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Updated: Mar 1, 2026
Whole-body PET/MRI of Pediatric Patients: The Details That Matter
Published on: December 19, 2017
T1-weighted dynamic contrast-enhanced brain magnetic resonance imaging: A preliminary study with low infusion rate in
Bruno-Bernard Rochetams1, Bénédicte Marechal2,3, Jean-Philippe Cottier4,5
11 Department of Pediatric Radiology, Clocheville Hospital, CHRU, Tours, France.
Insights
Dynamic contrast-enhanced MRI in pediatric patients at 1.5T is feasible with a low injection rate. This technique shows promise for differentiating pediatric brain tumor grades using pharmacokinetic parameters like Ktrans.
Area of Science:
- Radiology
- Pediatric Imaging
- Neuro-oncology
Background:
- Dynamic contrast-enhanced (DCE) MRI is a valuable tool for evaluating brain lesions.
- Assessing pediatric brain tumors requires accurate grading for treatment planning.
Purpose of the Study:
- To evaluate the feasibility and diagnostic performance of T1-weighted DCE MRI at 1.5T in pediatric patients.
- To assess the utility of pharmacokinetic parameters derived from DCE MRI in differentiating brain tumor grades.
Main Methods:
- Prospective examination of pediatric patients with neurological symptoms using conventional and T1-weighted DCE MRI at 1.5T.
- Analysis of time-concentration curves and calculation of pharmacokinetic parameters (e.g., Ktrans).
- Comparison of Ktrans ratios between tumor tissue and surrounding/contralateral tissue, correlated with WHO tumor grade.
Main Results:
- Analyzable concentration-time curves were obtained in all 18 pediatric patients.
- Significant differences in Ktrans between tumor and surrounding/contralateral tissue (p=0.034).
- Ktrans ratios significantly differed between WHO Grade I and Grade IV tumors (p=0.027), with a Ktrans ratio > 0.63 discriminating Grade IV malignancy.
Conclusions:
- Pediatric T1-weighted DCE MRI at 1.5T with a low injection rate is feasible.
- DCE MRI-derived pharmacokinetic parameters, particularly Ktrans ratios, can aid in differentiating pediatric brain tumor grades.
- This technique holds potential for improving diagnostic accuracy in pediatric neuro-oncology.
Abstract:
Background The aim of this preliminary study is to evaluate the results of T1-weighted dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in pediatric patients at 1.5T, with a low peripheral intravenous gadoteric acid injection rate of 1 ml/s. Materials and methods Children with neurological symptoms were examined prospectively with conventional MRI and T1-weighted DCE MRI. An magnetic resonance perfusion analysis method was used to obtain time-concentration curves (persistent pattern, type-I; plateau pattern, type-II; washout pattern, type-III) and to calculate pharmacokinetic parameters. A total of two radiologists manually defined regions of interest (ROIs) in the part of the lesion exhibiting the greatest contrast enhancement and in the surrounding normal or contralateral tissue. Lesion/surrounding tissue or contralateral tissue pharmacokinetic parameter ratios were calculated. Tumors were categorized by grade (I-IV) using the World Health Organization (WHO) Grade. Mann-Whitney testing and receiver-operating characteristic (ROC) curves were performed. Results A total of nine boys and nine girls (mean age 10.5 years) were included. Lesions consisted of 10 brain tumors, 3 inflammatory lesions, 3 arteriovenous malformations and 2 strokes. We obtained analyzable concentration-time curves for all patients (6 type-I, 9 type-II, 3 type-III). Ktrans between tumor tissue and surrounding or contralateral tissue was significantly different ( p = 0.034). Ktrans ratios were significantly different between grade I tumors and grade IV tumors ( p = 0.027) and a Ktrans ratio value superior to 0.63 appeared to be discriminant to determine a grade IV of malignancy. Conclusions Our results confirm the feasibility of pediatric T1-weighted DCE MRI at 1.5T with a low injection rate, which could be of great value in differentiating brain tumor grades.
