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Selection of Fitting Model and Arterial Input Function for Repeatability in Dynamic Contrast-Enhanced Prostate MRI.

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Summary

The pharmacokinetic parameter k_ep showed better repeatability in dynamic contrast-enhanced MRI than K_trans, with both effectively distinguishing prostate cancer tissues. The parameter v_e demonstrated high repeatability but lacked discriminatory power.

Keywords:
Cancer imagingMagnetic resonancePharmacokinetic modelingProstateTest-retestTreatment response

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Area of Science:

  • Radiology
  • Medical Imaging
  • Oncology

Background:

  • Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) parameter analysis is prone to variability.
  • Understanding and minimizing measurement variability and modeling errors in DCE-MRI parameters is crucial for accurate clinical interpretation.

Purpose of the Study:

  • To evaluate measurement variability and modeling-induced errors in DCE-MRI parameters for prostate cancer.
  • To assess the repeatability and discriminatory power of pharmacokinetic parameters derived from DCE-MRI.

Main Methods:

  • 11 patients with suspected prostate cancer underwent two DCE-MRI scans.
  • Tofts-Kety models with varying arterial input functions and bolus arrival time (BAT) correction were applied.
  • Repeatability coefficients (%RC) for Ktrans, ve, and kep were calculated, and paired t-tests assessed tissue discrimination.

Main Results:

  • The simplest two-parameter Tofts-Kety model provided the best repeatability scores.
  • The best %RC in tumor-suspicious regions were 63% for kep, 28% for ve, and 83% for Ktrans.
  • kep and Ktrans showed significant discrimination between healthy and tumor tissues (p <10-5), while ve did not (p = 0.11).

Conclusions:

  • The parameter kep, when using directly measured blood signals as the arterial input function, exhibited superior repeatability compared to Ktrans.
  • Both Ktrans and kep are highly effective in differentiating between healthy and diseased prostate tissues.
  • The parameter ve, despite its repeatability, lacks the ability to distinguish between these tissue types.