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Article

Comparison of Voxel-Wise Tumor Perfusion Changes Measured with Dynamic Contrast-Enhanced (DCE) MRI and Volumetric DCE CT in Patients with Metastatic Brain Cancer Treated with Radiosurgery

by
Catherine Coolens
1,2,3,4,*,
Brandon Driscoll
1,
Warren Foltz
1,2,
Carly Pellow
1,
Cynthia Menard
1,2,5 and
Caroline Chung
1,2,4
1
Radiation Medicine Program, Princess Margaret Cancer Center and University Health Network, Toronto, Ontario, Canada
2
Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
3
Institute of Biomaterials and Biomedical Engineering, University of Toronto, Ontario, Canada
4
TECHNA Institute, University Health Network, Toronto, Ontario, Canada
5
Department of Radiation Oncology, University of Montreal Hospital, Montreal, QC, Canada
*
Author to whom correspondence should be addressed.
Tomography 2016, 2(4), 325-333; https://doi.org/10.18383/j.tom.2016.00178
Submission received: 7 September 2016 / Revised: 8 October 2016 / Accepted: 10 November 2016 / Published: 1 December 2016

Abstract

Dynamic contrast-enhanced (DCE)-MRI metrics are evaluated against volumetric DCE-CT quantitative parameters as a standard for tracer-kinetic validation using a common 4-dimensional temporal dynamic analysis platform in tumor perfusion measurements following stereotactic radiosurgery (SRS) for brain metastases. Patients treated with SRS as part of Research Ethics Board-approved clinical trials underwent volumetric DCE-CT and DCE-MRI at baseline, then at 7 and 21 days after SRS. Temporal dynamic analysis was used to create 3-dimensional pharmacokinetic parameter maps for both modalities. Individual vascular input functions were selected for DCE-CT and a population function was used for DCE-MRI. Semiquantitative and pharmacokinetic DCE parameters were assessed using a modified Tofts model within each tumor at every time point for both modalities for characterization of perfusion and capillary permeability, as well as their dependency on precontrast relaxation times (TRs), T10, and input function. Direct voxel-to-voxel Pearson analysis showed statistically significant correlations between CT and magnetic resonance which peaked at day 7 for Ktrans (R = 0.74, P ≤ .0001). The strongest correlation to DCE-CT measurements was found with DCE-MRI analysis using voxel-wise T10 maps (R = 0.575, P < .001) instead of assigning a fixed T10 value. Comparison of histogram features showed statistically significant correlations between modalities over all tumors for median Ktrans (R = 0.42, P = .01), median area under the enhancement curve (iAUC90) (R = 0.55, P < .01), and median iAUC90 skewness (R = 0.34, P = .03). Statistically significant, strong correlations were found for voxel-wise Ktrans, iAUC90, and ve values between DCE-CT and DCE-MRI. For DCE-MRI, the implementation of voxel-wise T10 maps plays a key role in ensuring the accuracy of heterogeneous pharmacokinetic maps.
Keywords: DCE MRI; tumor response; quantitative imaging; biomarker; CT perfusion DCE MRI; tumor response; quantitative imaging; biomarker; CT perfusion

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MDPI and ACS Style

Coolens, C.; Driscoll, B.; Foltz, W.; Pellow, C.; Menard, C.; Chung, C. Comparison of Voxel-Wise Tumor Perfusion Changes Measured with Dynamic Contrast-Enhanced (DCE) MRI and Volumetric DCE CT in Patients with Metastatic Brain Cancer Treated with Radiosurgery. Tomography 2016, 2, 325-333. https://doi.org/10.18383/j.tom.2016.00178

AMA Style

Coolens C, Driscoll B, Foltz W, Pellow C, Menard C, Chung C. Comparison of Voxel-Wise Tumor Perfusion Changes Measured with Dynamic Contrast-Enhanced (DCE) MRI and Volumetric DCE CT in Patients with Metastatic Brain Cancer Treated with Radiosurgery. Tomography. 2016; 2(4):325-333. https://doi.org/10.18383/j.tom.2016.00178

Chicago/Turabian Style

Coolens, Catherine, Brandon Driscoll, Warren Foltz, Carly Pellow, Cynthia Menard, and Caroline Chung. 2016. "Comparison of Voxel-Wise Tumor Perfusion Changes Measured with Dynamic Contrast-Enhanced (DCE) MRI and Volumetric DCE CT in Patients with Metastatic Brain Cancer Treated with Radiosurgery" Tomography 2, no. 4: 325-333. https://doi.org/10.18383/j.tom.2016.00178

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