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

Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address:
Elsevier Science
Publication Date:
Acad Radiol
Volume Number:
Issue Number:
Acad Radiol. 2019 Sep;26(9):e241-e251.
PubMed ID:
Cancer imaging, Magnetic resonance, Pharmacokinetic modeling, Prostate, Test-retest, Treatment response
Appears in Collections:
P41 EB015898/EB/NIBIB NIH HHS/United States
P41 EB015902/EB/NIBIB NIH HHS/United States
U01 CA151261/CA/NCI NIH HHS/United States
U24 CA180918/CA/NCI NIH HHS/United States
Generated Citation:
Peled S., Vangel M., Kikinis R., Tempany C.M., Fennessy F.M., Fedorov A. Selection of Fitting Model and Arterial Input Function for Repeatability in Dynamic Contrast-Enhanced Prostate MRI. Acad Radiol. 2019 Sep;26(9):e241-e251. PMID: 30467073. PMCID: PMC6526092.
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RATIONALE AND OBJECTIVES: Analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging is notable for the variability of calculated parameters. The purpose of this study was to evaluate the level of measurement variability and error/variability due to modeling in DCE magnetic resonance imaging parameters. MATERIALS AND METHODS: Two prostate DCE scans were performed on 11 treatment-naïve patients with suspected or confirmed prostate peripheral zone cancer within an interval of less than two weeks. Tumor-suspicious and normal-appearing regions of interest (ROI) in the prostate peripheral zone were segmented. Different Tofts-Kety based models and different arterial input functions, with and without bolus arrival time (BAT) correction, were used to extract pharmacokinetic parameters. The percent repeatability coefficient (%RC) of fitted model parameters Ktrans, ve, and kep was calculated. Paired t-tests comparing parameters in tumor-suspicious ROIs and in normal-appearing tissue evaluated each parameter's sensitivity to pathology. RESULTS: Although goodness-of-fit criteria favored the four-parameter extended Tofts-Kety model with the BAT correction included, the simplest two-parameter Tofts-Kety model overall yielded the best repeatability scores. The best %RC in the tumor-suspicious ROI was 63% for kep, 28% for ve, and 83% for Ktrans . The best p values for discrimination between tissues were p <10-5 for kep and Ktrans, and p = 0.11 for ve. Addition of the BAT correction to the models did not improve repeatability. CONCLUSION: The parameter kep, using an arterial input functions directly measured from blood signals, was more repeatable than Ktrans. Both Ktrans and kep values were highly discriminatory between healthy and diseased tissues in all cases. The parameter ve had high repeatability but could not distinguish the two tissue types.