon Y, Partovi S, Müller-Eschner M, Amarteifio E, Bäuerle T, Weber MA, Kauczor HU, Rengier F. Dynamic contrast-enhanced magnetic resonance imaging: fundamentals and application to the evaluation of the peripheral perfusion. Cardiovasc Diagn Ther 2014; 4:147-64. [PMID: 24834412 DOI: 10.3978/j.issn.2223-3652.2014.03.01] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 02/08/2014] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The ability to ascertain information pertaining to peripheral perfusion through the analysis of tissues' temporal reaction to the inflow of contrast agent (CA) was first recognized in the early 1990's. Similar to other functional magnetic resonance imaging (MRI) techniques such as arterial spin labeling (ASL) and blood oxygen level-dependent (BOLD) MRI, dynamic contrast-enhanced MRI (DCE-MRI) was at first restricted to studies of the brain. Over the last two decades the spectrum of ailments, which have been studied with DCE-MRI, has been extensively broadened and has come to include pathologies of the heart notably infarction, stroke and further cerebral afflictions, a wide range of neoplasms with an emphasis on antiangiogenic treatment and early detection, as well as investigations of the peripheral vascular and musculoskeletal systems. APPLICATIONS TO PERIPHERAL PERFUSION DCE-MRI possesses an unparalleled capacity to quantitatively measure not only perfusion but also other diverse microvascular parameters such as vessel permeability and fluid volume fractions. More over the method is capable of not only assessing blood flowing through an organ, but in contrast to other noninvasive methods, the actual tissue perfusion. These unique features have recently found growing application in the study of the peripheral vascular system and most notably in the diagnosis and treatment of peripheral arterial occlusive disease (PAOD). REVIEW OUTLINE The first part of this review will elucidate the fundamentals of data acquisition and interpretation of DCE-MRI, two areas that often remain baffling to the clinical and investigating physician because of their complexity. The second part will discuss developments and exciting perspectives of DCE-MRI regarding the assessment of perfusion in the extremities. Emerging clinical applications of DCE-MRI will be reviewed with a special focus on investigation of physiology and pathophysiology of the microvascular and vascular systems of the extremities.
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Affiliation(s)
- Yaron Gordon
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Sasan Partovi
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Matthias Müller-Eschner
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Erick Amarteifio
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Tobias Bäuerle
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Marc-André Weber
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Hans-Ulrich Kauczor
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Fabian Rengier
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
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Delli Pizzi S, Madonna R, Caulo M, Romani GL, De Caterina R, Tartaro A. MR angiography, MR imaging and proton MR spectroscopy in-vivo assessment of skeletal muscle ischemia in diabetic rats. PLoS One 2012; 7:e44752. [PMID: 23028603 PMCID: PMC3448608 DOI: 10.1371/journal.pone.0044752] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 08/06/2012] [Indexed: 02/04/2023] Open
Abstract
To prospectively evaluate the feasibility of using magnetic resonance (MR) techniques for in-vivo assessing a rat diabetic model of limb ischemia. Unilateral hind limb ischemia was induced by ligation of the iliac-femoral artery in male streptozotocin-treated and non-diabetic control rats. Four weeks after ligation, rats underwent MR Angiography (MRA), T1-weighted and Short Time Inversion Recovery (STIR) sequences and muscle Proton MR Spectroscopy (1H-MRS) on both hind limbs. After MR examinations, immunoblotting and immunofluorescence analysis were performed. MRA showed a signal void due to flow discontinuation distal to the artery ligation. T1-weighted and STIR images showed, respectively, the presence of tissue swelling (p = 0.018 for non-diabetic; p = 0.027 for diabetic rats) and signal hyperintensity in tissue affected by occlusion. Mean total creatine/water for the occluded limb was significantly lower than for the non-occluded limbs in both non-diabetic (5.46×10−4 vs 1.14×10−3, p = 0.028) and diabetic rats (1.37×10−4 vs 1.10×10−3; p = 0.018). MR Imaging and 1H-MRS changes were more pronounced in diabetic than in non-diabetic occluded limbs (p = 0.032). MR findings were confirmed by using histological findings. Combined MR techniques can be used to demonstrate the presence of structural and metabolic changes produced by iliac-femoral artery occlusion in rat diabetic model of limb ischemia.
