Diagnosis of Spinal Lesions Using Heuristic and Pharmacokinetic Parameters Measured by Dynamic Contrast-Enhanced MRI

Content Provider	Scilit
Author	Lang, Ning Yuan, Huishu Yu, Hon J. Su, Min-Ying
Copyright Year	2017
Description	Journal: Academic radiology 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 $K^{trans}$ and $k_{ep}$. 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 $k_{ep}$ and wash-out slope were highly correlated (r = 0.92), and they showed a similar diagnostic performance. The $K^{trans}$ 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.
Related Links	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6279440/pdf http://www.academicradiology.org/article/S1076633217300168/pdf
Ending Page	875
Page Count	9
Starting Page	867
ISSN	10766332
e-ISSN	18784046
DOI	10.1016/j.acra.2016.12.014
Journal	Academic radiology
Issue Number	7
Volume Number	24
Language	English
Publisher	Elsevier BV
Publisher Date	2017-02-02
Access Restriction	Open
Subject Keyword	Journal: Academic radiology Radiology, Nuclear Medicine and Imaging Dynamic Contrast-enhanced Mri Dce Kinetic Pattern Pharmacokinetic Analysis Spinal Lesion Diagnosis Wash-out Slope
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging