Delay of Aortic Arterial Input Function Time Improves Detection of Malignant Vertebral Body Lesions on Dynamic Contrast-Enhanced MRI Perfusion
Dynamic contrast-enhanced MRI (DCE) is an emerging modality in the study of vertebral body malignancies. DCE-MRI analysis relies on a pharmacokinetic model, which assumes that contrast uptake is simultaneous in the feeding of arteries and tissues of interest. While true in the highly vascularized br...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/8/2353 |
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| author | Felipe Camelo Kyung K. Peck Atin Saha Julio Arevalo-Perez John K. Lyo Jamie Tisnado Eric Lis Sasan Karimi Andrei I. Holodny |
| author_facet | Felipe Camelo Kyung K. Peck Atin Saha Julio Arevalo-Perez John K. Lyo Jamie Tisnado Eric Lis Sasan Karimi Andrei I. Holodny |
| author_sort | Felipe Camelo |
| collection | DOAJ |
| description | Dynamic contrast-enhanced MRI (DCE) is an emerging modality in the study of vertebral body malignancies. DCE-MRI analysis relies on a pharmacokinetic model, which assumes that contrast uptake is simultaneous in the feeding of arteries and tissues of interest. While true in the highly vascularized brain, the perfusion of the spine is delayed. This delay of contrast reaching vertebral body lesions can affect DCE-MRI analyses, leading to misdiagnosis for the presence of active malignancy in the bone marrow. To overcome the limitation of delayed contrast arrival to vertebral body lesions, we shifted the arterial input function (AIF) curve over a series of phases and recalculated the plasma volume values (V<sub>p</sub>) for each phase shift. We hypothesized that shifting the AIF tracer curve would better reflect actual contrast perfusion, thereby improving the accuracy of V<sub>p</sub> maps in metastases. We evaluated 18 biopsy-proven vertebral body metastases in which standard DCE-MRI analysis failed to demonstrate the expected increase in V<sub>p</sub>. We manually delayed the AIF curve for multiple phases, defined as the scan-specific phase temporal resolution, and analyzed DCE-MRI parameters with the new AIF curves. All patients were found to require at least one phase-shift delay in the calculated AIF to better visualize metastatic spinal lesions and improve quantitation of V<sub>p</sub>. Average normalized V<sub>p</sub> values were 1.78 ± 1.88 for zero phase shifts (P0), 4.72 ± 4.31 for one phase shift (P1), and 5.59 ± 4.41 for two phase shifts (P2). Mann–Whitney U tests obtained <i>p</i>-values = 0.003 between P0 and P1, and 0.0004 between P0 and P2. This study demonstrates that image processing analysis for DCE-MRI in patients with spinal metastases requires a careful review of signal intensity curve, as well as a possible adjustment of the phase of aortic AIF to increase the accuracy of V<sub>p</sub>. |
| first_indexed | 2024-03-11T05:10:25Z |
| format | Article |
| id | doaj.art-c1b7296e36ca4463b0835f1886c5ff83 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T05:10:25Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-c1b7296e36ca4463b0835f1886c5ff832023-11-17T18:39:49ZengMDPI AGCancers2072-66942023-04-01158235310.3390/cancers15082353Delay of Aortic Arterial Input Function Time Improves Detection of Malignant Vertebral Body Lesions on Dynamic Contrast-Enhanced MRI PerfusionFelipe Camelo0Kyung K. Peck1Atin Saha2Julio Arevalo-Perez3John K. Lyo4Jamie Tisnado5Eric Lis6Sasan Karimi7Andrei I. Holodny8Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADynamic contrast-enhanced MRI (DCE) is an emerging modality in the study of vertebral body malignancies. DCE-MRI analysis relies on a pharmacokinetic model, which assumes that contrast uptake is simultaneous in the feeding of arteries and tissues of interest. While true in the highly vascularized brain, the perfusion of the spine is delayed. This delay of contrast reaching vertebral body lesions can affect DCE-MRI analyses, leading to misdiagnosis for the presence of active malignancy in the bone marrow. To overcome the limitation of delayed contrast arrival to vertebral body lesions, we shifted the arterial input function (AIF) curve over a series of phases and recalculated the plasma volume values (V<sub>p</sub>) for each phase shift. We hypothesized that shifting the AIF tracer curve would better reflect actual contrast perfusion, thereby improving the accuracy of V<sub>p</sub> maps in metastases. We evaluated 18 biopsy-proven vertebral body metastases in which standard DCE-MRI analysis failed to demonstrate the expected increase in V<sub>p</sub>. We manually delayed the AIF curve for multiple phases, defined as the scan-specific phase temporal resolution, and analyzed DCE-MRI parameters with the new AIF curves. All patients were found to require at least one phase-shift delay in the calculated AIF to better visualize metastatic spinal lesions and improve quantitation of V<sub>p</sub>. Average normalized V<sub>p</sub> values were 1.78 ± 1.88 for zero phase shifts (P0), 4.72 ± 4.31 for one phase shift (P1), and 5.59 ± 4.41 for two phase shifts (P2). Mann–Whitney U tests obtained <i>p</i>-values = 0.003 between P0 and P1, and 0.0004 between P0 and P2. This study demonstrates that image processing analysis for DCE-MRI in patients with spinal metastases requires a careful review of signal intensity curve, as well as a possible adjustment of the phase of aortic AIF to increase the accuracy of V<sub>p</sub>.https://www.mdpi.com/2072-6694/15/8/2353spine metastasesperfusiondynamic contrast-enhanced MRIarterial input function |
| spellingShingle | Felipe Camelo Kyung K. Peck Atin Saha Julio Arevalo-Perez John K. Lyo Jamie Tisnado Eric Lis Sasan Karimi Andrei I. Holodny Delay of Aortic Arterial Input Function Time Improves Detection of Malignant Vertebral Body Lesions on Dynamic Contrast-Enhanced MRI Perfusion Cancers spine metastases perfusion dynamic contrast-enhanced MRI arterial input function |
| title | Delay of Aortic Arterial Input Function Time Improves Detection of Malignant Vertebral Body Lesions on Dynamic Contrast-Enhanced MRI Perfusion |
| title_full | Delay of Aortic Arterial Input Function Time Improves Detection of Malignant Vertebral Body Lesions on Dynamic Contrast-Enhanced MRI Perfusion |
| title_fullStr | Delay of Aortic Arterial Input Function Time Improves Detection of Malignant Vertebral Body Lesions on Dynamic Contrast-Enhanced MRI Perfusion |
| title_full_unstemmed | Delay of Aortic Arterial Input Function Time Improves Detection of Malignant Vertebral Body Lesions on Dynamic Contrast-Enhanced MRI Perfusion |
| title_short | Delay of Aortic Arterial Input Function Time Improves Detection of Malignant Vertebral Body Lesions on Dynamic Contrast-Enhanced MRI Perfusion |
| title_sort | delay of aortic arterial input function time improves detection of malignant vertebral body lesions on dynamic contrast enhanced mri perfusion |
| topic | spine metastases perfusion dynamic contrast-enhanced MRI arterial input function |
| url | https://www.mdpi.com/2072-6694/15/8/2353 |
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