Dynamic contrast-enhanced MRI in oncology: how we do it
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Dynamic contrast‑enhanced MRI in oncology: how we do it Giuseppe Petralia1,2 · Paul E. Summers9 · Andrea Agostini3,4 · Roberta Ambrosini5 · Roberta Cianci6 · Giulia Cristel7 · Linda Calistri8 · Stefano Colagrande8 Received: 3 December 2019 / Accepted: 27 April 2020 © Italian Society of Medical Radiology 2020
Abstract Magnetic resonance imaging (MRI) is particularly attractive for clinical application in perfusion imaging thanks to the absence of ionizing radiation and limited volumes of contrast agent (CA) necessary. Dynamic contrast-enhanced MRI (DCE–MRI) involves sequentially acquiring T 1-weighted images through an organ of interest during the passage of a bolus administration of CA. It is a particularly flexible approach to perfusion imaging as the signal intensity time course allows not only rapid qualitative assessment, but also quantitative measures of intrinsic perfusion and permeability parameters. We examine aspects of the T1-weighted image series acquisition, CA administration, post-processing that constitute a DCE–MRI study in clinical practice, before considering some heuristics that may aid in interpreting the resulting contrast enhancement time series. While qualitative DCE–MRI has a well-established role in the diagnostic assessment of a range of tumours, and a central role in MR mammography, clinical use of quantitative DCE–MRI remains limited outside of clinical trials. The recent publication of proposals for standardized acquisition and analysis protocols for DCE–MRI by the Quantitative Imaging Biomarker Alliance may be an opportunity to consolidate and advance clinical practice. Keywords Dynamic contrast-enhanced MRI · DCE–MRI · MR perfusion imaging · MR permeability mapping · Quantitative MRI
3
Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Università Politecnica delle Marche, Via Lodovico Menicucci 6, 60121 Ancona, Italy
4
Divisione of Radiologia Pediatrica e Specialistica, Dipartimento di Scienze Radiologiche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Ancona “Umberto I, G. Salesi, G.M. Lancisi”, Via Conca 71, 60126 Ancona, Italy
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1° Radiologia Diagnostica ed Interventistica, Azienda Ospedaliera-Universitaria, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123 Brescia, BS, Italy
6
Giulia Cristel [email protected]
Dipartimento di Neuroscienze, Imaging e Scienze Cliniche, Istituto di Radiologia, Università Gabriele d’Annunzio, Ospedale SS. Annunziata, Via dei Vestini, 66100 Chieti, Italy
7
Linda Calistri [email protected]
Unità operativa di Radiologia, Ospedale San Raffaele IRCCS, Via Olgettina 60, 20132 Milan, Italy
8
Struttura Complessa di Radiodiagnostica Universitaria (SOD 2), Dipartimento di Scienze Biomediche Sperimentali e Cliniche, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy
9
Divisione di Radiologia, IEO, Istituto Europeo di Oncologia IRCCS, Via Ripamonti 435, 20141 Milan, Italy
* Stefano Colagrande stefano.colagr
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