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Lewis D, Li KL, Waqar M, Coope DJ, Pathmanaban ON, King AT, Djoukhadar I, Zhao S, Cootes TF, Jackson A, Zhu X. Low-dose GBCA administration for brain tumour dynamic contrast enhanced MRI: a feasibility study. Sci Rep 2024; 14:4905. [PMID: 38418818 PMCID: PMC10902320 DOI: 10.1038/s41598-024-53871-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 02/06/2024] [Indexed: 03/02/2024] Open
Abstract
A key limitation of current dynamic contrast enhanced (DCE) MRI techniques is the requirement for full-dose gadolinium-based contrast agent (GBCA) administration. The purpose of this feasibility study was to develop and assess a new low GBCA dose protocol for deriving high-spatial resolution kinetic parameters from brain DCE-MRI. Nineteen patients with intracranial skull base tumours were prospectively imaged at 1.5 T using a single-injection, fixed-volume low GBCA dose, dual temporal resolution interleaved DCE-MRI acquisition. The accuracy of kinetic parameters (ve, Ktrans, vp) derived using this new low GBCA dose technique was evaluated through both Monte-Carlo simulations (mean percent deviation, PD, of measured from true values) and an in vivo study incorporating comparison with a conventional full-dose GBCA protocol and correlation with histopathological data. The mean PD of data from the interleaved high-temporal-high-spatial resolution approach outperformed use of high-spatial, low temporal resolution datasets alone (p < 0.0001, t-test). Kinetic parameters derived using the low-dose interleaved protocol correlated significantly with parameters derived from a full-dose acquisition (p < 0.001) and demonstrated a significant association with tissue markers of microvessel density (p < 0.05). Our results suggest accurate high-spatial resolution kinetic parameter mapping is feasible with significantly reduced GBCA dose.
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Affiliation(s)
- Daniel Lewis
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK.
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Stott Lane, Salford, Greater Manchester, M6 8HD, UK.
| | - Ka-Loh Li
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Mueez Waqar
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - David J Coope
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Omar N Pathmanaban
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - Andrew T King
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - Ibrahim Djoukhadar
- Department of Neuroradiology, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sha Zhao
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Timothy F Cootes
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Alan Jackson
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Xiaoping Zhu
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Ren Z, Easley TO, Pineda FD, Guo X, Barber RF, Karczmar GS. Pharmacokinetic Analysis of Enhancement-Constrained Acceleration (ECA) reconstruction-based high temporal resolution breast DCE-MRI. PLoS One 2023; 18:e0286123. [PMID: 37319275 PMCID: PMC10270582 DOI: 10.1371/journal.pone.0286123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
The high spatial and temporal resolution of dynamic contrast-enhanced MRI (DCE-MRI) can improve the diagnostic accuracy of breast cancer screening in patients who have dense breasts or are at high risk of breast cancer. However, the spatiotemporal resolution of DCE-MRI is limited by technical issues in clinical practice. Our earlier work demonstrated the use of image reconstruction with enhancement-constrained acceleration (ECA) to increase temporal resolution. ECA exploits the correlation in k-space between successive image acquisitions. Because of this correlation, and due to the very sparse enhancement at early times after contrast media injection, we can reconstruct images from highly under-sampled k-space data. Our previous results showed that ECA reconstruction at 0.25 seconds per image (4 Hz) can estimate bolus arrival time (BAT) and initial enhancement slope (iSlope) more accurately than a standard inverse fast Fourier transform (IFFT) when k-space data is sampled following a Cartesian based sampling trajectory with adequate signal-to-noise ratio (SNR). In this follow-up study, we investigated the effect of different Cartesian based sampling trajectories, SNRs and acceleration rates on the performance of ECA reconstruction in estimating contrast media kinetics in lesions (BAT, iSlope and Ktrans) and in arteries (Peak signal intensity of first pass, time to peak, and BAT). We further validated ECA reconstruction with a flow phantom experiment. Our results show that ECA reconstruction of k-space data acquired with 'Under-sampling with Repeated Advancing Phase' (UnWRAP) trajectories with an acceleration factor of 14, and temporal resolution of 0.5 s/image and high SNR (SNR ≥ 30 dB, noise standard deviation (std) < 3%) ensures minor errors (5% or 1 s error) in lesion kinetics. Medium SNR (SNR ≥ 20 dB, noise std ≤ 10%) was needed to accurately measure arterial enhancement kinetics. Our results also suggest that accelerated temporal resolution with ECA with 0.5 s/image is practical.
