Literature DB >> 27187599

Arterial input functions in dynamic contrast-enhanced magnetic resonance imaging: which model performs best when assessing breast cancer response?

David K Woolf1, N Jane Taylor2, Andreas Makris1, Nina Tunariu3, David J Collins3, Sonia P Li1, Mei-Lin Ah-See1, Mark Beresford4, Anwar R Padhani2.   

Abstract

OBJECTIVE: To evaluate the performance of six models of population arterial input function (AIF) in the setting of primary breast cancer and neoadjuvant chemotherapy (NAC). The ability to fit patient dynamic contrast-enhanced MRI (DCE-MRI) data, provide physiological plausible data and detect pathological response was assessed.
METHODS: Quantitative DCE-MRI parameters were calculated for 27 patients at baseline and after 2 cycles of NAC for 6 AIFs. Pathological complete response detection was compared with change in these parameters from a reproduction cohort of 12 patients using the Bland-Altman approach and receiver-operating characteristic analysis.
RESULTS: There were fewer fit failures pre-NAC for all models, with the modified Fritz-Hansen having the fewest pre-NAC (3.6%) and post-NAC (18.8%), contrasting with the femoral artery AIF (19.4% and 43.3%, respectively). Median transfer constant values were greatest for the Weinmann function and also showed greatest reductions with treatment (-68%). Reproducibility (r) was the lowest for the Weinmann function (r = -49.7%), with other AIFs ranging from r = -27.8 to -39.2%.
CONCLUSION: Using the best performing AIF is essential to maximize the utility of quantitative DCE-MRI parameters in predicting response to NAC treatment. Applying our criteria, the modified Fritz-Hansen and cosine bolus approximated Parker AIF models performed best. The Fritz-Hansen and biexponential approximated Parker AIFs performed less well, and the Weinmann and femoral artery AIFs are not recommended. ADVANCES IN KNOWLEDGE: We demonstrate that using the most appropriate AIF can aid successful prediction of response to NAC in breast cancer.

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Year:  2016        PMID: 27187599      PMCID: PMC5257308          DOI: 10.1259/bjr.20150961

Source DB:  PubMed          Journal:  Br J Radiol        ISSN: 0007-1285            Impact factor:   3.039


  22 in total

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