Comparison of Intravoxel incoherent motion imaging and multiecho dynamic contrast‐based MRI in rectal cancer

Abstract

Background Dynamic contrast‐based MRI and intravoxel incoherent motion imaging (IVIM) MRI are both methods showing promise as diagnostic and prognostic tools in rectal cancer. Both methods aim at measuring perfusion‐related parameters, but the relationship between them is unclear. Purpose To investigate the relationship between perfusion‐ and permeability‐related parameters obtained by IVIM‐MRI, T1‐weighted dynamic contrast‐enhanced (DCE)‐MRI and T2*‐weighted dynamic susceptibility contrast (DSC)‐MRI. Study Type Prospective. Subjects In all, 94 patients with histologically confirmed rectal cancer. Field Strength/Sequence Subjects underwent pretreatment 1.5T clinical procedure MRI, and in addition a study‐specific diffusion‐weighted sequence (b = 0, 25, 50, 100, 500, 1000, 1300 s/mm2) and a multiecho dynamic contrast‐based echo‐planer imaging sequence. Assessment Median tumor values were obtained from IVIM (perfusion fraction [f], pseudodiffusion [D*], diffusion [D]), from the extended Tofts model applied to DCE data (Ktrans, kep, vp, ve) and from model free deconvolution of DSC (blood flow [BF] and area under curve). A subgroup of the excised tumors underwent immunohistochemistry with quantification of microvessel density and vessel size. Statistical Test Spearman's rank correlation test. Results D* was correlated with BF (rs = 0.47, P < 0.001), and f was negatively correlated with kep (rs = –0.31, P = 0.002). BF was correlated with Ktrans (rs = 0.29, P = 0.004), but this correlation varied extensively when separating tumors into groups of low (rs = 0.62, P < 0.001) and high (rs = –0.06, P = 0.68) BF. Ktrans was negatively correlated with vessel size (rs = –0.82, P = 0.004) in the subgroup of tumors with high BF. Data Conclusion We found an association between D* from IVIM and BF estimated from DSC‐MRI. The relationship between IVIM and DCE‐MRI was less clear. Comparing parameters from DSC‐MRI and DCE‐MRI highlights the importance of the underlying biology for the interpretation of these parameters. Level of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1114–1124.

Sex Differences and Tumor Blood Flow from Dynamic Susceptibility Contrast MRI Are Associated with Treatment Response after Chemoradiation and Long-term Survival in Rectal Cancer

“…Furthermore, in participants undergoing neoadjuvant treatment, low tumor BF was also associated with shorter OS (Table 4). Low D*, which has been previously shown to be correlated with tumor BF (10), was also associated with shorter PFS (HR = 0.82; 95% confidence interval: 0.70, 0.96; P = .01) ( Table 4, Fig 6c). No other functional MRI parameters were associated with PFS (for example, K trans : HR = 0.01, P = .25; DR 2 *-peak: HR = 0.97, P = .57; f: HR = 0.04, P = .40) or OS (see Table E6 [online] for full list of results).…”

“…Details of the postprocessing have been published previously (10). In brief, acquired multiecho data were used to extract two dynamic time series: T1-and T2*-weighted series.…”

“…Distant metastasis (M stage) was detected with pelvic, thoracic, or abdominal CT according to clinical practice. Data from some study participants have been previously published; 17 were in a pilot study of the multiecho MRI method (9), and 94 were in a methodologic study comparing DW, DSC, and DCE MRI (10).…”

Perfusion-driven Intravoxel Incoherent Motion (IVIM) MRI in Oncology: Applications, Challenges, and Future Trends

“…[28][29][30][31][32][33][34][35][36][37][38] It is interesting to see that the correlation can be observed both in human tumors and animal xenografts; however, some studies have found no significant correlation. Bakke et al 32 found no significant correlation between f and microvessel density or vessel size in 12 rectal cancer patients, and Li et al 38 also found no significant correlation between f and microvessel density in 16 liver tumors in rabbits (r = 0.281, P = 0.291). Conversely, IVIM parameter maps obtained by clustering approaches with Gaussian mixture models might be useful for the identification of tumor subregions with proliferative activity (Ki-67 index).…”

Low-Rank Matrix Denoising Algorithm-Based MRI Image Feature for Therapeutic Effect Evaluation of NCRT on Rectal Cancer

“…Subsequently, dynamic enhanced magnetic resonance technology was proposed, and studies suggested that MRIenhanced scanning can improve the accuracy of rectal cancer staging [21]. Bakke et al [22] found that the preoperative staging accuracy of dynamic enhanced MRI was as high as 92%. After NCRT treatment, tumor cells died, the cell morphology changed, and the production inflammatory substances led to cell edema, making it difficult to distinguish the boundary between the lesion and other tissue, so that the accuracy of T staging was reduced.…”