PubDB - Clinical Application of Pharmacokinetic Analysis as a Biomarker of Solitary Pulmonary Nodules: Dynamic Contrast-enhanced MR imaging

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Clinical Application of Pharmacokinetic Analysis as a Biomarker of Solitary Pulmonary Nodules: Dynamic Contrast-enhanced MR imaging

Mamata H.1, Tokuda J.1, Gill R.1, Padera R.2, Lenkinski R.3, Sugarbaker D.4, Butler J.1, Hatabu H.1
Institution:
1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
2Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
3Department of Radiology, Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
4Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Publisher:
John Wiley & Sons, Inc.
Publication Date:
Nov-2012
Journal:
Magn Reson Med
Volume Number:
68
Issue Number:
5
Pages:
1614-22
Citation:
Magn Reson Med. 2012 Nov;68(5):1614-22.
PubMed ID:
22231729
PMCID:
PMC3335927
Keywords:
perfusion MRI, lung tumor, pharmacokinetic parameters, Biomarker
Appears in Collections:
SNR, NCIGT, SLICER, SPL
Sponsors:
P01 CA067165/CA/NCI NIH HHS/United States
P41 EB015898/EB/NIBIB NIH HHS/United States
P41 RR019703/RR/NCRR NIH HHS/United States
R21 CA116271/CA/NCI NIH HHS/United States
R25 CA089017/CA/NCI NIH HHS/United States
Generated Citation:
Mamata H., Tokuda J., Gill R., Padera R., Lenkinski R., Sugarbaker D., Butler J., Hatabu H. Clinical Application of Pharmacokinetic Analysis as a Biomarker of Solitary Pulmonary Nodules: Dynamic Contrast-enhanced MR imaging. Magn Reson Med. 2012 Nov;68(5):1614-22. PMID: 22231729. PMCID: PMC3335927.
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The purpose of this study is to evaluate perfusion indices and pharmacokinetic parameters in solitary pulmonary nodules (SPNs). Thirty patients of 34 enrolled with SPNs (15-30 mm) were evaluated in this study. T1 and T2-weighted structural images and 2D turbo FLASH perfusion images were acquired with shallow free breathing. B-spline nonrigid image registration and optimization by χ² test against pharmacokinetic model curve were performed on dynamic contrast-enhanced MRI. This allowed voxel-by-voxel calculation of k(ep), the rate constant for tracer transport to and from plasma and the extravascular extracellular space. Mean transit time, time-to-peak, initial slope, and maximum enhancement (E(max) ) were calculated from time-intensity curves fitted to a gamma variate function. After blinded data analysis, correlation with tissue histology from surgical resection or biopsy samples was performed. Histologic evaluation revealed 25 malignant and five benign SPNs. All benign SPNs had k(ep) < 1.0 min⁻¹. Nineteen of 25 (76%) malignant SPNs showed k(ep) > 1.0 min⁻¹. Sensitivity to diagnose malignant SPNs at a cutoff of k(ep) = 1.0 min⁻¹ was 76%, specificity was 100%, positive predictive value was 100%, negative predictive value was 45%, and accuracy was 80%. Of all indices studied, k(ep) was the most significant in differentiating malignant from benign SPNs.

Additional Material
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Mamata-MRM2012-fig1.jpg (51.509kB)