R2* Relaxation Affects Pharmacokinetic Analysis of Dynamic Contrast-Enhanced MRI in Cancer and Underestimates Treatment Response at 7 T

Tomography. 2019 Sep;5(3):308-319. doi: 10.18383/j.tom.2019.00015.

Abstract

Effective transverse relaxivity of gadolinium-based contrast agents is often neglected in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Here, we assess time and tissue dependence of R2* enhancement and its impact on pharmacokinetic parameter quantification and treatment monitoring. Multiecho DCE-MRI was performed at 7 T on mice bearing subcutaneous TOV-21G human ovarian cancer xenografts (n = 8) and on the transgenic adenocarcinoma of the mouse prostate (TRAMP) model (n = 7). Subsequently, the TOV-21G tumor-bearing mice were treated with bevacizumab and rescanned 2 days later. Pharmacokinetic analysis (extended Tofts model) was performed using either the first echo signal only (standard single-echo DCE-MRI) or the estimated signal at TE = 0 derived from exponential fitting of R2* relaxation (R2*-corrected). Neglecting R2* enhancement causes underestimation of Gd-DOTA concentration (peak enhancement underestimated by 9.4%-16% in TOV-21G tumors and 13%-20% in TRAMP prostates). Median Ktrans and ve were underestimated in every mouse (TOV-21G Ktrans: 11%-19%, TOV-21G ve: 5.3%-8.9%; TRAMP Ktrans: 8.6%-19%, TRAMP ve: 12%-21%). Bevacizumab treatment reduced Ktrans in all TOV-21G tumors after 48 hours. Treatment effect was significantly greater in all tumors after R2* correction (median change of -0.050 min-1 in R2*-corrected Ktrans vs. -0.037 min-1 in uncorrected Ktrans). R2* enhancement in DCE-MRI is both time- and tissue-dependent and may not be negligible at 7 T in tissue with high Ktrans. This has consequences for the use of Ktrans and other DCE-MRI parameters as biomarkers, because treatment effect size can be underestimated when R2* enhancement is neglected.

Keywords: DCE-MRI; multi-echo; r2* correction; transverse relaxation; treatment monitoring.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Animals
  • Bevacizumab / administration & dosage*
  • Bevacizumab / pharmacokinetics*
  • Contrast Media
  • Disease Models, Animal
  • Female
  • Gadolinium DTPA*
  • Heterografts
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging / methods*
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Nude
  • Ovarian Neoplasms / diagnostic imaging*
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / pathology
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / pathology
  • Radiographic Image Enhancement / methods
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Bevacizumab
  • Gadolinium DTPA