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Affiliation(s)
- Zhen Ren
- Department of Radiology, The University of Chicago, Chicago, Illinois, United States of America
| | - Ty O. Easley
- McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Federico D. Pineda
- Department of Radiology, The University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Xiaodong Guo
- Department of Radiology, The University of Chicago, Chicago, Illinois, United States of America
| | - Rina F. Barber
- Department of Statistics, The University of Chicago, Chicago, Illinois, United States of America
| | - Gregory S. Karczmar
- Department of Radiology, The University of Chicago, Chicago, Illinois, United States of America
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Ren Z, Pineda FD, Howard FM, Hill E, Szasz T, Safi R, Medved M, Nanda R, Yankeelov TE, Abe H, Karczmar GS. Differences Between Ipsilateral and Contralateral Early Parenchymal Enhancement Kinetics Predict Response of Breast Cancer to Neoadjuvant Therapy. Acad Radiol 2022; 29:1469-1479. [PMID: 35351365 DOI: 10.1016/j.acra.2022.02.008] [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: 10/25/2021] [Revised: 02/02/2022] [Accepted: 02/08/2022] [Indexed: 12/14/2022]
Abstract
RATIONALE AND OBJECTIVES To determine whether kinetics measured with ultrafast dynamic contrast-enhanced magnetic resonance imaging in tumor and normal parenchyma pre- and post-neoadjuvant therapy (NAT) can predict the response of breast cancer to NAT. MATERIALS AND METHODS Twenty-four patients with histologically confirmed invasive breast cancer were enrolled. They were scanned with ultrafast dynamic contrast-enhanced magnetic resonance imaging (3-7 seconds/frame) pre- and post-NAT. Four kinetic parameters were calculated in the segmented tumors, and ipsi- and contra-lateral normal parenchyma: (1) tumor (tSE30) or background parenchymal relative enhancement at 30 seconds (BPE30), (2) maximum relative enhancement slope (MaxSlope), (3) bolus arrival time (BAT), and (4) area under relative signal enhancement curve for the initial 30 seconds (AUC30). The tumor kinetics and the differences between ipsi- and contra-lateral parenchymal kinetics were compared for patients achieving pathologic complete response (pCR) vs those who had residual disease after NAT. The chi-squared test and two-sided t-test were used for baseline demographics. The Wilcoxon rank sum test and one-way analysis of variance were used for differential responses to therapy. RESULTS Patients with similar pre-NAT mean BPE30, median BAT and mean AUC30 in the ipsi- and contralateral normal parenchyma were more likely to achieve pCR following NAT (p < 0.02). Patients classified as having residual cancer burden (RCB) II after NAT showed higher post-NAT tSE30 and tumor AUC30 and higher post-NAT MaxSlope in ipsilateral normal parenchyma compared to those classified as RCB I or pCR (p < 0.05). CONCLUSION Bilateral asymmetry in normal parenchyma could predict treatment outcome prior to NAT. Post-NAT tumor kinetics could evaluate the aggressiveness of residual tumor.
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Affiliation(s)
- Zhen Ren
- Department of Radiology, The University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637
| | - Federico D Pineda
- Department of Radiology, The University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637
| | - Frederick M Howard
- Section of Hematology and Oncology, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Elle Hill
- Department of Radiology, The University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637
| | - Teodora Szasz
- Research Computing Center, The University of Chicago, Chicago, Illinois
| | - Rabia Safi
- Department of Radiology, The University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637
| | - Milica Medved
- Department of Radiology, The University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637
| | - Rita Nanda
- Section of Hematology and Oncology, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Thomas E Yankeelov
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas; Department of Diagnostic Medicine, The University of Texas at Austin, Austin, Texas; Department of Oncology, The University of Texas at Austin, Austin, Texas; Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, Texas; Livestrong Cancer Institutes, The University of Texas at Austin, Austin, Texas; Department of Imaging Physics, MD Anderson Cancer Center, Houston, Texas
| | - Hiroyuki Abe
- Department of Radiology, The University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637
| | - Gregory S Karczmar
- Department of Radiology, The University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637.
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