Dataset Information

Clinical Implementation of a Free-Breathing, Motion-Robust Dynamic Contrast-Enhanced MRI Protocol to Evaluate Pleural Tumors.

ABSTRACT: OBJECTIVE. The purpose of this study was to develop a motion insensitive clinical dynamic contrast-enhanced MRI (DCE-MRI) protocol to assess the response of pleural tumors in clinical trials. MATERIALS AND METHODS. Thirty-two patients with pleura-based lesions were administered contrast material and imaged with gradient-recalled echo DCE-MRI sequence variants: either a traditional cartesian k-space acquisition (FLASH), a time-resolved imaging with stochastic trajectories acquisition (TWIST), or a radial stack-of-stars acquisition (radial) sequence in addition to other standard-of-care imaging sequences. Each image acquisition's sensitivity to motion was evaluated by comparing the motion of the thoracic border in 3D throughout the acquisition. One-way ANOVA was used to compare the image quality between different acquisitions. The 95% CIs were calculated for mean thoracic border displacement. The effects of motion on kinetic parameter estimation were explored with simulations according to clinically acquired data. RESULTS. Radial was the most motion-robust sequence with subvoxel mean displacement in the superior-inferior direction (0.4 ± 1.2 [SD] mm). FLASH showed intermediate displacement (4.6 ± 2.0 mm), whereas TWIST was most sensitive to motion (6.4 ± 3.4 mm). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the images acquired with the radial sequence were on par or better than the FLASH and TWIST sequences when reconstructed with an improved density compensation algorithm. Simulations showed that motion on scans showing pleural-based lesions can lead to markedly inaccurate kinetic parameter estimation and inappropriate kinetic model convergence within a nested model analysis. CONCLUSION. A practical radial k-space trajectory sequence that provides motion-insensitive pharmacokinetic parameters was incorporated as part of the DCE-MRI protocol of pleural tumors. Validation and usefulness in clinical trials assessing response to therapy is needed.

SUBMITTER: Ng TSC

PROVIDER: S-EPMC7341067 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Clinical Implementation of a Free-Breathing, Motion-Robust Dynamic Contrast-Enhanced MRI Protocol to Evaluate Pleural Tumors.

Ng Thomas S C TSC Seethamraju Ravi T RT Bueno Raphael R Gill Ritu R RR

AJR. American journal of roentgenology 20200429 1

<b>OBJECTIVE.</b> The purpose of this study was to develop a motion insensitive clinical dynamic contrast-enhanced MRI (DCE-MRI) protocol to assess the response of pleural tumors in clinical trials. <b>MATERIALS AND METHODS.</b> Thirty-two patients with pleura-based lesions were administered contrast material and imaged with gradient-recalled echo DCE-MRI sequence variants: either a traditional cartesian k-space acquisition (FLASH), a time-resolved imaging with stochastic trajectories acquisitio ...[more]

PMID: 32348181

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Project description:BACKGROUND:Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been shown to be a promising technique for assessing lung lesions. However, DCE-MRI often suffers from motion artifacts and insufficient imaging speed. Therefore, highly accelerated free-breathing DCE-MRI is of clinical interest for lung exams. PURPOSE:To test the performance of rapid free-breathing DCE-MRI for simultaneous qualitative and quantitative assessment of pulmonary lesions using Golden-angle RAdial Sparse Parallel (GRASP) imaging. STUDY TYPE:Prospective. POPULATION:Twenty-six patients (17 males, mean age?=?55.1?±?14.4) with known pulmonary lesions. FIELD STRENGTH/SEQUENCE:3T MR scanner; a prototype fat-saturated, T1 -weighted stack-of-stars golden-angle radial sequence for data acquisition and a Cartesian breath-hold volumetric-interpolated examination (BH-VIBE) sequence for comparison. ASSESSMENT:After a dual-mode GRASP reconstruction, one with 3-second temporal resolution (3s-GRASP) and the other with 15-second temporal resolution (15s-GRASP), all GRASP and BH-VIBE images were pooled together for blind assessment by two experienced radiologists, who independently scored the overall image quality, lesion delineation, overall artifact level, and diagnostic confidence of each case. Perfusion analysis was performed for the 3s-GRASP images using a Tofts model to generate the volume transfer coefficient (Ktrans ) and interstitial volume (Ve ). STATISTICAL TESTS:Nonparametric paired two-tailed Wilcoxon signed-rank test; Cohen's kappa; unpaired Student's t-test. RESULTS:15s-GRASP achieved comparable image quality with conventional BH-VIBE (P?>?0.05), except for the higher overall artifact level in the precontrast phase (P?=?0.018). The Ktrans and Ve in inflammation were higher than those in malignant lesions (Ktrans : 0.78?±?0.52?min-1 vs. 0.37?±?0.22?min-1 , P?=?0.020; Ve : 0.36?±?0.16 vs. 0.26?±?0.1, P?=?0.177). Also, the Ktrans and Ve in malignant lesions were also higher than those in benign lesions (Ktrans : 0.37?±?0.22?min-1 vs. 0.04?±?0.04?min-1 , P?=?0.001; Ve : 0.26?±?0.12 vs. 0.10?±?0.00, P?=?0.063). DATA CONCLUSION:This feasibility study demonstrated the performance of high spatiotemporal resolution free-breathing DCE-MRI of the lung using GRASP for qualitative and quantitative assessment of pulmonary lesions. LEVEL OF EVIDENCE:2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2018;48:459-468.

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Dataset Information

Clinical Implementation of a Free-Breathing, Motion-Robust Dynamic Contrast-Enhanced MRI Protocol to Evaluate Pleural Tumors.

Publications

Clinical Implementation of a Free-Breathing, Motion-Robust Dynamic Contrast-Enhanced MRI Protocol to Evaluate Pleural Tumors.

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