This is a U.S. national stage application of PCT Application No. PCT/CN2020/100740 under 35 U.S.C. 371, filed Jul. 8, 2020 in Chinese, claiming priority to Chinese Patent Applications No. 201910621579.6, filed Jul. 10, 2019, all of which are hereby incorporated by reference.
The present invention belongs to the field of imaging technology, in particular to an analysis method of dynamic contrast-enhanced magnetic resonance images.
DCE-MRI (dynamic contrast-enhanced magnetic resonance imaging) uses fast MRI sequence to continuously collect images before, during and after intravenous injection of contrast agent to show the information that contrast agent enters target organs or blood vessels, passes through capillaries and is finally cleared. Conventional contrast-enhanced MRI can only diagnose by morphological features of lesions, and it can only reflect the enhancement characteristics of a certain or some fixed time points, and the result analysis depends on the doctor's experience. DCE-MRI can produce continuous and dynamic images by multi-phase scanning, which can reflect the enhancement characteristics of lesions more objectively, and have more abundant and comprehensive information on the pathophysiological characteristics of the displayed areas. In this sense, DCE-MRI, like other functional imaging techniques, can identify the pathophysiological characteristics of lesions in addition to displaying their anatomical structures.
At present, there are mainly two methods for DCE-MRI data analysis: semi quantitative analysis and quantitative analysis. Semi quantitative analysis is based on multiple metrics obtained from the signal intensity time-dependent curve to describe the characteristics of tissue enhancement, and does not involve the application of pharmacokinetic models. Quantitative analysis can calculate the concentration of contrast agent in the region of interest, and then improve the comparability of different research results. Quantitative analysis can also fit the pharmacokinetic model to analyze and calculate the signal intensity time-dependent curve, and derive a series of quantitative parameters for evaluation. After decades of development, the current pharmacokinetic models have many choices from single parameter to multi parameters, for example, four-parameter models can be divided into plasma model interstitial model, exchange model, and boundary stage model. The typical representatives of the three-parameter models are the extended Tofts model and two-parameter model includes single chamber model and Patlak model. The SSM model mentioned in the present invention is also one of the pharmacokinetic models for quantitative analysis of DCE-MRI.
In recent years, DCE-MRI analysis method based on transmembrane water exchange (TWE) has been proposed and proved to be a novel, high-resolution, non-invasive method of describing cell metabolic activity (Springer et al., 2014; Rooney et al., 2015; Springer, 2018). The results show that the transmembrane water exchange in biological tissues is determined mainly by the active pathway, which is a metabolism-dependent process mainly driven by Na-K-ATPase (NKA) pump (Springer, 2018). The transmembrane water exchange rate constant of normal brain tissue can reach 2 s−1, and the metabolic driving component can reach 70% (Bai et al., 2018b). As long as enough contrast agent (CA) penetrates into the extravascular-extracellular space, the metabolism image based on TWE can be realized by analyzing the shutter speed model (SSM) of DCE-MRI time-series data (Springer, 2018). The SSM analysis based on DCE-MRI has the advantages of submillimeter spatial resolution, low cost and convenient for clinical use. Recently, SSM analysis based on DCE-MRI revealed intratumoral heterogeneity, showing the possibility of being a potential biomarker for evaluating chemotherapy outcomes (Springer et al., 2014).
In the conventional SSM analysis of DCE-MRI data, in order to reduce the model fitting parameters, a single SSM sub model is often selected for a certain disease. For example, in muscle, (Landis et al., 1999), breast cancer (Huang et al., 2011; Springer et al., 2014), prostate cancer (Li et al., 2012), esophageal cancer (Bai et al., 2018a), head and neck cancer (Chawla et al., 2018), it is often considered that there is enough contrast agent outflow, and the SSM submodel without vascular factors is used for analysis. However, in biological tissues, especially in brain lesions, biological tissues often show complexity, and a single SSM submodel cannot meet the accurate analysis of all pixels. For example, in normal brain tissue, because of the existence of blood-brain barrier (BBB), contrast media cannot leak from blood vessels quickly, so it is necessary to establish a new SSM sub model. However, in brain tumors, due to the increase of vascular density and permeability, there may be a large number of contrast media leakage, so SSMfull model is more suitable.