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Affiliation(s)
- Stefano Delli Pizzi
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, “G. d'Annunzio University” Foundation, Chieti, Italy
| | - Rosalinda Madonna
- Department of Neuroscience and Imaging, Cardiology Division of Center of Excellence on Aging, University “G. d'Annunzio”, Chieti, Italy
| | - Massimo Caulo
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, “G. d'Annunzio University” Foundation, Chieti, Italy
| | - Gian Luca Romani
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, “G. d'Annunzio University” Foundation, Chieti, Italy
| | - Raffaele De Caterina
- Department of Neuroscience and Imaging, Cardiology Division of Center of Excellence on Aging, University “G. d'Annunzio”, Chieti, Italy
| | - Armando Tartaro
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, “G. d'Annunzio University” Foundation, Chieti, Italy
- * E-mail:
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Versluis B, Dremmen MHG, Nelemans PJ, Wildberger JE, Schurink GW, Leiner T, Backes WH. Dynamic contrast-enhanced MRI assessment of hyperemic fractional microvascular blood plasma volume in peripheral arterial disease: initial findings. PLoS One 2012; 7:e37756. [PMID: 22662212 PMCID: PMC3360623 DOI: 10.1371/journal.pone.0037756] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 04/26/2012] [Indexed: 11/19/2022] Open
Abstract
Objectives The aim of the current study was to describe a method that assesses the hyperemic microvascular blood plasma volume of the calf musculature. The reversibly albumin binding contrast agent gadofosveset was used in dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) to assess the microvascular status in patients with peripheral arterial disease (PAD) and healthy controls. In addition, the reproducibility of this method in healthy controls was determined. Materials and Methods Ten PAD patients with intermittent claudication and 10 healthy control subjects were included. Patients underwent contrast-enhanced MR angiography of the peripheral arteries, followed by one DCE MRI examination of the musculature of the calf. Healthy control subjects were examined twice on different days to determine normative values and the interreader and interscan reproducibility of the technique. The MRI protocol comprised dynamic imaging of contrast agent wash-in under reactive hyperemia conditions of the calf musculature. Using pharmacokinetic modeling the hyperemic fractional microvascular blood plasma volume (Vp, unit: %) of the anterior tibial, gastrocnemius and soleus muscles was calculated. Results Vp was significantly lower for all muscle groups in PAD patients (4.3±1.6%, 5.0±3.3% and 6.1±3.6% for anterior tibial, gastrocnemius and soleus muscles, respectively) compared to healthy control subjects (9.1±2.0%, 8.9±1.9% and 9.3±2.1%). Differences in Vp between muscle groups were not significant. The coefficient of variation of Vp varied from 10–14% and 11–16% at interscan and interreader level, respectively. Conclusions Using DCE MRI after contrast-enhanced MR angiography with gadofosveset enables reproducible assessment of hyperemic fractional microvascular blood plasma volume of the calf musculature. Vp was lower in PAD patients than in healthy controls, which reflects a promising functional (hemodynamic) biomarker for the microvascular impairment of macrovascular lesions.
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Affiliation(s)
- Bas Versluis
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Marjolein H. G. Dremmen
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Patty J. Nelemans
- Department of Epidemiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Joachim E. Wildberger
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Geert-Willem Schurink
- Department of Surgery, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Tim Leiner
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Walter H. Backes
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
- * E-mail:
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Towards endometriosis diagnosis by gadofosveset-trisodium enhanced magnetic resonance imaging. PLoS One 2012; 7:e33241. [PMID: 22457748 PMCID: PMC3310862 DOI: 10.1371/journal.pone.0033241] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 02/06/2012] [Indexed: 11/19/2022] Open
Abstract
Endometriosis is defined as the presence of endometrial tissue outside the uterus. It affects 10-15% of women during reproductive age and has a big personal and social impact due to chronic pelvic pain, subfertility, loss of work-hours and medical costs. Such conditions are exacerbated by the fact that the correct diagnosis is made as late as 8-11 years after symptom presentation. This is due to the lack of a reliable non-invasive diagnostic test and the fact that the reference diagnostic standard is laparoscopy (invasive, expensive and not without risks). High-molecular weight gadofosveset-trisodium is used as contrast agent in Magnetic Resonance Imaging (MRI). Since it extravasates from hyperpermeable vessels more easily than from mature blood vessels, this contrast agent detects angiogenesis efficiently. Endometriosis has high angiogenic activity. Therefore, we have tested the possibility to detect endometriosis non-invasively using Dynamic Contrast-Enhanced MRI (DCE-MRI) and gadofosveset-trisodium as a contrast agent in a mouse model. Endometriotic lesions were surgically induced in nine mice by autologous transplantation. Three weeks after lesion induction, mice were scanned by DCE-MRI. Dynamic image analysis showed that the rates of uptake (inwash), persistence and outwash of the contrast agent were different between endometriosis and control tissues (large blood vessels and back muscle). Due to the extensive angiogenesis in induced lesions, the contrast agent persisted longer in endometriotic than control tissues, thus enhancing the MRI signal intensity. DCE-MRI was repeated five weeks after lesion induction, and contrast enhancement was similar to that observed three weeks after endometriosis induction. The endothelial-cell marker CD31 and the pericyte marker α-smooth-muscle-actin (mature vessels) were detected with immunohistochemistry and confirmed that endometriotic lesions had significantly higher prevalence of new vessels (CD31 only positive) than the uterus and control tissues. The diagnostic value of gadofosveset-trisodium to detect endometriosis should be tested in human settings.
