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Estimating the arterial input function from dynamic contrast-enhanced MRI data with compensation for flow enhancement
Jeroen J N van Schie1, Cristina Lavini2, Lucas J van Vliet1
1Quantitative Imaging Group, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands.
Background:
Pharmacokinetic (PK) models can describe microvascular density and integrity. An essential component of PK models is the arterial input function (AIF) representing the time-dependent concentration of contrast agent (CA) in the blood plasma supplied to a tissue.
Purpose/Hypothesis:
To evaluate a novel method for subject-specific AIF estimation that takes inflow effects into account.
Study Type:
Retrospective study.
Subjects:
Thirteen clinical patients referred for spine-related complaints; 21 patients from a study into luminal Crohn's disease with known Crohn's Disease Endoscopic Index of Severity (CDEIS).
Field Strength/Sequence:
Dynamic fast spoiled gradient echo (FSPGR) at 3T.
Assessment:
A population-averaged AIF, AIFs derived from distally placed regions of interest (ROIs), and the new AIF method were applied. Tofts' PK model parameters (including vp and Ktrans ) obtained with the three AIFs were compared. In the Crohn's patients Ktrans was correlated to CDEIS.
Statistical Tests:
The median values of the PK model parameters from the three methods were compared using a Mann-Whitney U-test. The associated variances were statistically assessed by the Brown-Forsythe test. Spearman's rank correlation coefficient was computed to test the correlation of Ktrans to CDEIS.
Results:
The median vp was significantly larger when using the distal ROI approach, compared to the two other methods (P < 0.05 for both comparisons, in both applications). Also, the variances in vp were significantly larger with the ROI approach (P < 0.05 for all comparisons). In the Crohn's disease study, the estimated Ktrans parameter correlated better with the CDEIS (r = 0.733, P < 0.001) when the proposed AIF was used, compared to AIFs from the distal ROI method (r = 0.429, P = 0.067) or the population-averaged AIF (r = 0.567, P = 0.011).
Data Conclusion:
The proposed method yielded realistic PK model parameters and improved the correlation of the Ktrans parameter with CDEIS, compared to existing approaches.
Level Of Evidence:
3 Technical Efficacy Stage 1 J. Magn. Reson. Imaging 2018;47:1197-1204.
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