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Feasibility of test-bolus DCE-MRI using CAIPIRINHA-VIBE for the evaluation of pancreatic malignancies

  • Magnetic Resonance
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Abstract

Objectives

To evaluate the feasibility of test-bolus dynamic contrast-enhanced (DCE) MRI with CAIPIRINHA-VIBE for pancreatic malignancies.

Methods

Thirty-two patients underwent DCE-MRI with CAIPIRINHA-VIBE after injection of 2 mL gadolinium. From the resulting time–intensity curve (TIC), we estimated the arterial (AP) and portal venous phase (PVP) scan timing for subsequent multiphasic MRI. DCE-MRI perfusion maps were generated, and perfusion parameters were calculated. The image quality was rated on a 5-point scale (1: poor, 5: excellent). Goodness-of-fit of the TIC was evaluated by Pearson’s χ2 test.

Results

Test-bolus DCE-MRIs with high temporal (3 s) and spatial resolution (1 × 1 × 4 mm3) were acquired with good-quality perfusion maps of Ktrans and iAUC (mean score 4.313 ± 0.535 and 4.125 ± 0.554, respectively). The mean χ2 values for fitted TICs were 0.115 ± 0.082 for the pancreatic parenchyma and 0.784 ± 0.074 for pancreatic malignancies, indicating an acceptable goodness-of-fit. Test-bolus DCE-MRI was highly accurate in estimating the proper timing of AP (90.6 %) and PVP (100 %) of subsequent multiphasic MRI. Between pancreatic adenocarcinomas and neuroendocrine tumours, there were significant differences in the Ktrans (0.073 ± 0.058 vs. 0.308 ± 0.062, respectively; p = 0.007) and iAUC (1.501 ± 0.828 vs. 3.378 ± 0.378, respectively; p = 0.045).

Conclusions

Test-bolus DCE-MRI using CAIPIRINHA-VIBE is feasible for incorporating perfusion analysis of pancreatic tumours into routine multiphasic MRI.

Key Points

• Test-bolus DCE-MRI using CAIPIRINHA-VIBE is feasible for perfusion analysis of pancreatic tumours.

• CAIPIRINHA-VIBE enables DCE-MRI with high temporal and spatial resolution.

• Test-bolus DCE-MRI is highly accurate in estimating the proper timing of multiphasic MRI.

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Abbreviations

DCE:

Dynamic contrast-enhanced

AP:

Arterial phase

PVP:

Portal venous phase

CAIPIRINHA:

Controlled aliasing in parallel imaging results in higher acceleration

VIBE:

Volume interpolated breath-hold examination

TIC:

Time-intensity curve

TPEAK :

Time to peak aorta enhancement

Ktrans:

Volume transfer constant

iAUC:

Initial area under the concentration curve in 60 s

Radial-VIBE:

Radial T1-weighted gradient-echo sequence

KWIC:

K-space-weighted image contrast

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Acknowledgments

The scientific guarantor of this publication is Kyung Won Kim. Two authors (In Seong Kim, Dominik Nickel) are employees of Siemens Healthcare. They provided us technical advice. However, they did not control or access the patients’ data. Only authors from academic institution handled the patients’ data. This study was supported by a grant (No. 2015-0636) from the Asan Institute for Life Sciences of Asan Medical Center and a grant (No. 2014R1A1A1006823) from the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT, & Future Planning. This study did not require a statistical expertise, because it is a study to evaluate technical feasibility. Institutional Review Board approval was obtained. Informed consent was waived because of the retrospective nature of this study. Methodology: retrospective, observational, performed at one institution.

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    Authors and Affiliations

    1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

      Jimi Huh, Nieun Seo, Bohyun Kim & Kyung Won Kim

    2. Bioimaging Center, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro, Seoul, Korea

      Yoonseok Choi, Dong-Cheol Woo, Chang Kyung Lee & Kyung Won Kim

    3. Siemens Healthcare, 23 Chungjung-ro, Seoul, Korea

      In Seong Kim

    4. Siemens Healthcare, Henkestrabe 127, Erlangen, Germany

      Dominik Nickel

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    1. Jimi Huh
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    Correspondence to Kyung Won Kim.

    Additional information

    Jimi Huh and Yoonseok Choi contributed equally to this work.

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    Huh, J., Choi, Y., Woo, DC. et al. Feasibility of test-bolus DCE-MRI using CAIPIRINHA-VIBE for the evaluation of pancreatic malignancies. Eur Radiol 26, 3949–3956 (2016). https://doi.org/10.1007/s00330-016-4209-6

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    • DOI: https://doi.org/10.1007/s00330-016-4209-6

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