Natalia V Korobova1, Susanne S Rauh2, Marian A Troelstra1, Matthew R Orton3, Eric M. Schrauben1, Oliver Maier4, Aart J Nederveen1, and Oliver J Gurney-Champion1
1Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands, 2Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, Amsterdam, Netherlands, 3Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom, 4Institute of Medical Engineering, Technical University Graz, Graz, Austria
Synopsis
Keywords: Contrast Agent, Quantitative Imaging, Model-based reconstruction
Dynamic contrast enhanced (DCE) MRI
is a minimally invasive technique that is able to quantitatively investigate the tumor
vasculature microenvironment. Such information shows great potential for
treatment stratification and response monitoring. However, DCE typically suffers
from low spatial resolution, Rician noise bias, and errors due to complex perfusion
modeling. Model-based reconstruction, in which DCE parameters are estimated
directly from k-space, may overcome these shortcomings. In this study, we
implemented model-based reconstruction for DCE-MRI data, validated it in
simulations, and showed its performance in-vivo. With model-based
reconstruction the estimated parameter maps exhibited less noise and preserved
more anatomical details.
Introduction
Perfusion and vascularization, as
studied by dynamic-contrast enhanced (DCE) MRI, show great potential, e.g. for
treatment stratification and response monitoring in cancer patients(1-3). However, the quantification of DCE-MRI
data faces several challenges hampering its introduction to clinical practice.
First, the need to fill sufficient k-space to produce dynamic images generates
a trade-off between temporal resolution, needed to capture the complex contrast
dynamics, and spatial resolution, desired for accurately depicting the tumor.
Second, the Rician-distribution of noise in the image domain introduces a noise-dependent
bias to quantified parameters. Third, due to complex modeling, quantitative
perfusion estimations show high variance. These shortcomings result in large
day-to-day variations and sequence-dependent biases in estimations, preventing
routine clinical use of DCE.
Model-based reconstruction (MBR)
has the potential to overcome these challenges. MBR includes a biophysical
model mapping quantitative parameters back to the signal in the k-space (Figure
1), rather than just to the conventional image space. The inverse problem
associated with the model is solved with an iterative approach that compares
measured k-space data to results of the forward modeling of the estimated
parameters. MBR removes the noise-dependent bias, as noise is Gaussian in
k-space. Furthermore, MBR no longer has the implicit trade-off between temporal
and spatial resolution as the need for intermediate images is removed.
Therefore, we implemented the extended
Tofts DCE model in the PyQMRI MBR framework(4), validated its
performance in a digital phantom (XCAT(5)), mimicking DCE-MRI in the abdominal
region, showed its feasibility in-vivo, and compared it to the conventional
nonlinear least squares fitting (LSQ).Methods
For the modeling
of pharmacokinetic (PK) parameters, the Extended Tofts model was used(6). Estimated PK
parameters included fractional plasma volume (vp), the fractional volume of extracellular extravascular space (EES)
(ve), and the mass reflux rate from EES back into plasma (kep). A population-based arterial input function was used and treated
in analytical representation allowing for analytical integration(7).
We implemented
the Extended Tofts model for DCE in the PyQMRI framework for MBR(4). PyQMRI applies an
iteratively regularized Gauss-Newton approach combined with a primal-dual inner
loop for the non-linear fitting. A total generalized variation functional was
used as a regularization strategy(8). The forward model was
based upon the contribution by Orton et al. to the OSIPI GitHub(9). In MBR the forward
model mapped PK parameters directly to the k-space data.
A 2D
coronal plane of the extended Cardiac-Torso anatomical (XCAT) phantom was used for
validation(5) (Figure 2A). Several organs from the phantom
were selected for our simulations: liver, pancreas, spleen, and kidneys. The
simulation of DCE-MRI signal was calculated using a forward model based on the
PK parameters from the literature for all organs except for the kidneys, which
were estimated from healthy volunteers scanned at our center(10) (Figure 4B). For simplicity, the baseline T1 map was considered to be
constant over the image and equal to 700ms. A golden angle radial undersampling
trajectory was simulated for which the scan and sampling parameters are listed in
Figure 2B. The noise in simulations was considered to be caused
by undersampling only. Additionally, two 2D axial planes from scans
of healthy volunteers were used to show MBR’s feasibility in vivo (Figure 2C).
As a comparison
to MBR, a conventional analysis with a NUFFT followed
by voxel-wise nonlinear LSQ fit was performed. The mean values and
standard deviation of predicted PK parameters were calculated in simulations for
both methods.Results
MBR
successfully estimated PK parameters and resulted in more homogenous (less
noisy) parameters within each organ than the LSQ reference, which was
especially visible in vp map in the liver
(Figure 3). MBR resulted in less bias and smaller spread in parameter values in
9 out of 15 organ/parameter combinations (Figure 4). The accuracy of estimated
PK parameters in small anatomical regions, such as in renal medulla, was higher
or equal with MBR.
In vivo we have
similar observations as in the simulations: quantitative maps were more
homogeneous and better depicted smaller anatomical objects when estimated with MBR
(Figure 5). Additionally, the border of different organs is more clearly
visible on MBR maps which might be important for the delineation of anomaly.Discussion
In this work, we
implemented MBR for DCE-MRI and validated it in a digital phantom and in vivo.
We showed that MBR removes the noise-dependent bias due to direct
reconstruction from raw k-space and is robust to random errors due to
regularization. Furthermore, small anatomical details and borders of organs
were better distinguishable with MBR. Given these results, MBR has the
potential to achieve better scan-rescan repeatability, which is essential in daily
clinical practice.
In this study,
the regularization weight was tuned based on visual impression. A systematic
optimization could further improve the results. Moreover, we used the same T1 relaxation time for all
organs. Including T1 in
the fitting is desirable since it varies per tissue and could influence PK parameters.
Lastly, the conventional LSQ fitting is not a state-of-the-art method, and a
comparison with more advanced algorithms is recommended.
In the future, a
detailed comparison of MBR and conventional fitting will be investigated in
vivo.Conclusion
MBR for DCE-MRI
can be used to substantially improve PK map quality.Acknowledgements
This research has been financed by KWF-UVA 2021.13785 and CCA 2020-7-01.
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