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Shalom ES, Khan A, Van Loo S, Sourbron SP. Current status in spatiotemporal analysis of contrast-based perfusion MRI. Magn Reson Med 2024; 91:1136-1148. [PMID: 37929645 PMCID: PMC10962600 DOI: 10.1002/mrm.29906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023]
Abstract
In perfusion MRI, image voxels form a spatially organized network of systems, all exchanging indicator with their immediate neighbors. Yet the current paradigm for perfusion MRI analysis treats all voxels or regions-of-interest as isolated systems supplied by a single global source. This simplification not only leads to long-recognized systematic errors but also fails to leverage the embedded spatial structure within the data. Since the early 2000s, a variety of models and implementations have been proposed to analyze systems with between-voxel interactions. In general, this leads to large and connected numerical inverse problems that are intractible with conventional computational methods. With recent advances in machine learning, however, these approaches are becoming practically feasible, opening up the way for a paradigm shift in the approach to perfusion MRI. This paper seeks to review the work in spatiotemporal modelling of perfusion MRI using a coherent, harmonized nomenclature and notation, with clear physical definitions and assumptions. The aim is to introduce clarity in the state-of-the-art of this promising new approach to perfusion MRI, and help to identify gaps of knowledge and priorities for future research.
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Affiliation(s)
- Eve S. Shalom
- School of Physics and AstronomyUniversity of LeedsLeedsUK
- Division of Clinical MedicineUniversity of SheffieldSheffieldUK
| | - Amirul Khan
- School of Civil EngineeringUniversity of LeedsLeedsUK
| | - Sven Van Loo
- School of Physics and AstronomyUniversity of LeedsLeedsUK
- Department of Applied PhysicsGhent UniversityGhentBelgium
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2
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Axel L. Modeling of factors affecting late gadolinium enhancement kinetics in MRI of cardiac amyloid. J Cardiovasc Magn Reson 2023; 25:46. [PMID: 37563646 PMCID: PMC10413700 DOI: 10.1186/s12968-023-00952-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/07/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Late gadolinium enhancement (LGE) is a valuable part of cardiac magnetic resonance imaging (CMR). In particular, inversion-recovery imaging of LGE, with nulling of the signal from reference areas of myocardium, can have a distinctive pattern in some patients with cardiac amyloid, including both diffuse (relatively faint) subendocardial LGE and a relatively dark appearance of the blood. However, the underlying reasons for this distinctive appearance have not previously been well investigated. Pharmacokinetic modeling of myocardial contrast enhancement kinetics can potentially provide insight into the mechanisms of the distinctive LGE appearance that can be seen in cardiac amyloid, as well as why it may be unreliable in some patients. METHODS An interactive three-compartment pharmacokinetic model of the dynamics of myocardial contrast enhancement in CMR was implemented, and used to simulate LGE dynamics in normal, scar, and cardiac amyloid myocardium; the results were compared with previously published values. RESULTS The three-compartment model is able to capture the qualitative features of LGE, in patients with cardiac amyloid. In particular, the characteristic "dark blood" appearance of PSIR images of LGE in cardiac amyloid is seen to likely primarily reflect expansion of the extravascular extracellular space (EES) by amyloid in the "reference" myocardium; the cardiac amyloid contrast enhancement dynamics also reflect expansion of the body EES. CONCLUSION The distinctive appearance of LGE in cardiac amyloid is likely due to a combination of diffuse expansion by amyloid of the EES of the reference myocardium and of the body EES.
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Affiliation(s)
- Leon Axel
- Department of Radiology, NYU Grossman School of Medicine, 660 First Avenue, Room 411, New York, NY, 1016, USA.
- Department of Internal Medicine, Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, 660 First Avenue, Room 411, NY, 1016, New York, USA.
