Diagnosis of Spinal Lesions Using Heuristic and Pharmacokinetic Parameters Measured by Dynamic Contrast-Enhanced MRI
Autor: | Ning Lang, Min-Ying Su, Huishu Yuan, Hon J. Yu |
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Rok vydání: | 2017 |
Předmět: |
Male
Pathology Contrast Media wash-out slope 030218 nuclear medicine & medical imaging Metastasis 0302 clinical medicine Diagnosis Heuristics Medicine Cancer screening and diagnosis medicine.diagnostic_test pharmacokinetic analysis Area under the curve Hematology Middle Aged Magnetic Resonance Imaging Detection Nuclear Medicine & Medical Imaging Area Under Curve Dynamic contrast-enhanced MRI Biomedical Imaging Female 4.2 Evaluation of markers and technologies Adult medicine.medical_specialty Clinical Sciences Article Diagnosis Differential 03 medical and health sciences Rare Diseases Pharmacokinetics Region of interest Humans Radiology Nuclear Medicine and imaging Retrospective Studies Aged Spinal Neoplasms Receiver operating characteristic business.industry Reproducibility of Results Magnetic resonance imaging Image Enhancement medicine.disease Good Health and Well Being ROC Curve Differential DCE kinetic pattern business Nuclear medicine spinal lesion diagnosis 030217 neurology & neurosurgery |
Zdroj: | Academic radiology, vol 24, iss 7 |
ISSN: | 1076-6332 |
DOI: | 10.1016/j.acra.2016.12.014 |
Popis: | Rationale and Objectives This study aimed to evaluate the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiation of four spinal lesions by using heuristic and pharmacokinetic parameters analyzed from DCE signal intensity time course. Materials and Methods DCE-MRI of 62 subjects with confirmed myeloma (n = 9), metastatic cancer (n = 22), lymphoma (n = 7), and inflammatory tuberculosis (TB) (n = 24) in the spine were analyzed retrospectively. The region of interest was placed on strongly enhanced tissues. The DCE time course was categorized as the “wash-out,” “plateau,” or “persistent enhancement” pattern. The maximum enhancement, steepest wash-in enhancement, and wash-out slope using the signal intensity at 67 seconds after contrast injection as reference were measured. The Tofts 2-compartmental pharmacokinetic model was applied to obtain Ktrans and kep. Pearson correlation between heuristic and pharmacokinetic parameters was evaluated, and receiver operating characteristic curve analysis was performed for pairwise group differentiation. Results The mean wash-out slope was −22% ± 10% for myeloma, 1% ± 0.4% for metastatic cancer, 3% ± 3% for lymphoma, and 7% ± 10% for TB, and it could significantly distinguish myeloma from metastasis (area under the curve [AUC] = 0.884), lymphoma (AUC = 1.0), and TB (AUC = 1.0) with P = .001, and distinguish metastasis from TB (AUC = 0.741) with P = .005. The kep and wash-out slope were highly correlated (r = 0.92), and they showed a similar diagnostic performance. The Ktrans was significantly correlated with the maximum enhancement (r = 0.71) and the steepest wash-in enhancement (r = 0.85), but they had inferior diagnostic performance compared to the wash-out slope. Conclusions DCE-MRI may provide additional diagnostic information, and a simple wash-out slope had the best diagnostic performance. The heuristic and pharmacokinetic parameters were highly correlated. |
Databáze: | OpenAIRE |
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