Department of Electrical Engineering, Eindhoven University of Technology, 5612 AZ Eindhoven, Netherlands.
Phys Med Biol. 2018 Oct 17;63(20):205012. doi: 10.1088/1361-6560/aae33b.
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is an established minimally-invasive method for assessment of extravascular leakage, hemodynamics, and tissue viability. However, differences in acquisition protocols, variety of pharmacokinetic models, and uncertainty on physical sources of MR signal hamper the reliability and widespread use of DCE-MRI in clinical practice. Measurements performed in a controlled in vitro setup could be used as a basis for standardization of the acquisition procedure, as well as objective evaluation and comparison of pharmacokinetic models. In this paper, we present a novel flow phantom that mimics a two-compartmental (blood plasma and extravascular extracellular space/EES) vascular bed, enabling systemic validation of acquisition protocols. The phantom consisted of a hemodialysis filter with two compartments, separated by hollow fiber membranes. The aim of this phantom was to vary the extravasation rate by adjusting the flow in the two compartments. Contrast agent transport kinetics within the phantom was interpreted using two-compartmental pharmacokinetic models. Boluses of gadolinium-based contrast-agent were injected in a tube network connected to the hollow fiber phantom; time-intensity curves (TICs) were obtained from image series, acquired using a T1-weighted DCE-MRI sequence. Under the assumption of a linear dilution system, the TICs obtained from the input and output of the system were then analyzed by a system identification approach to estimate the trans-membrane extravasation rates in different flow conditions. To this end, model-based deconvolution was employed to determine (identify) the impulse response of the investigated dilution system. The flow rates in the EES compartment significantly and consistently influenced the estimated extravasation rates, in line with the expected trends based on simulation results. The proposed phantom can therefore be used to model a two-compartmental vascular bed and can be employed to test and optimize DCE-MRI acquisition sequences in order to determine a standardized acquisition procedure leading to consistent quantification results.
动态对比增强磁共振成像(DCE-MRI)是一种成熟的微创方法,可用于评估血管外渗漏、血液动力学和组织活力。然而,由于采集方案的差异、各种药代动力学模型以及磁共振信号的物理来源的不确定性,限制了 DCE-MRI 在临床实践中的可靠性和广泛应用。在受控的体外设置中进行的测量可以用作采集程序标准化的基础,以及药代动力学模型的客观评估和比较。在本文中,我们提出了一种新的流动体模,可模拟双室(血液血浆和血管外细胞外空间/EES)血管床,从而能够对采集方案进行系统验证。该体模由两个隔室的血液透析过滤器组成,通过中空纤维膜分隔。该体模的目的是通过调整两个隔室中的流动来改变外渗率。使用双室药代动力学模型来解释体模内的对比剂转运动力学。将钆基对比剂的推注注入连接到中空纤维体模的管网络中;使用 T1 加权 DCE-MRI 序列获得图像序列,从而获得时间强度曲线(TIC)。在假设线性稀释系统的情况下,然后通过系统识别方法分析从系统的输入和输出获得的 TIC,以估计不同流动条件下的跨膜外渗率。为此,采用基于模型的反卷积来确定(识别)所研究的稀释系统的脉冲响应。EES 隔室中的流速显著且一致地影响了估计的外渗率,与基于模拟结果的预期趋势一致。因此,所提出的体模可用于模拟双室血管床,并可用于测试和优化 DCE-MRI 采集序列,以确定导致一致定量结果的标准化采集程序。