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Jarrett AM, Kazerouni AS, Wu C, Virostko J, Sorace AG, DiCarlo JC, Hormuth DA, Ekrut DA, Patt D, Goodgame B, Avery S, Yankeelov TE. Quantitative magnetic resonance imaging and tumor forecasting of breast cancer patients in the community setting. Nat Protoc 2021; 16:5309-5338. [PMID: 34552262 PMCID: PMC9753909 DOI: 10.1038/s41596-021-00617-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/12/2021] [Indexed: 02/07/2023]
Abstract
This protocol describes a complete data acquisition, analysis and computational forecasting pipeline for employing quantitative MRI data to predict the response of locally advanced breast cancer to neoadjuvant therapy in a community-based care setting. The methodology has previously been successfully applied to a heterogeneous patient population. The protocol details how to acquire the necessary images followed by registration, segmentation, quantitative perfusion and diffusion analysis, model calibration, and prediction. The data collection portion of the protocol requires ~25 min of scanning, postprocessing requires 2-3 h, and the model calibration and prediction components require ~10 h per patient depending on tumor size. The response of individual breast cancer patients to neoadjuvant therapy is forecast by application of a biophysical, reaction-diffusion mathematical model to these data. Successful application of the protocol results in coregistered MRI data from at least two scan visits that quantifies an individual tumor's size, cellularity and vascular properties. This enables a spatially resolved prediction of how a particular patient's tumor will respond to therapy. Expertise in image acquisition and analysis, as well as the numerical solution of partial differential equations, is required to carry out this protocol.
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Affiliation(s)
- Angela M Jarrett
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
- Livestrong Cancer Institutes, Austin, TX, USA
| | - Anum S Kazerouni
- Departments of Biomedical Engineering, Austin, TX, USA
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Chengyue Wu
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
| | - John Virostko
- Livestrong Cancer Institutes, Austin, TX, USA
- Departments of Diagnostic Medicine, Austin, TX, USA
- Departments of Oncology, Austin, TX, USA
| | - Anna G Sorace
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Julie C DiCarlo
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
- Livestrong Cancer Institutes, Austin, TX, USA
| | - David A Hormuth
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
- Livestrong Cancer Institutes, Austin, TX, USA
| | - David A Ekrut
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
| | | | - Boone Goodgame
- Departments of Oncology, Austin, TX, USA
- Departments of Internal Medicine, The University of Texas at Austin, Austin, Texas, USA
- Seton Hospital, Austin, TX, USA
| | - Sarah Avery
- Austin Radiological Association, Austin, TX, USA
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA.
- Livestrong Cancer Institutes, Austin, TX, USA.
- Departments of Biomedical Engineering, Austin, TX, USA.
- Departments of Diagnostic Medicine, Austin, TX, USA.
- Departments of Oncology, Austin, TX, USA.
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Sinno N, Taylor E, Milosevic M, Jaffray DA, Coolens C. Incorporating cross-voxel exchange into the analysis of dynamic contrast-enhanced imaging data: theory, simulations and experimental results. Phys Med Biol 2021; 66. [PMID: 34650009 DOI: 10.1088/1361-6560/ac2205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/27/2021] [Indexed: 12/26/2022]
Abstract
Predictions of tumour perfusion are key determinants of drug delivery and responsiveness to therapy. Pharmacokinetic models allow for the estimation of perfusion properties of tumour tissues but many assume no dispersion associated with tracer transport away from the capillaries and through the tissue. At the level of a voxel, this translates to assuming no cross-voxel tracer exchange, often leading to the misinterpretation of derived perfusion parameters. Tofts model (TM), a compartmental model widely used in oncology, also makes this assumption. A more realistic description is required to quantify kinetic properties of tracers, such as convection and diffusion. We propose a Cross-Voxel Exchange Model (CVXM) for analysing cross-voxel tracer kinetics.In silicodatasets quantifying the roles of convection and diffusion in tracer transport (which TM ignores) were employed to investigate the interpretation of Tofts' perfusion parameters compared to CVXM. TM returned inaccurate values ofKtransandvewhere diffusive and convective mechanisms are pronounced (up to 20% and 300% error respectively). A mathematical equation, developed in this work, predicts and gives the correct physiological interpretation of Tofts've.Finally, transport parameters were derived from dynamic contrast enhanced-magnetic resonance imaging of a TS-415 human cervical carcinoma xenograft by using TM and CVXM. The latter deduced lower values ofKtransandvecompared to TM (lower by up to 63% and 76% respectively). It also allowed the detection of a diffusive flux (mean diffusivity 155μm2s-1) in the tumour tissue, as well as an increased convective flow at the periphery (mean velocity 2.3μm s-1detected). The results serve as a proof of concept establishing the feasibility of using CVXM for accurately determining transport metrics that characterize the exchange of tracer between voxels. CVXM needs to be investigated further as its parameters can be linked to the tumour microenvironment properties (permeability, pressure…), potentially leading to enhanced personalized treatment planning.