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Goyault G, Bierry G, Holl N, Lhermitte B, Dietemann JL, Beregi JP, Kremer S. Diffusion-weighted MRI, dynamic susceptibility contrast MRI and ultrasound perfusion quantification of denervated muscle in rabbits. Skeletal Radiol 2012; 41:33-40. [PMID: 21308468 DOI: 10.1007/s00256-011-1108-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 12/16/2010] [Accepted: 01/14/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to assess denervated muscle perfusion using dynamic susceptibility contrast MRI (DSCMRI) and contrast-enhanced ultrasound (CEUS), and to measure denervated muscle apparent diffusion coefficient (ADC) on b1000 diffusion-weighted MRI (DWMRI) at 3 T in order to clarify whether muscle denervation leads to an increase in the extracellular extravascular space, or an increase in blood flow-or both. MATERIALS AND METHODS Axotomy of the right sciatic nerve of six white rabbits was performed at day 0. At day 9, hind limb muscles MRI and CEUS were performed to assess the consequences of denervation and both semimembranosus muscles of each rabbit were explanted for histological studies. Signal intensity on T2- and T1-weighted MRI, ADC on DWMRI, maximum signal drop (MSD) on DSCMRI and the area under the curve (AUC) on CEUS were measured over circular regions of interest (ROI), in both semimembranosus muscles. Non-parametric Wilcoxon matched-pairs tests were used to assess the mean differences between denervated and normal muscles. RESULTS T2 fat-saturated (FS) MRI studies showed a strong signal in the right semimembranosus muscles compared with the left side, and gadolinium enhancement was observed on T1 FS MRI. Denervated muscles show a significant increase in ADC on DWMRI (p < 0.01) and a significant signal enhancement on DSCMR imaging (p < 0.05) and on first-pass CEUS (p < 0.05). CONCLUSION The results of this study--based on perfusion- and diffusion-weighted images--suggest that, after denervation, both increased blood flow through muscle tissue and expansion of the extracellular water volume are present.
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Affiliation(s)
- G Goyault
- Department of Cardiovascular imaging, Cardiologic Hospital, University Hospital, 59037, Lille, Cedex, France.
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Schraml C, Schwenzer NF, Martirosian P, Claussen CD, Schick F. Temporal course of perfusion in human masseter muscle during isometric contraction assessed by arterial spin labeling at 3T. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2011; 24:201-9. [DOI: 10.1007/s10334-011-0254-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 04/19/2011] [Accepted: 04/19/2011] [Indexed: 11/29/2022]
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Sourbron SP, Buckley DL. On the scope and interpretation of the Tofts models for DCE-MRI. Magn Reson Med 2011; 66:735-45. [PMID: 21384424 DOI: 10.1002/mrm.22861] [Citation(s) in RCA: 267] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Revised: 12/13/2010] [Accepted: 01/10/2011] [Indexed: 11/06/2022]
Abstract
The Tofts model (TM) and extended Tofts model (ETM) have become a standard for the analysis of dynamic contrast-enhanced MRI. In this study, a mathematical analysis is used to identify exactly in which tissue types the Tofts models may be applied. The results show that the TM is accurate if and only if the tissue is weakly vascularised (small blood volume). The ETM is additionally accurate in highly perfused tissues (high blood flow). In tissues that are highly vascularised, or where tracer exchange is very fast or very slow, TM and ETM accurately fit the data but lead to a misinterpretation of the parameters. In tissue types with intermediate vascularity, perfusion and tracer exchange, neither model offers a good fit to the tissue concentrations. A good fit can be obtained with a measured input function by reducing the temporal resolution, but this does not improve the accuracy of the parameters. In conclusion, the Tofts models only produce reliable parameter values if the tissue is weakly vascularized (TM or ETM) or highly perfused (ETM). Without prior knowledge that at least one of these constraints is fulfilled, the physiological interpretation of the values produced by the Tofts models is unclear.
