Pharmacokinetic modeling of multislice dynamic contrast-enhanced MRI in normal-healing radial fractures: A pilot study

Mark Lewis; Darren Ebreo; Paul N. Malcolm; Richard Greenwood; Amratlal D. Patel; Bahman Kasmai; Glyn Johnson; Andoni P. Toms

doi:10.1002/jmri.25039

Pharmacokinetic modeling of multislice dynamic contrast-enhanced MRI in normal-healing radial fractures: A pilot study

Mark Lewis (Lead Author), Darren Ebreo, Paul N. Malcolm, Richard Greenwood, Amratlal D. Patel, Bahman Kasmai, Glyn Johnson, Andoni P. Toms

Research output: Contribution to journal › Article › peer-review

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Abstract

PURPOSE: To define the range of quantitative pharmacokinetic parameters in normal-healing bone with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DCE-MRI is an established technique for characterizing abnormal tissue microvasculature within solid tumors, but has also shown promise for assessing bone and bone marrow.

MATERIALS AND METHODS: In this study ethical approval for eight patients was obtained. Inclusion criteria were an extra-articular distal radial fracture in patients aged 20-50 years which had united by 6 weeks in plaster cast. This was assessed by an experienced orthopedic surgeon. DCE-MRI was performed at 1.5T 6 weeks after initial injury. The transfer constant (K(trans) ), transfer rate (Kep ), and initial area under the curve (IAUC) values for the fracture site and adjacent marrow were obtained for each patient.

RESULTS: The mean T1 , K(trans) , Kep , and IAUC at the fracture site were 1713 (standard deviation [SD] 645), 0.09 (SD 0.07), 0.17 (SD 0.17) and 4.9 (SD 4.4). The relative standard deviation (RSD) for the fracture site ranged from 0.38 to 0.97 and for the adjacent marrow ranged from 0.95-3.88. Within each patient the range of RSDs was 0.04-0.42 for T1 , 0.26-0.91 for K(trans) , 0.14-1.06 for Kep , and 0.35-0.96 for the IAUC.

CONCLUSION: Pharmacokinetic measures of perfusion can be obtained from healing fractures using DCE-MRI with "excellent" intraclass correlation coefficients for inter- and intrarater reliability. The use of these perfusion parameters is limited by wide patient-to-patient variation and slice-to-slice variation within patients. J. Magn. Reson. Imaging 2015.

Original language	English
Pages (from-to)	611-619
Number of pages	9
Journal	Journal of Magnetic Resonance Imaging
Volume	43
Issue number	3
Early online date	2 Sep 2015
DOIs	https://doi.org/10.1002/jmri.25039
Publication status	Published - Mar 2016

Keywords

DCE_MRI
fracture
radius
reliability

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10.1002/jmri.25039

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Cite this

@article{eb45e1afcea34f58a62288dff635348e,

title = "Pharmacokinetic modeling of multislice dynamic contrast-enhanced MRI in normal-healing radial fractures: A pilot study",

abstract = "PURPOSE: To define the range of quantitative pharmacokinetic parameters in normal-healing bone with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DCE-MRI is an established technique for characterizing abnormal tissue microvasculature within solid tumors, but has also shown promise for assessing bone and bone marrow. MATERIALS AND METHODS: In this study ethical approval for eight patients was obtained. Inclusion criteria were an extra-articular distal radial fracture in patients aged 20-50 years which had united by 6 weeks in plaster cast. This was assessed by an experienced orthopedic surgeon. DCE-MRI was performed at 1.5T 6 weeks after initial injury. The transfer constant (K(trans) ), transfer rate (Kep ), and initial area under the curve (IAUC) values for the fracture site and adjacent marrow were obtained for each patient. RESULTS: The mean T1 , K(trans) , Kep , and IAUC at the fracture site were 1713 (standard deviation [SD] 645), 0.09 (SD 0.07), 0.17 (SD 0.17) and 4.9 (SD 4.4). The relative standard deviation (RSD) for the fracture site ranged from 0.38 to 0.97 and for the adjacent marrow ranged from 0.95-3.88. Within each patient the range of RSDs was 0.04-0.42 for T1 , 0.26-0.91 for K(trans) , 0.14-1.06 for Kep , and 0.35-0.96 for the IAUC. CONCLUSION: Pharmacokinetic measures of perfusion can be obtained from healing fractures using DCE-MRI with {"}excellent{"} intraclass correlation coefficients for inter- and intrarater reliability. The use of these perfusion parameters is limited by wide patient-to-patient variation and slice-to-slice variation within patients. J. Magn. Reson. Imaging 2015. ",

