Quality-based pharmacokinetic model selection on DCE-MRI for characterizing orbital lesions

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Dynamic contrast-enhanced MRI (DCE-MRI) is valuable for orbital lesion detection and diagnosis.
• Previous studies have not evaluated pharmacokinetic models for orbital DCE-MRI.

Purpose of the Study:

• To select a quality-based pharmacokinetic model for characterizing orbital lesions using 3.0T DCE-MRI.
• To identify the most effective DCE-MRI pharmacokinetic model for orbital lesion analysis.

Main Methods:

• A prospective study included 151 patients with orbital lesions undergoing 3.0T DCE-MRI.
• Six pharmacokinetic models were tested, with analyses including univariate, multivariate, and ROC curve assessments.
• Model performance was evaluated on training and test datasets for sensitivity, specificity, and accuracy.

Main Results:

• Tissue blood flow and volume were significantly higher in malignant versus benign lesions.
• Extracellular volume fraction and permeability-surface area product were less relevant for discrimination.
• No significant differences in AUC were found between models, but the two-compartment exchange (2CX) model ranked highest in quality.

Conclusions:

• DCE-MRI pharmacokinetic parameters effectively distinguish benign from malignant orbital lesions.
• The 2CX model offers the best modeling quality and is recommended for clinical use.
• Perfusion-related DCE parameters are crucial for the diagnostic process in orbital lesions.