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Open Access 01-07-2016 | Magnetic Resonance

Assessment of repeatability and treatment response in early phase clinical trials using DCE-MRI: comparison of parametric analysis using MR- and CT-derived arterial input functions

Authors: Mihaela Rata, David J. Collins, James Darcy, Christina Messiou, Nina Tunariu, Nandita Desouza, Helen Young, Martin O. Leach, Matthew R. Orton

Published in: European Radiology | Issue 7/2016

Abstract

Objectives

Pharmacokinetic (PK) modelling of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data requires a reliable measure of the arterial input function (AIF) to robustly characterise tumour vascular properties. This study compared repeatability and treatment-response effects of DCE-MRI-derived PK parameters using a population-averaged AIF and three patient-specific AIFs derived from pre-bolus MRI, DCE-MRI and dynamic contrast computed tomography (DC-CT) data.

Methods

The four approaches were compared in 13 patients with abdominal metastases. Baseline repeatability [Bland-Altman statistics; coefficient of variation (CoV)], cohort percentage change and p value (paired t test) and number of patients with significant DCE-MRI parameter change post-treatment (limits of agreement) were assessed.

Results

Individual AIFs were obtained for all 13 patients with pre-bolus MRI and DC-CT-derived AIFs, but only 10/13 patients had AIFs measurable from DCE-MRI data. The best CoV (7.5 %) of the transfer coefficient between blood plasma and extravascular extracellular space (K ^trans) was obtained using a population-averaged AIF. All four AIF methods detected significant treatment changes: the most significant was the DC-CT-derived AIF. The population-based AIF was similar to or better than the pre-bolus and DCE-MRI-derived AIFs.

Conclusions

A population-based AIF is the recommended approach for measuring cohort and individual effects since it has the best repeatability and none of the PK parameters derived using measured AIFs demonstrated an improvement in treatment sensitivity.

Key Points

• Pharmacokinetic modelling of DCE-MRI data requires a reliable measure of AIF.

• Individual MRI-DCE-derived AIFs cannot reliably be extracted from patients.

• All four AIF methods detected significant K ^trans changes after treatment.

• A population-based AIF can be recommended for measuring cohort treatment responses in trials.

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Title: Assessment of repeatability and treatment response in early phase clinical trials using DCE-MRI: comparison of parametric analysis using MR- and CT-derived arterial input functions
Authors: Mihaela Rata
David J. Collins
James Darcy
Christina Messiou
Nina Tunariu
Nandita Desouza
Helen Young
Martin O. Leach
Matthew R. Orton
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4012-9

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Assessment of repeatability and treatment response in early phase clinical trials using DCE-MRI: comparison of parametric analysis using MR- and CT-derived arterial input functions

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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