Korean J Radiol.  2013 Feb;14(1):102-109. 10.3348/kjr.2013.14.1.102.

Preliminary Experience Using Dynamic MRI at 3.0 Tesla for Evaluation of Soft Tissue Tumors

• Park MY
• Jee WH
• Kim SK
• Lee SY
• Jung JY

• KMID: 1430052
• DOI: http://doi.org/10.3348/kjr.2013.14.1.102

Abstract

OBJECTIVE
We aimed to evaluate the use of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) at 3.0 T for differentiating the benign from malignant soft tissue tumors. Also we aimed to assess whether the shorter length of DCE-MRI protocols are adequate, and to evaluate the effect of temporal resolution.
MATERIALS AND METHODS
Dynamic contrast-enhanced magnetic resonance imaging, at 3.0 T with a 1 second temporal resolution in 13 patients with pathologically confirmed soft tissue tumors, was analyzed. Visual assessment of time-signal curves, subtraction images, maximal relative enhancement at the first (maximal peak enhancement [Emax]/1) and second (Emax/2) minutes, Emax, steepest slope calculated by using various time intervals (5, 30, 60 seconds), and the start of dynamic enhancement were analyzed.
RESULTS
The 13 tumors were comprised of seven benign and six malignant soft tissue neoplasms. Washout on time-signal curves was seen on three (50%) malignant tumors and one (14%) benign one. The most discriminating DCE-MRI parameter was the steepest slope calculated, by using at 5-second intervals, followed by Emax/1 and Emax/2. All of the steepest slope values occurred within 2 minutes of the dynamic study. Start of dynamic enhancement did not show a significant difference, but no malignant tumor rendered a value greater than 14 seconds.
CONCLUSION
The steepest slope and early relative enhancement have the potential for differentiating benign from malignant soft tissue tumors. Short-length rather than long-length DCE-MRI protocol may be adequate for our purpose. The steepest slope parameters require a short temporal resolution, while maximal peak enhancement parameter may be more optimal for a longer temporal resolution.

Keyword

Dynamic contrast enhanced MRI; Soft tissue tumor; MRI; Time signal intensity curve; Maximal relative enhancement; Maximal peak enhancement

MeSH Terms

Adult
Aged
Aged, 80 and over
Contrast Media/diagnostic use
Diagnosis, Differential
Female
Gadolinium DTPA/diagnostic use
Humans
Image Interpretation, Computer-Assisted/methods
Magnetic Resonance Imaging/*methods
Male
Middle Aged
Soft Tissue Neoplasms/*pathology
Statistics, Nonparametric
Subtraction Technique

Figure

• 

  Fig. 1 Subjective classification of time-signal intensity curves were as follows. Type I = no enhancement, type II = gradual increase of enhancement, type III = rapid early enhancement followed by plateau phase, type IV = rapid early enhancement followed by washout, type V = rapid early enhancement followed by sustained delayed enhancement

• 

  Fig. 2 Box plot of Emax/1 grouped by benign and malignant soft tissue tumor groups shows significant difference between two groups with malignant soft tissue tumor group showing higher Emax/1. Emax = maximal peak enhancement

• 

  Fig. 3 Steepest slope calculated using 5 seconds time intervals was most discriminating factor. Box plot of steepest slope calculated using 5 seconds time intervals grouped by benign and malignant soft tissue tumor groups shows significant difference between two groups with malignant soft tissue tumor group showing higher steepest slope.

• 

  Fig. 4 DCE-MR images in patient with pathologically confirmed soft tissue lymphoma. A. Subtraction image S2-5 min representing washout shows diffuse washout in tumor. B. ROI drawn in lymphoma tumor. C. DCE-MR time-signal curve showing type IV curve. DCE-MR = dynamic contrast enhance magnetic resonance, ROI = region of interest

• 

  Fig. 5 DCE-MR images in patient with pathologically confirmed parachordoma. A. Subtraction image S2-5min representing washout shows no washout in tumor. B. ROI drawn in parachordoma tumor. C. DCE-MR time-signal curve showing type II curve. DCE-MR = dynamic contrast enhance magnetic resonance, ROI = region of interest

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