The purpose of the present invention is to provide an analysis method of dynamic contrast-enhanced magnetic resonance image, in other words, a general analysis method of the shutter speed model (SSM) of dynamic contrast-enhanced magnetic resonance image, which can automatically match the best SSM model for each pixel, so as to improve the estimation accuracy of the five physiological parameters: contrast agent volume transfer constant between blood plasma and extravascular-extracellular space (Ktrans), intravascular water mole fractions (pb), extravascular-extracellular water mole fractions (po), vascular water efflux rate constant (kbo) and the cellular water efflux rate constant (kio).
The present invention provides the following technical solutions:
An analysis method of dynamic contrast-enhanced magnetic resonance image, the analysis method includes the following steps:
(1) Obtaining the time-series signal of vascular contrast agent concentration, AIF, of biological individual in DCE-MRI time-series data.
(2) According to the time-series signal of vascular contrast agent concentration in step (1), the DCE-MRI time-series signal of each pixel is fitted with the nonlinear least square algorithm and two SSM models including the full shutter speed model (SSMfull) and the simplified vascular shutter speed model (SSMvas). The DCE-MRI signal fitting results of SSMfull and SSMvas of each pixel are then obtained, respectively.
(3) The DCE-MRI signal fitting results of SSMfull and SSMvas of each pixel is scored and compared using the corrected Akaike Information Criterion. According to the corrected Akaike Information Criterion scores of SSMfull model and SSMvas model of each pixel, the optimal model is selected from SSMfull and SSMvas.
(4) According to the optimal model selected in step (3), when the optimal model is SSMfull, the distribution maps of five physiological parameters are generated after fitting. The five physiological parameters include Ktrans, pb, po, kbo and kio; when the optimal model is SSMvas, because po and kio are not as the estimated parameters, the distribution maps of three physiological parameters are generated after fitting and the three physiological parameters are Ktrans, pb and kbo.
(5) The error analysis of kio and kbo in step (4) is carried out. Only pixel results with 95% confidence interval in [0 s−1 20 s−1] or the lower limit of 95% confidence interval bigger than 5 s−1 are retained to generate the final distribution map of kio and kbo, along with the distribution map of Ktrans, pb, po.
The SSMfull in the step (2) is the complete DCE-MRI shutter speed model (full shutter speed model). The specific method of SSMfull is as follows. SSMfull divides water molecules into three compartments (blood vessel (b), interstitial (o) and intracellular space (i)). In other words, water molecules are in three physical spaces of vascular space, extravascular-extracellular space and intercellular space, and are in two exchange process, including water molecule exchange between vascular and extravascular-extracellular space and between intercellular space and extravascular-extracellular space. It is assumed that there is no exchange of water molecules between vascular and intracellular spaces. In this method, the longitudinal relaxation time (T1) contrast agent, such as Magnevist, ProHance, etc., is used. The concentration of contrast agent in the interstitial space [CAo] (T) was determined by the Kety Schmidt rate law,
[CAo](T)=Ktransvo−1∫0T[CAp](t)exp(−Ktransvo−1(T−t))dt (1)
Among them, vo is the volume fraction of interstitial space, and is linearly proportional to po(vo=po fw), [CAp] is the concentration of CA in plasma, T is the measurement time, t is the time to carry out, fw is t the tissue volume fraction accessible to mobile aqueous solutes (here the fixed value is 0.80).
The SSMfull in step (2) is composed of five independent physiological parameters: Ktrans, pb, po, kbo and kio where Ktrans is obtained by the CA extravasation rate constant kpe and plasma volume fraction vp
(Ktrans=kpe*vp, vp=vb (1−h)=pb fw(1−h), vb is the fraction of blood volume, h is the microvascular hematocrit (=0.42), fw is the tissue volume fraction accessible to mobile aqueous solutes (=0.80). The mole fraction of intracellular water pi was obtained by the relationship between po+pi+pb=1. In the SSMfull, the fast exchange limit of water exchange between blood plasma and blood cells is assumed.