keywords = "DCE_MRI, fracture, radius, reliability",

author = "Mark Lewis and Darren Ebreo and Malcolm, {Paul N.} and Richard Greenwood and Patel, {Amratlal D.} and Bahman Kasmai and Glyn Johnson and Toms, {Andoni P.}",

note = "{\textcopyright} 2015 Wiley Periodicals, Inc.",

year = "2016",

month = mar,

doi = "10.1002/jmri.25039",

language = "English",

volume = "43",

pages = "611--619",

journal = "Journal of Magnetic Resonance Imaging",

issn = "1053-1807",

publisher = "Wiley",

number = "3",

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TY - JOUR

T1 - Pharmacokinetic modeling of multislice dynamic contrast-enhanced MRI in normal-healing radial fractures: A pilot study

AU - Lewis, Mark

AU - Ebreo, Darren

AU - Malcolm, Paul N.

AU - Greenwood, Richard

AU - Patel, Amratlal D.

AU - Kasmai, Bahman

AU - Johnson, Glyn

AU - Toms, Andoni P.

PY - 2016/3

Y1 - 2016/3

N2 - PURPOSE: To define the range of quantitative pharmacokinetic parameters in normal-healing bone with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DCE-MRI is an established technique for characterizing abnormal tissue microvasculature within solid tumors, but has also shown promise for assessing bone and bone marrow. MATERIALS AND METHODS: In this study ethical approval for eight patients was obtained. Inclusion criteria were an extra-articular distal radial fracture in patients aged 20-50 years which had united by 6 weeks in plaster cast. This was assessed by an experienced orthopedic surgeon. DCE-MRI was performed at 1.5T 6 weeks after initial injury. The transfer constant (K(trans) ), transfer rate (Kep ), and initial area under the curve (IAUC) values for the fracture site and adjacent marrow were obtained for each patient. RESULTS: The mean T1 , K(trans) , Kep , and IAUC at the fracture site were 1713 (standard deviation [SD] 645), 0.09 (SD 0.07), 0.17 (SD 0.17) and 4.9 (SD 4.4). The relative standard deviation (RSD) for the fracture site ranged from 0.38 to 0.97 and for the adjacent marrow ranged from 0.95-3.88. Within each patient the range of RSDs was 0.04-0.42 for T1 , 0.26-0.91 for K(trans) , 0.14-1.06 for Kep , and 0.35-0.96 for the IAUC. CONCLUSION: Pharmacokinetic measures of perfusion can be obtained from healing fractures using DCE-MRI with "excellent" intraclass correlation coefficients for inter- and intrarater reliability. The use of these perfusion parameters is limited by wide patient-to-patient variation and slice-to-slice variation within patients. J. Magn. Reson. Imaging 2015.

AB - PURPOSE: To define the range of quantitative pharmacokinetic parameters in normal-healing bone with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DCE-MRI is an established technique for characterizing abnormal tissue microvasculature within solid tumors, but has also shown promise for assessing bone and bone marrow. MATERIALS AND METHODS: In this study ethical approval for eight patients was obtained. Inclusion criteria were an extra-articular distal radial fracture in patients aged 20-50 years which had united by 6 weeks in plaster cast. This was assessed by an experienced orthopedic surgeon. DCE-MRI was performed at 1.5T 6 weeks after initial injury. The transfer constant (K(trans) ), transfer rate (Kep ), and initial area under the curve (IAUC) values for the fracture site and adjacent marrow were obtained for each patient. RESULTS: The mean T1 , K(trans) , Kep , and IAUC at the fracture site were 1713 (standard deviation [SD] 645), 0.09 (SD 0.07), 0.17 (SD 0.17) and 4.9 (SD 4.4). The relative standard deviation (RSD) for the fracture site ranged from 0.38 to 0.97 and for the adjacent marrow ranged from 0.95-3.88. Within each patient the range of RSDs was 0.04-0.42 for T1 , 0.26-0.91 for K(trans) , 0.14-1.06 for Kep , and 0.35-0.96 for the IAUC. CONCLUSION: Pharmacokinetic measures of perfusion can be obtained from healing fractures using DCE-MRI with "excellent" intraclass correlation coefficients for inter- and intrarater reliability. The use of these perfusion parameters is limited by wide patient-to-patient variation and slice-to-slice variation within patients. J. Magn. Reson. Imaging 2015.

KW - DCE_MRI

KW - fracture

KW - radius

KW - reliability

U2 - 10.1002/jmri.25039

DO - 10.1002/jmri.25039

M3 - Article

C2 - 26331701

VL - 43

SP - 611

EP - 619

JO - Journal of Magnetic Resonance Imaging

JF - Journal of Magnetic Resonance Imaging

SN - 1053-1807

IS - 3

ER -