A preferred embodiment of the invention and various experimentally verified uses for it will be disclosed in detail with respect to the drawings, in which:
A preferred embodiment of the invention will now be set forth in detail with reference to the drawings.
The phantom 100 was used to determine the relationship between changes in gadolinium concentration at different native T1 values and observed signal intensity changes for the perfusion sequence and receiver coil being used. The expected result is shown in
The results from the site using the matrix coil are given
The non-monotonic relationship between signal delta and gadolinium concentration is most likely due to strong spatial variability in the coil sensitivity. That is a common problem with phased array and composite coils. That level of spatial variability renders the subject data obtained using that system extremely suspect, since a small difference in subject positioning could result in a large change in apparent enhancement. Moreover, the relationship between the observed arterial input function and the tumor enhancement will be strongly affected by the relative locations of the tumor and source artery.
The results from the site using the body coil are given in
Those results are somewhat more surprising, and indicate that switching to a body coil will not be sufficient to provide reliable data. The problems seen in the results have two possible sources: the pulse sequence used and the receiving coil.
To locate the source of the problem, the phantom can be used as shown in the flow chart of
Another use for the phantom according to the preferred embodiment will now be explained.
In order to test the relative accuracy and precision of Ktrans measurements with and without conversion of signal intensity to tracer concentration, a modified version of the phantom was developed, each containing 100 vials in a 10×10 grid.
A preliminary idea of the quality of data likely to result from parameter calculation using signal intensity information can be obtained by directly examining the relationship between signal intensity changes and nominal Gd concentration changes. Scatterplots of nominal Gd concentration vs. signal with baseline subtracted, and calculated Gd concentration are given in
It should also be noted that the scatter seen in the data is actually higher in the converted tracer concentration data than in the signal intensity data. That may at first seem counter-intuitive. However, that is in fact a predictable result of the fact that noise is introduced into the data through both the T1 mapping and the registration processes needed to produce the converted data.
In clinical trials using human subjects, T1 maps are most frequently generated by scanning the subject using multiple flip angles, and then fitting the resulting signal intensity values at each pixel to a standard signal formation model. In that work, we made use of multiple inversion time T1 measurement. Five sequences were used, with TI/TR of 1.65/1.88, 0.65/0.88, 0.35/0.58, 0.15/0.38, and 0.027/0.260. T1 relaxation times were calculated using the following signal formation model:
where S is the observed signal intensity, σ is the spin density, A is a proportionality constant, and T1 and TR are the inversion and repetition times, respectively. That method is generally considered to be both more accurate and more stable than T1 measurement using multiple flip angles. However, the scan time requirements of that technique make it impractical for use in vivo in regions such as the abdomen and chest, which cannot be immobilized for long periods of time. That experiment, therefore, is something of an ideal case for T1 mapping and calculation of tracer concentrations.
Both phantoms were scanned using a dynamic acquisition sequence. A 3D SPGR sequence was used, with a flip angle of 30 degrees, TR/TE of 5.6/1.2, a 256×160 matrix, and an 8 slice, 64 mm slab. Twenty phases were acquired in 3:38, yielding a temporal resolution of 10.9 s.
Those data allowed the construction of simulated uptake curves with various base T1 values and rates of increase for either tracer concentration or observed signal intensity. Those simulated curves were then used to calculate Ktrans values, using a scaled model arterial input function. Moreover, because the true molar concentrations of gadolinium in each vial were known, it was also possible to calculate a ground truth or ideal Ktrans value for each simulated uptake curve.
Simulated uptake curves were generated using four different base T1 values: 208 ms, 388 ms, 667 ms, and 1016 ms. That was done in order to address the question of dependence on base T1 when using signal intensity changes to calculate Ktrans. In addition, 8 different ideal tissue uptake curves were used, with peak concentrations ranging from 0.1 mM to 0.6 mM. That spans the range of concentrations that would be expected in solid tumors in humans, assuming a 0.1 mmol/kg injection of a gadolinium labeled tracer such as gadopentetate dimeglumine. Ideal tissue and AIF curves are shown in
Corresponding signal based uptake curves were generated for each of the 8 ideal tissue uptake curves at each of the 4 base T1 values. Signal curves were generated by interpolating at each time point between the signals observed in the vials with known tracer concentrations above and below the ideal tracer concentration at the appropriate baseline T1 value. Signal curves for the 8 ideal tissue uptake curves with baseline T1=1016 ms are shown in
Ktrans values were calculated in three ways: (1) using the known nominal gadolinium concentration values; (2) using gadolinium concentration values derived from apparent signal changes in the dynamic data; (3) using apparent signal change, defined as S(t)-S(0). Ktrans values derived from the nominal gadolinium concentration were treated as the gold standard. Results for the other methods were evaluated based on their correspondence to those ideal values.
Those results demonstrate that, for the tracer concentrations and base T1 values that are commonly seen in solid tumors and for a variety of tracer uptake rates, conversion from signal intensity to apparent tracer concentration is likely to increase, rather than decrease, the measurement noise in the estimation of kinetic parameters such as Ktrans. Moreover, that added noise is likely to be greater than that shown here in vivo, due to subject motion which may complicate and corrupt the co-registration of the T1 map and dynamic data.
It is important when determining the proper method to use for a particular application to consider the differential penalty paid for loss of either precision or accuracy. In that experiment there is no apparent bias introduced through the use of raw signal intensity values in the estimation of Ktrans. However, that lack of bias is dependent upon appropriate scaling of the arterial input function, which may not always be possible. If the scaling is not done with great care, some bias in the measurement is likely to be introduced. Therefore, in the case where an absolute value of Ktrans in units of 1/min is required, conversion to tracer concentration is necessary.
It should be noted, however, that that is not generally the case. Ktrans has no absolute defined biological meaning. It is a composite parameter made up of flow and vascular permeability in some unknown ratio. For that reason, the most common use of that parameter is as a marker for change in tumor vascularity induced by either disease progression or response to treatment. For those types of applications, the primary parameter of interest is not the absolute value of Ktrans at a particular time point, but rather the percentage change in that parameter over time. Absolute accuracy is therefore less important, while precision is much more so. The results of that work indicate that in cases where the primary goal is the tracking of vascular changes over time, calculating Ktrans using change in signal intensity rather than tracer concentration provides the optimal solution.
While a preferred embodiment and various uses have been set forth above, those skilled in the art who have reviewed the present disclosure will readily appreciate that other embodiments can be realized within the scope of the invention. For example, disclosures of numerical quantities, specific substances, and imaging modalities are illustrative rather than limiting. Also, other arrays of vials can be used, such as three-dimensional arrays. Therefore, the present invention should be construed as limited only by the appended claims.
The present application claims the benefit of U.S. Provisional Patent Application No. 60/793,710, filed Apr. 21, 2006, whose disclosure is hereby incorporated by reference in its entirety into the present application.
Number | Date | Country | |
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60793710 | Apr 2006 | US |