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
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