Dynamic contrast-enhanced MRI: Study of inter-software accuracy and reproducibility using simulated and clinical data

J Magn Reson Imaging. 2016 Jun;43(6):1288-300. doi: 10.1002/jmri.25101. Epub 2015 Dec 21.

Abstract

Purpose: To test the reproducibility and accuracy of pharmacokinetic parameter measurements on five analysis software packages (SPs) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), using simulated and clinical data.

Materials and methods: This retrospective study was Institutional Review Board-approved. Simulated tissues consisted of pixel clusters of calculated dynamic signal changes for combinations of Tofts model pharmacokinetic parameters (volume transfer constant [K(trans) ], extravascular extracellular volume fraction [ve ]), longitudinal relaxation time (T1 ). The clinical group comprised 27 patients treated for rectal cancer, with 36 3T DCE-MR scans performed between November 2012 and February 2014, including dual-flip-angle T1 mapping and a dynamic postcontrast T1 -weighted, 3D spoiled gradient-echo sequence. The clinical and simulated images were postprocessed with five SPs to measure K(trans) , ve , and the initial area under the gadolinium curve (iAUGC). Modified Bland-Altman analysis was conducted, intraclass correlation coefficients (ICCs) and within-subject coefficients of variation were calculated.

Results: Thirty-one examinations from 23 patients were of sufficient technical quality and postprocessed. Measurement errors were observed on the simulated data for all the pharmacokinetic parameters and SPs, with a bias ranging from -0.19 min(-1) to 0.09 min(-1) for K(trans) , -0.15 to 0.01 for ve , and -0.65 to 1.66 mmol.L(-1) .min for iAUGC. The ICC between SPs revealed moderate agreement for the simulated data (K(trans) : 0.50; ve : 0.67; iAUGC: 0.77) and very poor agreement for the clinical data (K(trans) : 0.10; ve : 0.16; iAUGC: 0.21).

Conclusion: Significant errors were found in the calculated DCE-MRI pharmacokinetic parameters for the perfusion analysis SPs, resulting in poor inter-software reproducibility. J. Magn. Reson. Imaging 2016;43:1288-1300.

Keywords: DCE-MRI; Tofts model; inter-software variability; quantitative parameters; rectal cancer; simulated images.

Publication types

  • Comparative Study
  • Evaluation Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Computer Simulation
  • Contrast Media / pharmacokinetics
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Kidney Neoplasms / diagnostic imaging*
  • Kidney Neoplasms / metabolism*
  • Kidney Neoplasms / pathology
  • Magnetic Resonance Imaging / instrumentation
  • Magnetic Resonance Imaging / methods*
  • Male
  • Meglumine / pharmacokinetics*
  • Middle Aged
  • Models, Biological*
  • Organometallic Compounds / pharmacokinetics*
  • Phantoms, Imaging
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Software Validation
  • Software*

Substances

  • Contrast Media
  • Organometallic Compounds
  • Meglumine
  • gadoterate meglumine