The SSMfull in step (2) assumes that the system is in equilibrium or steady state (homeostasis), The exchange process of water molecules in any two physical spaces satisfies the principle of microscopic reversibility (detailed equilibrium):
kio/koi=po/pi (2)
kbo/kob=po/pb (3)
The SSMfull in step (2) comprehensively considers the water longitudinal relaxation and exchange into Bloch equation, and the specific form can be expressed as follows:
Among them, the longitudinal magnetization vector and relaxation rate vector are M=(Mb, Mo, Mi) and C=(Mb0R1b, Mo0R1o, Mi0R1i), respectively. The subscript “0” represents the equilibrium state, and R1b, R1o and R1i represent the longitudinal relaxation rate constants of blood, interstitial and intracellular water without exchange. R1b and R1o are linearly related to the contrast agent concentration [CA] in the corresponding space, that is, R1=R1,0+r1[CA], r1 is the longitudinal relaxation rate of CA, and R1 is R1b or R1o. In the present invention, the exchange matrix X is as follows:
For DCE-MRI based on Gradient Recalled Echo (GRE) the time-series signal strength S follows the MR steady-state hypothesis, which is expressed as follows:
S=11×3M=11×3[I−eTR·X cos(α)]−1(I−eTR·X)M0 sin(α) (6)
TR and α are the repetition time and flip angle of GRE sequence, respectively.
SSMvas in step (2) is a simplified model of SSMfull. On the basis of SSMfull, SSMvas further assumes that the influence of the water exchange between extravascular-extracellular and intracellular spaces on the time-series signal of DCE-MRI is ignored, that is, the basic assumption of SSMvas is that water molecules are in three physical spaces of blood vessel, extravascular-extracellular space and intercellular space, and there is water molecule exchange between vascular and extravascular-extracellular spaces, but there is no water molecule exchange between vascular and intracellular spaces, and the effect of transmembrane water exchange between intracellular and extravascular-extracellular spaces and the intracellular water mole fraction on magnetic resonance signal can be ignored. po and kio are not fitting parameters and fixed at 0.20 and 1000 s−1, respectively. Therefore, there are three pharmacokinetic or physiological parameters to be estimated in SSMvas, which are Ktrans, pb and kbo.
In step (3), if the difference between the corrected Akaike Information Criterion scores of SSMfull and SSMvas in a pixel is no more than −10, the optimal model for this pixel is SSMfull, and if the difference is more than −10, the optimal model is SSMvas.
The calculation formula of the corrected Akaike Information Criterion (AICc) score is as follows:
Among them, K is the number of independent parameters of the fitting model and equal to 4 and 6 for SSMvas and SSMfull, respectively, N is the number of measurement points in DCE-MRI data, and log L is the maximum logarithmic likelihood probability.
In step (5), the error analysis is mainly used to determine the 95% confidence interval for the parameters of vascular water efflux rate constant (kbo) and the cellular water efflux rate constant (kio). The 95% confidence interval of kbo or kio in the error analysis is determined as follows: fix the value of kbo or kio and fit all the remaining parameters through the nonlinear least square sum of squares, and then change the value of kbo or kio within the interval of [0 s−1 20 s−1] in small steps, and repeat the fitting until:
Among them, χ2 is the reduced chi-squared value from the fitting with the kbo or kio fixed at a certain value, χ02 is the reduced chi-squared value with all parameters optimized, F is the F distribution function, K is the number of independent parameters in the fitting model, and N is the number of measurement points in the DCE-MRI data.
The analysis method (automatic shutter speed analysis method) provided by the present invention provides two SSM models (SSM full model (SSMfull) and simplified SSM model SSMvas without consideration of water molecule exchange across cell membrane) that can cover different physiological conditions of tissues. For the first time, the best SSM of each pixel is automatically matched by using the corrected Akaike Information Criterion method, so as to improve the estimation accuracy of the following five physiological parameters of DCE: contrast agent volume transfer constant between blood plasma and extravascular-extracellular space (Ktrans) intravascular water mole fractions (pb), extravascular-extracellular water mole fractions (po), vascular water efflux rate constant (kbo), and the cellular water efflux rate constant (kio). The present invention mainly aims at the complex situation of vascular permeability in biological tissues, such as glioblastoma. By providing two kinds of SSM models covering different physiological situations and providing automatic screening methods of the two models, the shutter speed model analysis of biological tissues with spatial heterogeneity is realized. At the same time, the present invention overcomes the potential bias of kio estimation due to insufficient leakage of contrast agent by error analysis method.
The present invention is further described in detail below in conjunction with the accompanying figures and embodiments (e.g., head imaging).
1. As shown in
2. As shown in
3. As shown in
4. As shown in
As shown in
(4-1) As shown in
(4-1-1) in the SSMfull, DCE-MRI time-series signal, T1 image and AIF (namely [CAp]) signal is imported at first.
