Dual-input two-compartment pharmacokinetic model of dynamic contrast-enhanced magnetic resonance imaging in hepatocellular carcinoma

Yang, Jianfeng; Zhao, Zhenhua; Zhang, Yu; Zhao, Li; Yang, Li‐Ming; Zhang, Minming; Wang, Boyin; Wang, Ting; Lu, Baochun

doi:10.3748/wjg.v22.i13.3652

Cited by 20 publications

(20 citation statements)

References 22 publications

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“…Since ktrans only indicates alterations of vascular permeability or blood flow, it seems logical to not be affected by tumor size, as we have also observed [11, 19, 22, 23]. A prior study showed that a higher ktrans value prior to the initiation of sunitinib therapy in advanced HCC is associated with a higher PFS [6].…”

Section: Discussionsupporting

confidence: 53%

“…Furthermore, this technique provides quantitative evaluation of tumor vascular modifications after treatment [2, 6, 11, 16]. One of the parameters obtained by the p-MRI is ktrans, which determines the flow of contrast from the intravascular space to the extracellular space that may indicate a change in tumor blood flow or vascular permeability [8, 11, 19, 23]. …”

Section: Discussionmentioning

confidence: 99%

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Perfusion Magnetic Resonance as a Biomarker for Sorafenib-Treated Advanced Hepatocellular Carcinoma: A Pilot Study

Campos

Candelária

Papanikolaou

et al. 2019

GE Port J Gastroenterol

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Background: Sorafenib is the currently recommended therapy in patients with advanced hepatocellular carcinoma (HCC). Among the several biomarkers available for the evaluation of the therapeutic response and prognosis, there is perfusion magnetic resonance imaging (p-MRI) that, through measurement of the vascular permeability unit (ktrans), may retrieve useful information regarding the microvascular properties of focal liver lesions. The aim of this study was to evaluate the impact of sorafenib therapy in patients with advanced HCC using the p-MRI technique. Materials and Methods: In this retrospective study, 27 patients with the diagnosis of advanced HCC were included for palliative therapy using sorafenib. MRI of the liver was performed before the beginning of the oral therapy (T0), after 3 (T3), and after 6 months (T6). Dynamic acquisitions of the tumor (n = 50, during the first 2 min after contrast injection) were obtained in the coronal plane and were used to compute the parametric perfusion maps, acquiring the ktrans value using the extended Tofts pharmacokinetic model. Results: The value of ktrans obtained at T0 was significantly different from the value of ktrans obtained at T6 (p = 0.028). There were no significant differences between T0 and T3 (p = 0.115) or a correlation between ktrans at T0 and the size of the lesion (p = 0.376). The ktrans value at T0 in patients with progression-free survival (PFS) > 6 months was not significantly different from the ktrans value in patients with PFS ≤6 months (p = 0.113). The ktrans value at T0 was not significantly different between patients who were previously submitted to chemoembolization and those who were not submitted (p = 0.587). Conclusion: In this pilot study, the ktrans value may serve as a biomarker of tumor response to antiangiogenic therapy, but only 6 months after its initiation. Clinical outcomes such as PFS were not predicted before the initiation of treatment.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Perfusion Magnetic Resonance as a Biomarker for Sorafenib-Treated Advanced Hepatocellular Carcinoma: A Pilot Study

Campos

Candelária

Papanikolaou

et al. 2019

GE Port J Gastroenterol

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“…The modified Tofts model was used in postprocessing of DCE‐MRI, with the following equations:

\begin{matrix} C_{t} false(t false) = V_{p} C_{p} false(t false) + K^{trans} {false\int}_{0}^{t} C_{p} (t^{'}) e x p ()(, \frac{- K^{trans}}{V_{e}}) ()(, t - t^{'}) d t^{'} \\ K_{ep} = \frac{K^{italictrans}}{V_{e}} \end{matrix}

where C t (t) is the concentration of the agent in the voxel at time t , while C p is the concentration of the agent in the plasma volume. V e is the proportional volume of the extravascular extracellular distribution space (EES).…”

Section: Methodsmentioning

confidence: 99%

Combined application of pharamcokinetic DCE‐MRI and IVIM‐DWI could improve detection efficiency in early diagnosis of ductal carcinoma in situ

