Octavia Bane1, Stefanie Hectors1, Mathilde Wagner1,2, Lori R Arlinghaus3, Madhava Aryal4, Michael Boss5, Yue Cao4, Thomas L Chenevert6, Fiona Fennessy7, Wei Huang8, Nola Hylton9, Jayashree Kalpathy-Cramer10, Kathryn E Keenan5, Dariya Malyarenko6, Robert Mulkern7, David Newitt9, Karl F Stupic5, Lisa Wilmes9, Thomas Yankeelov11, Yi-Fen Yen10, Stephen E Russek5, and Bachir Taouli1
1Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States, 2Radiology, Groupe Hospitalier Pitié Salpêtrière, Paris, France, 3Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States, 4Radiation Oncology, University of Michigan, Ann Arbor, MI, United States, 5Physical Measurement Laboratory, National Institute of Standards and Technology (NIST), Boulder, CO, United States, 6Radiology, University of Michigan, Ann Arbor, MI, United States, 7Radiology, Brigham and Women's Hospital, Boston, MA, United States, 8Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, United States, 9Radiology, University of California San Francisco Mount Zion Hospital, San Francisco, CA, United States, 10Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States, 11Biomedical Engineering, University of Texas at Austin, Austin, TX, United States
Synopsis
Our multicenter study examined variability in T1 quantification
by testing common inversion-recovery spin echo and variable flip angle (VFA)
protocols, as well as T1 mapping methods used by participating sites, using a
phantom with known T1 values. We found field strength dependence of the accuracy, and platform dependence of the repeatability of T1
measurements with the common VFA protocol. Accuracy for site-specific protocols
was influenced by site, while repeatability, by type of protocol. Our findings
suggest modified IR methods and VFA protocols with multiple flip angles and B1
correction as good methods for repeatable T1 measurement.
Purpose
The precision of pharmacokinetic parameters derived from DCE-MRI studies
is highly dependent on accurate measurement of the baseline T1 value
of the tissue of interest1,2. The objectives of this study (sponsored by NCI
Quantitative Imaging Network) are threefold: (1) measure interplatform
variability in T1 quantification in a multicenter study by testing
common inversion-recovery spin echo (IR-SE) and variable flip angle (VFA)
protocols using a dedicated phantom, (2) determine the accuracy and precision
of several T1 mapping methods currently used by participating
centers in a phantom with known T1 and (3) determine the feasibility
of a harmonized T1 mapping protocol across platforms and centers.Methods
The study included 8 centers that
routinely perform DCE-MRI with T1 measurement at 1.5T (2 sites) and/or
3T (7 sites), for different organs/tissues (Table 1). The methods and protocols
used for T1 measurement varied among sites, with VFA being the most
commonly used sequence (Table 1), due to its capability of covering extensive
spatial range in a short amount of time. To assess the variability and accuracy
of T1 measurements between platforms/sequences/protocols, we used a dedicated
T1 phantom (Fig.1) produced by the National Institute of Standards
and Technology (NIST)3. The phantom (Fig
1) contains 14 spherical polypropylene vials of deionized water doped with NiCl2,
with T1 values known from previous NMR spectroscopy
measurements at 200C3. The phantom was
imaged at each site in duplicate (test-retest) sessions. Phantom temperature
was measured at the start and end of each experiment. Sites imaged the phantom
with the coils employed for their DCE-MRI studies. In addition to the T1
measurement protocols specific to each site, all sites collected data with common
IR-SE and VFA protocols (Table 2). Data was analyzed by a single observer who
placed circular ROIs in a central slice of each sphere using OsiriX. The mean
ROI signal was fitted by central analysis site according to the signal equation
for each sequence to obtain T1 values, using MATLAB R2015. For the common
VFA and site-specific T1 measurements, accuracy with respect to
standard NMR T1 values and test-retest precision were calculated4 (Eqs. 1 and 2).
$$
Accuracy Error (%)=100 x |T1
protocol -T1 NMR|/T1 NMR $$ Eq.1
$$
Test-Retest Precision Error (%)= 100 x |T1 test-T1 retest|/ Mean (T1
test ,T1 retest) $$ Eq.2
Interplatform reproducibility for
the common protocols was assessed by measuring the coefficient of variation
(CV). Agreement of IR-SE and reference NMR T1 values was assessed by
Lin’s concordance correlation5. In order to
compare accuracy and precision across sites, platforms, and protocols, general
linear mixed models were used4. Vial, scanner,
vendor, site and field strength were included as fixed effects for the common VFA
protocol. Protocol and sequence type were included as additional fixed effects
for site-specific T1 measurements.
Results
The temperatures
recorded in the phantom were 21.1 ± 1.1 0C (18.9-22.6 0C)
across all experiments. Interplatform CVs are shown in Figure 2 (mean IR-SE
CV=5%, VFA CV=15.3%). Significant Lin’s concordance correlations were observed between
IR-SE and NMR T1 (r>.99, p<1x10-6). The general linear mixed model
analysis showed less accuracy (Fig.3.a) at 3T than at 1.5T with the standard VFA
protocol (p=0.006). Platform had a significant (p<1x10-6) effect on
test-retest precision (Fig 3 b). Among site-specific protocols, site was the
most significant (p=0.0004) predictor of accuracy (Fig.3.c). Test-retest precision
error for site-specific protocols (Fig 3.d.) was higher at 3T than at 1.5T for
VFA protocols (p<1x10-4), although VFA brain protocols (with 6 or 7
flip angles) performed better than liver and prostate VFA protocols (with 2
flip angles) (p<1x10-4). Among
protocols, the Look-Locker protocol for the liver had the greatest test-retest
precision at both field strengths.
Discussion and conclusions
We observed
high interplatform variability for the common VFA protocol, especially at
higher field strengths. The deviations from reference NMR T1 values of
common VFA and site-specific protocols (> 10%) cannot be attributed only to
temperature (accounting for <2% error in T1 for the range of
temperatures recorded3). The field
strength dependence of common VFA accuracy and the platform dependence of VFA
test-retest precision suggest an effect of B1 inhomogeneity on VFA T1
measurements consistent with previous in
vivo observations6. Site was the most
significant predictor of accuracy for site-specific T1 measurements,
which suggests that protocol optimization influences T1 accuracy more
than choice of sequence. Repeatability was influenced by protocol. The findings of this study suggest modified IR
sequences (e.g. Look-Locker) as good methods for repeatable T1
measurement. If more slice coverage is needed, VFA protocols with more flip
angles could be used with B1 map correction. Acknowledgements
This study was sponsored by the
National Cancer Institute Quantitative Imaging Network (NCI QIN). The sites
participating in this QIN Working Group project receive funding for
quantitative cancer imaging projects from
the following NIH NCI grants: U01 CA172320, U01 CA142565,
U01 CA183848, U01 CA166104, U01 CA151261, U01 CA154602, U01 CA151235, U01 CA154601. The work of Octavia Bane
was partly supported by the NCI training grant 5T32CA078207-15, and of Mathilde
Wagner by Fondation ARC (France) SAE20140601302.References
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