(4-1-2) SSMfull sets the initial values and ranges of the five fitting parameters, pb, po, Ktrans, kio, kbo. In this embodiment, the initial values of the five parameters are 0.02, 0.2, 0.01 min−1, 3 s−1, 3 s−1, and the fitting ranges are 0.001˜0.3, 0.01˜0.65, 10−5˜1 min−1, 0˜20 s−1, 0˜20 s−1, respectively.
(4-1-3) Substitute the five parameters pb, po, Ktrans, kio, kbo.
(4-1-4) Calculate the contrast agent concentration in interstitial space according to the following formula,
[CAo](T)=Ktransvo−1∫0T[CAp](t)exp(−Ktransvo−1(T−t))dt
where vo is the volume fraction of interstitial space and is linearly proportional to po (vo=pofw), [CAp] is the concentration of CA in plasma, T is the measurement time, t is the time to proceed.
(4-1-5) R1b and R1o are obtained from the contrast agent concentration [CA], assuming that they were linearly related to the contrast agent concentration, that is, R1=R1,0+r1[CA], R1 is R1b or R1o, and r1 is the relaxation rate of contrast agent.
(4-1-6) koi and kob are obtained by proportional relation, because in equilibrium or steady state (homeostasis), the two water exchange processes satisfy the principle of microscopic reversibility, that is, kio/koi=po/pi, kbo/kob=po/pb, where pi=1−pb−po.
(4-1-7) it can be obtained that the exchange matrix is X, and X is shown in the following formula,
(4-1-8) The Bloch equation considering the longitudinal 1H2O relaxation and water molecule exchange can be expressed as dM/dt=XM+C, where the longitudinal magnetization vector and relaxation rate vector are M=(Mb, Mo, Mi) and C=(Mb0R1b, Mo0R1o, Mi0R1i, respectively. The subscript “0” represents the equilibrium state.
(4-1-9) For DCE-MRI based on Gradient Recalled Echo (GRE) type, the time-series signal strength S can be obtained by substituting parameters, and the formula is as follows:
S=11×3M=11×3[I−eTR·X cos(α)]−1(I−eTR·X)M0 sin(α)
TR and α are the reputation time and flip angle of GRE sequence, respectively
(4-1-10) Compare the fitted time-series signal strength S obtained by substituting the parameters with the scanned DCE-MRI time-series signal.
(4-1-11) Judge whether the fitting results meet the fitting error requirements of nonlinear least square sum algorithm.
(4-1-12) If step (4-1-11) does not meet the requirements, adjust the substitution values of five parameters pb, po, Ktrans, kio, kbo according to the parameter fitting range and nonlinear least square algorithm iteration, and start from step (4-1-3) again until the requirements of step (4-1-11) are met.
(4-1-13) If step (4-1-11) is satisfied, the pb, po, Ktrans, kio, kbo of SSMfull fitting can be obtained, and then pb, po, Ktrans, kio, kbo parameter distributions, signal fitting results and fitting error of all pixels fitted by SSMfull can be obtained.
(4-2) As shown in
(4-2-1) Firstly, DCE-MRI time-series signal, T1 signal and AIF (i.e. [CAp]) signal were imported into SSMvas.
(4-2-2) Fix po=0.2 and kio=1000 s−1 in SSMvas, and set the initial values and fitting ranges of three parameters pb, Ktrans and kbo. In this embodiment, the initial values of the three parameters and the fitting range and steps (4-1-2) are the same.
(4-2-3) Substitute the five parameters pb, po, Ktrans, kio, kbo.
(4-2-4) repeat steps (4-1-3) to (4-1-9)
(4-2-5) The parameters are substituted into the fitted signal strength S and compare S with the scanned DCE-MRI time-series signal.
(4-2-6) Judge whether the fitting results meet the fitting error requirements of nonlinear least square sum algorithm.
(4-2-7) if step (4-2-6) is not satisfied, adjust the substitution values of pb, Ktrans and kbo according to the parameters fitting range and nonlinear least squares sum algorithm iteration, and start from step (4-2-3) again until the requirements of step (4-2-6) are met. If step (4-2-6) is satisfied, the pb, Ktrans and kbo of SSMvas fitting can be obtained, and then the pb, Ktrans and kbo parameter distributions of all pixels fitted by SSMvas, as well as signal fitting results and fitting errors, can be obtained.
5. As shown in
6. As shown in
(6-1) In the error analysis after fitting, the fitting results of SSMfull and SSMvas are imported firstly.