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Affiliation(s)
- Noha Sinno
- The Institute of Biomedical Engineering (BME), University of Toronto, Toronto, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Edward Taylor
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada.,TECHNA Institute, University Health Network, Toronto, Canada
| | - Michael Milosevic
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| | - David A Jaffray
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada.,TECHNA Institute, University Health Network, Toronto, Canada.,University of Texas, MD Anderson Cancer Centre, Texas, United States of America
| | - Catherine Coolens
- The Institute of Biomedical Engineering (BME), University of Toronto, Toronto, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada.,TECHNA Institute, University Health Network, Toronto, Canada
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Wu C, Hormuth DA, Oliver TA, Pineda F, Lorenzo G, Karczmar GS, Moser RD, Yankeelov TE. Patient-Specific Characterization of Breast Cancer Hemodynamics Using Image-Guided Computational Fluid Dynamics. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:2760-2771. [PMID: 32086203 PMCID: PMC7438313 DOI: 10.1109/tmi.2020.2975375] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The overall goal of this study is to employ quantitative magnetic resonance imaging (MRI) data to constrain a patient-specific, computational fluid dynamics (CFD) model of blood flow and interstitial transport in breast cancer. We develop image processing methodologies to generate tumor-related vasculature-interstitium geometry and realistic material properties, using dynamic contrast enhanced MRI (DCE-MRI) and diffusion weighted MRI (DW-MRI) data. These data are used to constrain CFD simulations for determining the tumor-associated blood supply and interstitial transport characteristics unique to each patient. We then perform a proof-of-principle statistical comparison between these hemodynamic characteristics in 11 malignant and 5 benign lesions from 12 patients. Significant differences between groups (i.e., malignant versus benign) were observed for the median of tumor-associated interstitial flow velocity ( P = 0.028 ), and the ranges of tumor-associated blood pressure (P = 0.016) and vascular extraction rate (P = 0.040). The implication is that malignant lesions tend to have larger magnitude of interstitial flow velocity, and higher heterogeneity in blood pressure and vascular extraction rate. Multivariable logistic models based on combinations of these hemodynamic data achieved excellent differentiation between malignant and benign lesions with an area under the receiver operator characteristic curve of 1.0, sensitivity of 1.0, and specificity of 1.0. This image-based model system is a fundamentally new way to map flow and pressure fields related to breast tumors using only non-invasive, clinically available imaging data and established laws of fluid mechanics. Furthermore, the results provide preliminary evidence for this methodology's utility for the quantitative characterization of breast cancer.
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Elkin R, Nadeem S, LoCastro E, Paudyal R, Hatzoglou V, Lee NY, Shukla-Dave A, Deasy JO, Tannenbaum A. Optimal mass transport kinetic modeling for head and neck DCE-MRI: Initial analysis. Magn Reson Med 2019; 82:2314-2325. [PMID: 31273818 DOI: 10.1002/mrm.27897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/13/2019] [Accepted: 06/14/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE Current state-of-the-art models for estimating the pharmacokinetic parameters do not account for intervoxel movement of the contrast agent (CA). We introduce an optimal mass transport (OMT) formulation that naturally handles intervoxel CA movement and distinguishes between advective and diffusive flows. METHOD Ten patients with head and neck squamous cell carcinoma (HNSCC) were enrolled in the study between June 2014 and October 2015 and underwent DCE MRI imaging prior to beginning treatment. The CA tissue concentration information was taken as the input in the data-driven OMT model. The OMT approach was tested on HNSCC DCE data that provides quantitative information for forward flux ( Φ F ) and backward flux ( Φ B ). OMT-derived Φ F was compared with the volume transfer constant for CA, K trans , derived from the Extended Tofts Model (ETM). RESULTS The OMT-derived flows showed a consistent jump in the CA diffusive behavior across the images in accordance with the known CA dynamics. The mean forward flux was 0.0082 ± 0.0091 ( min - 1 ) whereas the mean advective component was 0.0052 ± 0.0086 ( min - 1 ) in the HNSCC patients. The diffusive percentages in forward and backward flux ranged from 8.67% to 18.76% and 12.76% to 30.36%, respectively. The OMT model accounts for intervoxel CA movement and results show that the forward flux ( Φ F ) is comparable with the ETM-derived K trans . CONCLUSIONS This is a novel data-driven study based on optimal mass transport principles applied to patient DCE imaging to analyze CA flow in HNSCC.
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Affiliation(s)
- Rena Elkin
- Applied Mathematics & Statistics, Stony Brook University, Stony Brook, New York
| | - Saad Nadeem
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Eve LoCastro
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ramesh Paudyal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Vaios Hatzoglou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joseph O Deasy
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Allen Tannenbaum
- Computer Science and Applied Mathematics & Statistics, Stony Brook University, Stony Brook, New York
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