Tao

Zhang

et al. 2019

J Applied Clin Med Phys

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Purpose Ductal carcinoma in situ (DCIS) is a precursor of invasive ductal breast carcinoma (IDC). This study aimed to use pharamcokinetic dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) and intravoxel incoherent motion diffusion‐weighted imaging (IVIM‐DWI) for the early diagnosis of DCIS. Methods Forty‐seven patients, including 25 with DCIS (age: 28–70 yr, mean age: 48.7 yr) and 22 with benign disease (age: 25–67 yr, mean age: 43.1 yr) confirmed by pathology, underwent pharamcokinetic DCE‐MRI and IVIM‐DWI in this study. The quantitative parameters Ktrans, Kep, Ve, Vp, and D, f, D* were obtained by processing of DCE‐MRI and IVIM‐DWI images with Omni‐Kinetics and MITK‐Diffusion softwares, respectively. Parameters were analyzed statistically using GraphPad Prism and MedCalc softwares. Results All low‐grade DCIS lesions demonstrated mass enhancement with clear boundaries, while most middle‐grade and high‐grade DCIS lesions showed non‐mass‐like enhancement (NMLE). DCIS lesions were significantly different from benign lesions in terms of Ktrans, Kep, and D (t = 5.959, P < 0.0001; t = 5.679, P < 0.0001; and t = 5.629, P < 0.0001, respectively). The AUC of Ktrans, Kep, D and the combined indicator of Ktrans, Kep, and D were 0.936, 0.902, 0.860, and 0.976, respectively. There was a significant difference in diagnostic efficacy only between D and the combined indicator (Z = 2.408, P = 0.016). Conclusion DCE‐MRI and IVIM‐DWI could make for the early diagnosis of DCIS, and reduce the misdiagnosis of DCIS and over‐treatment of benign lesions.

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“…Chen et al evaluated blood flow in HCC using CT perfusion imaging 7 . Dynamic contrast-enhanced MRI 8 and diffusion MRI imaging 9 have also been used to evaluate blood flow in HCC. Ultrasonography can depict tumor morphology, and the Doppler method can be used to analyze vascularity.…”

Section: Introductionmentioning

confidence: 99%

Comparison of vascularity observed using contrast-enhanced 3D ultrasonography and pathological changes in patients with hepatocellular carcinoma after sorafenib treatment

et al. 2018

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Aim: The aim of this study was to compare vascularity observed using contrast-enhanced 3D ultrasonography and pathological changes in human hepatocellular carcinoma (HCC) and surrounding non-tumorous areas after sorafenib treatment.Materials and methods: Twelve patients with HCC were enrolled in this clinical study. The maximum tumor diameter as measured using sonography ranged from 15 to 33 mm (mean, 24.0 mm; SD, 5.7 mm). Assessments using contrast-enhanced (0.2 mL of Sonazoid suspension; Daiichi Sankyo, Tokyo, Japan) 3D ultrasonography (LOGIQ 7; GE Healthcare, Milwaukee) were performed in all the patients before and 1 week after sorafenib treatment. The microvessel density (MVD) of the HCC and surrounding non-tumorous area was evaluated based on the immunohistochemical staining of microvessels using an antigen for CD34.Results: Blood flow in the tumor was decreased in all 12 cases after sorafenib treatment. The MVD of the tumorous area at 1 week after sorafenib administration (38.8 ± 5.2) was significantly lower than that observed before sorafenib administration (72.4 ± 13.0) (P < 0.01). Blood flow in the non-tumorous area had decreased in 6 cases at 1 week after sorafenib treatment and had not changed in the 6 other cases. In the reduced blood flow group, the MVD of the non-tumorous area at 1 week after sorafenib administration had decreased significantly, compared with the MVD of the non-tumorous area before sorafenib administration. However, in the group with no change in blood flow, the MVD of the non-tumorous area at 1 week after sorafenib treatment had not changed, compared with the MVD of the non-tumorous area before sorafenib treatment.Conclusion: Contrast-enhanced 3D ultrasonography studies showed a correlation between vascularity and pathological changes in human HCC and the surrounding non-tumorous area after sorafenib treatment.

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Dual-input two-compartment pharmacokinetic model of dynamic contrast-enhanced magnetic resonance imaging in hepatocellular carcinoma

Cited by 20 publications

References 22 publications

Perfusion Magnetic Resonance as a Biomarker for Sorafenib-Treated Advanced Hepatocellular Carcinoma: A Pilot Study

Perfusion Magnetic Resonance as a Biomarker for Sorafenib-Treated Advanced Hepatocellular Carcinoma: A Pilot Study

Combined application of pharamcokinetic DCE‐MRI and IVIM‐DWI could improve detection efficiency in early diagnosis of ductal carcinoma in situ

Comparison of vascularity observed using contrast-enhanced 3D ultrasonography and pathological changes in patients with hepatocellular carcinoma after sorafenib treatment

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