(6-2) The corrected Akaike Information Criterion scores of SSMfull and SSMvas are calculated respectively. Among them, the calculation formula of corrected Akaike Information Criterion score is as follows:
where K is the number of independent parameters of the fitting model and equal to 4 and 6 for SSMvas and SSMfull, respectively, N is the number of measurement points in DCE-MRI data, and log L is the maximum logarithmic likelihood probability.
(6-3) Calculate the corrected Akaike Information Criterion score difference between the two models, ΔAICc=AICc(SSMfull)−AICc (SSMvas).
(6-4) Judge whether AAICc is no more than −10.
(6-5) when the conditions in step (6-4) are satisfied, it means that the pixel is more suitable for SSMfull. The fitting parameter results pb, po, Ktrans, kio, kbo obtained by SSMfull are assigned to the final pb, po, Ktrans, kio, kbo. When the conditions in step (6-4) are not met, it means that the pixel is more suitable for SSMvas. The fitting parameter results pb, Ktrans, kbo obtained by SSMvas are assigned to the final pb, Ktrans, kbo. In the process of SSMvas, po and kio are not fitting parameters and fixed, so they have no fitting values and are set as invalid values (NaN).
7. As shown in
(7-1) When the optimal model is SSMfull, the specific process of kbo (or kio) error analysis is as follows:
(7-1-1) Determine the 95% confidence interval of kbo (or kio) by fixed kbo (or kio) value, fitting all the remaining parameters of SSMfull by the nonlinear least square algorithm, and then changing the value of kbo (or kio) in the interval of [0 s−1 20 s−1] in small steps, and repeat the fitting processes until:
Among them, χ2 is the reduced chi-squared value from the fitting with the kbo or kio fixed at a certain value, χ02 is the reduced chi-squared value with all parameters optimized, F is the F distribution function, K is the number of independent parameters in the fitting model, and N is the number of measurement points in the DCE-MRI data.
(7-1-2) If the 95% confidence interval of kbo or kio is in the interval of [0 s−1 20 s−1] or the lower limit of 95% confidence interval is bigger than 5 s−1, the fitted kbo or kio are retained. When this requirement cannot be met, kbo or kio=NaN.
The (A) in
(7-2) When the optimal model is SSMvas, the specific process of kbo error analysis is as follows:
(7-2-1) Determine the 95% confidence interval of kbo by fixed kbo value, fitting all the remaining parameters of SSMvas by the nonlinear least square algorithm, and then changing the value of kbo in the interval of [0 s−1 20 s−1] in small steps, and repeat the fitting processes until:
Among them, χ2 is the reduced chi-squared value from the fitting with the kbo fixed at a certain value, χ02 is the reduced chi-squared value with all parameters optimized, F is the F distribution function, K is the number of independent parameters in the fitting model, and N is the number of measurement points in the DCE-MRI data.
(7-2-2) If the 95% confidence interval of kbo is in the interval of [0 s−1 20 s−1] or the lower limit of 95% confidence interval is bigger than 5 s−1, the fitted kbo are retained. When this requirement cannot be met, kbo=NaN.
The (B) in
Through the above steps 1-7, pb, po, Ktrans, kio, kbo distribution maps can be generated.
In the present invention, the analysis results of this method are shown in
Tumor tissues show obvious enhancement of Ktrans, pb and kpe*, which was in line with expectations. A large number of references show that there are vascular hyperplasia and enhanced vascular permeability in tumors. However, there is an obvious heterogeneity of kio distribution in tumors, which may represent the distribution of tumor subcells with different metabolic levels and pathology. The tumor shows a rapid decrease of kbo, which may indicate that the active transmembrane water molecule exchange of vascular is stopped in the tumor.
Number | Date | Country | Kind |
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201910621579.6 | Jul 2019 | CN | national |
Filing Document | Filing Date | Country | Kind |
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PCT/CN2020/100740 | 7/8/2020 | WO |
Publishing Document | Publishing Date | Country | Kind |
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WO2021/004465 | 1/14/2021 | WO | A |
Number | Name | Date | Kind |
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20100253342 | Kimura | Oct 2010 | A1 |
Number | Date | Country |
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101912262 | Dec 2010 | CN |
103027682 | Apr 2013 | CN |
103076583 | May 2013 | CN |
103514607 | Jan 2014 | CN |
Number | Date | Country | |
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20220018924 A1 | Jan 2022 | US |