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European Radiology
Published in: European Radiology 9/2015

Open Access 01-09-2015 | Pediatric

Demonstration of the reproducibility of free-breathing diffusion-weighted MRI and dynamic contrast enhanced MRI in children with solid tumours: a pilot study

Authors: Keiko Miyazaki, Neil P. Jerome, David J. Collins, Matthew R. Orton, James A. d’Arcy, Toni Wallace, Lucas Moreno, Andrew D. J. Pearson, Lynley V. Marshall, Fernando Carceller, Martin O. Leach, Stergios Zacharoulis, Dow-Mu Koh

Published in: European Radiology | Issue 9/2015

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Abstract

Objectives

The objectives are to examine the reproducibility of functional MR imaging in children with solid tumours using quantitative parameters derived from diffusion-weighted (DW-) and dynamic contrast enhanced (DCE-) MRI.

Methods

Patients under 16-years-of age with confirmed diagnosis of solid tumours (n = 17) underwent free-breathing DW-MRI and DCE-MRI on a 1.5 T system, repeated 24 hours later. DW-MRI (6 b-values, 0-1000 sec/mm2) enabled monoexponential apparent diffusion coefficient estimation using all (ADC0-1000) and only ≥100 sec/mm2 (ADC100-1000) b-values. DCE-MRI was used to derive the transfer constant (Ktrans), the efflux constant (kep), the extracellular extravascular volume (ve), and the plasma fraction (vp), using a study cohort arterial input function (AIF) and the extended Tofts model. Initial area under the gadolinium enhancement curve and pre-contrast T1 were also calculated. Percentage coefficients of variation (CV) of all parameters were calculated.

Results

The most reproducible cohort parameters were ADC100-1000 (CV = 3.26 %), pre-contrast T1 (CV = 6.21 %), and Ktrans (CV = 15.23 %). The ADC100-1000 was more reproducible than ADC0-1000, especially extracranially (CV = 2.40 % vs. 2.78 %). The AIF (n = 9) derived from this paediatric population exhibited sharper and earlier first-pass and recirculation peaks compared with the literature’s adult population average.

Conclusions

Free-breathing functional imaging protocols including DW-MRI and DCE-MRI are well-tolerated in children aged 6 - 15 with good to moderate measurement reproducibility.

Key Points

• Diffusion MRI protocol is feasible and well-tolerated in a paediatric oncology population.
• DCE-MRI for pharmacokinetic evaluation is feasible and well tolerated in a paediatric oncology population.
• Paediatric arterial input function (AIF) shows systematic differences from the adult population-average AIF.
• Variation of quantitative parameters from paired functional MRI measurements were within 20 %.
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Metadata
Title
Demonstration of the reproducibility of free-breathing diffusion-weighted MRI and dynamic contrast enhanced MRI in children with solid tumours: a pilot study
Authors
Keiko Miyazaki
Neil P. Jerome
David J. Collins
Matthew R. Orton
James A. d’Arcy
Toni Wallace
Lucas Moreno
Andrew D. J. Pearson
Lynley V. Marshall
Fernando Carceller
Martin O. Leach
Stergios Zacharoulis
Dow-Mu Koh
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3666-7

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