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Affiliation(s)
- Steven P Sourbron
- Division of Medical Physics, University of Leeds, Leeds, United Kingdom.
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Jaspers K, Leiner T, Dijkstra P, Oostendorp M, van Golde JM, Post MJ, Backes WH. Optimized pharmacokinetic modeling for the detection of perfusion differences in skeletal muscle with DCE-MRI: effect of contrast agent size. Med Phys 2011; 37:5746-55. [PMID: 21158286 DOI: 10.1118/1.3484057] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE The goal of this study was to optimize dynamic contrast-enhanced (DCE)-MRI analysis for differently sized contrast agents and to evaluate the sensitivity for microvascular differences in skeletal muscle. METHODS In rabbits, pathophysiological perfusion differences between hind limbs were induced by unilateral femoral artery ligation. On days 14 and 21, DCE-MRI was performed using a medium-sized contrast agent (MCA) (Gadomer) or a small contrast agent (SCA) (Gd-DTPA). Acquisition protocols were adapted to the pharmacokinetic properties of the contrast agent. Model-based data analysis was optimized by selecting the optimal model, considering fit error, estimation uncertainty, and parameter interdependency from three two-compartment pharmacokinetic models (normal and extended generalized kinetic models and Patlak model). Model-based parameters were compared to the model-free parameter area-under-curve (AUC). Finally, the sensitivity of transfer constant Krans and AUC for physiological and pathophysiological microvascular differences was evaluated. RESULTS For the MCA, the optimal model included Ktrans and plasma fraction nu(p). For the SCA, Ktrans and interstitial fraction nu(e) should be incorporated. For the MCA, Ktrans were (4.8 +/- 0.2) x 10(-3) min(-1) (mean standard error) and (3.6 +/- 0.1) x 10(-3) min(-1) for the red soleus and white tibialis muscle, respectively, p < 0.01. With the SCA, Ktrans were (81 +/- 5) x 10(-3) min(-1) (soleus) and (66 +/- 5) x 10(-3) min(-1) (tibialis) p < 0.01. In the ischemic limb, Ktrans was significantly decreased relative to the control limb (soleus: 15%-20%; tibialis: 5%-10%). Similar differences in AUC were found for both contrast agents. CONCLUSIONS For optimal estimation of microvascular parameters, both model-based and model-free analysis should be adapted to the pharmacokinetic properties of the contrast agent. The detection of microvascular differences based on both Ktrans and AUC was most sensitive when the analysis strategy was tailored to the contrast agent used. The MCA was equally sensitive for microvascular differences as the SCA, with the advantage of improved spatial resolution.
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Affiliation(s)
- Karolien Jaspers
- Cardiovascular Research Institute Maastricht, 6200 MD Maastricht, The Netherlands
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Jaspers K, Aerts HJWL, Leiner T, Oostendorp M, van Riel NAW, Post MJ, Backes WH. Reliability of pharmacokinetic parameters: small vs. medium-sized contrast agents. Magn Reson Med 2009; 62:779-87. [PMID: 19623622 DOI: 10.1002/mrm.22035] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Current clinical applications of dynamic contrast-enhanced MRI (DCE-MRI) are based on the extravasation of relatively small contrast agents (SCAs). SCAs are considered disadvantageous, as they require high image sampling rates. Medium-sized contrast agents (MCAs) leak more slowly into tissue and allow longer dynamic acquisition times, enabling improved image quality. The influence of molecular size on the reliability of pharmacokinetic parameters, including the transfer constant K(trans), was investigated. Computer simulations were performed, with in vivo measured arterial input functions (AIFs), to determine the bias and variance of pharmacokinetic parameters as a function of contrast agent size, sampling frequency, noise level, and acquisition time. Better reliability of all parameters was obtained for the MCA compared to the SCA. To obtain similar variance (10%) in K(trans), the sampling frequency for the SCA (28 min(-1)) had to be 20 times faster than for the MCA (1.3 min(-1)). Optimal reliability in parameter estimation required longer acquisition times for MCAs (13 min for the fraction of the extravascular extracellular space into which the contrast agent distributes (v(e)) and 5 min for K(trans)) than for SCAs (1.7 min for K(trans) and v(e)). Reliable estimation of the fractional blood plasma volume (v(p)) was only achieved with MCAs. In conclusion, MCAs provided superior reliability for pharmacokinetic parameter estimation compared to SCAs.
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Affiliation(s)
- Karolien Jaspers
- Department of Radiology, Maastricht University Medical Centre, Maastricht, the Netherlands
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