Korean J Radiol.  2018 Aug;19(4):783-791. 10.3348/kjr.2018.19.4.783.

Application of Synthetic MRI for Direct Measurement of Magnetic Resonance Relaxation Time and Tumor Volume at Multiple Time Points after Contrast Administration: Preliminary Results in Patients with Brain Metastasis

• Kang KM
• Choi SH
• Hwang M
• Yoo RE
• Yun TJ
• Kim JH
• Sohn CH

• KMID: 2413708
• DOI: http://doi.org/10.3348/kjr.2018.19.4.783

Abstract

OBJECTIVE
The purpose of this study was to investigate the time-dependent effects of contrast medium on multi-dynamic, multi-echo (MDME) sequence in patients with brain metastases.
MATERIALS AND METHODS
This study included 7 patients with 15 brain metastases who underwent magnetic resonance (MR) examination which included MDME sequences at 1 minute, 10 minutes and 20 minutes after contrast injection. Two volumes of interests, covering an entire tumor (whole tumor) and the enhancing portion of the tumor, were derived from post-contrast synthetic T1-weighted images. Statistical comparisons were performed for three different time delays for histogram parameters of the longitudinal relaxation rate (R1) and the transverse relaxation rate (R2), and lesion volumes.
RESULTS
The mean and the median of R1 and the mean of R2 in both the whole tumor and the inner enhancing portion were larger on the 10 minutes delayed images than on the 1 minute or 20 minutes delayed images (mean of R1 in the whole tumor on the 1 minute, 10 minutes, and 20 minutes delayed images: 1.26 ms, 1.39 ms, and 1.37 ms; mean of R1 in the inner enhancing portion: 1.43 ms, 1.53 ms and 1.44 ms; all p < 0.017). The volumes of the whole tumor and the inner enhancing portion were significantly larger in the 10 minutes and 20 minutes delayed images than on the 1 minute delayed images (all p < 0.017).
CONCLUSION
Magnetic resonance relaxation times and the volumes of the whole tumor and the inner enhancing portion were measured larger on the 10 minutes or 20 minutes delayed images than on the 1 minute delayed images. The MDME sequence immediately after contrast injection cannot fully reflect the effects of gadolinium-based contrast agent leakage in the tissue.

Keyword

Brain tumor; Metastasis; Multi-echo sequence; Quantitative MRI; Contrast-enhanced MRI; Relaxometry

MeSH Terms

Brain Neoplasms
Brain*
Humans
Magnetic Resonance Imaging*
Neoplasm Metastasis*
Relaxation*
Tumor Burden*

Figure

• 

  Fig. 1 Representative pre- and post-contrast synthetic T1WI and quantitative R1 and R2 maps with different delay times in 63-year-old male patient with brain metastasis.R1 = longitudinal relaxation rate, R2 = transverse relaxation rate, T1WI = T1-weighted image, T2WI = T2-weighted image

• 

  Fig. 2 Post-contrast synthetic T1WI 20 minutes after contrast administration.Regions of interest for entire tumor (second row) and enhancing portion of tumor (third row) to derive volumes of interest.

• 

  Fig. 3 Box and whisker plots display distribution of mean R1 and R2 in whole tumor and enhancing portion of tumor, respectively.Central box represents values from lower to upper quartile (25–75 percentile). Middle line represents median. Horizontal line extends from minimum to maximum value, excluding outside and far out values that are displayed as separate points.

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