Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing

Zhang, Qihao; Lee, Kyungmouk Steve; Talenfeld, Adam D.; Spincemaille, Pascal; Prince, Martin R.; Wang, Yi

doi:10.3390/tomography8060224

Open AccessArticle

Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing

by

Qihao Zhang

¹,

Kyungmouk Steve Lee

²,

Adam D. Talenfeld

²,

Pascal Spincemaille

²,

Martin R. Prince

²

and

Yi Wang

^2,*

¹

Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA

²

Radiology, Weill Cornell Medicine, New York, NY 10065, USA

^*

Author to whom correspondence should be addressed.

Tomography 2022, 8(6), 2687-2697; https://doi.org/10.3390/tomography8060224

Submission received: 20 September 2022 / Revised: 27 October 2022 / Accepted: 31 October 2022 / Published: 3 November 2022

(This article belongs to the Special Issue New Advances in Medical Imaging and Applied Radiology in Cancers)

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Abstract

There is no noninvasive method to estimate lung shunting fraction (LSF) in patients with liver tumors undergoing Yttrium-90 (Y90) therapy. We propose to predict LSF from noninvasive dynamic contrast enhanced (DCE) MRI using perfusion quantification. Two perfusion quantification methods were used to process DCE MRI in 25 liver tumor patients: Kety’s tracer kinetic modeling with a delay-fitted global arterial input function (AIF) and quantitative transport mapping (QTM) based on the inversion of transport equation using spatial deconvolution without AIF. LSF was measured on SPECT following Tc-99m macroaggregated albumin (MAA) administration via hepatic arterial catheter. The patient cohort was partitioned into a low-risk group (LSF

\leq

10 %

) and a high-risk group (LSF

>

10 %

). Results: In this patient cohort, LSF was positively correlated with QTM velocity

| u |

(r = 0.61, F = 14.0363, p = 0.0021), and no significant correlation was observed with Kety’s parameters, tumor volume, patient age and gender. Between the low LSF and high LSF groups, there was a significant difference for QTM

| u |

(0.0760 ± 0.0440 vs. 0.1822 ± 0.1225 mm/s, p = 0.0011), and Kety’s

K^{t r a n s}

(0.0401 ± 0.0360 vs 0.1198 ± 0.3048, p = 0.0471) and

V_{e}

(0.0900 ± 0.0307 vs. 0.1495 ± 0.0485, p = 0.0114). The area under the curve (AUC) for distinguishing between low LSF and high LSF was 0.87 for

| u |

, 0.80 for

V_{e}

and 0.74 for

K^{t r a n s}

. Noninvasive prediction of LSF is feasible from DCE MRI with QTM velocity postprocessing.

Keywords: dynamic contrast enhanced MRI; lung shunting fraction; Yttrium-90 treatment; hepatocellular carcinoma; quantitative transport mapping

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MDPI and ACS Style

Zhang, Q.; Lee, K.S.; Talenfeld, A.D.; Spincemaille, P.; Prince, M.R.; Wang, Y. Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing. Tomography 2022, 8, 2687-2697. https://doi.org/10.3390/tomography8060224

AMA Style

Zhang Q, Lee KS, Talenfeld AD, Spincemaille P, Prince MR, Wang Y. Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing. Tomography. 2022; 8(6):2687-2697. https://doi.org/10.3390/tomography8060224

Chicago/Turabian Style

Zhang, Qihao, Kyungmouk Steve Lee, Adam D. Talenfeld, Pascal Spincemaille, Martin R. Prince, and Yi Wang. 2022. "Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing" Tomography 8, no. 6: 2687-2697. https://doi.org/10.3390/tomography8060224

APA Style

Zhang, Q., Lee, K. S., Talenfeld, A. D., Spincemaille, P., Prince, M. R., & Wang, Y. (2022). Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing. Tomography, 8(6), 2687-2697. https://doi.org/10.3390/tomography8060224

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Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing

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