Estimation of Gadolinium-based Contrast Agent Concentration Using Quantitative Synthetic MRI and Its Application to Brain Metastases: A Feasibility Study.

PURPOSE

Gadolinium-based contrast agents (GBCA) provide valuable information for assessing and differentiating lesions in the body. However, contrast enhancement evaluation on conventional MRI is qualitative because the signal intensity uses an arbitrary scale. An approach that allows more quantitative assessment of tissue enhancement that can be integrated into clinical use is desirable. This study aimed to provide a method that can estimate GBCA concentration in a clinically applicable scan-time.

METHODS

Gadolinium-based contrast agent concentrations were quantified in phantoms containing water and nine different concentrations of Gadoteridol (Gd-HP-DO3A), ranging from 0.02 to 1.00 mmol/L, using quantitative synthetic MRI. Simple linear regression analysis between the estimated GBCA concentration and the reference values were performed to assess the accuracy. We performed region of interest analysis on each phantom, and recorded the mean and standard deviation. We evaluated the precision of the GBCA map by calculating the coefficient of variation (CV) for each concentration. The GBCA concentration quantification method was applied for 10 patients with metastatic brain tumors to demonstrate the feasibility of this method.

RESULTS

For the phantom study, estimated GBCA concentrations were in a strong linear relationship (R = 0.998) with reference values, with a slope and intercept on simple linear regression analysis of 0.98 and 0.02, respectively. On precision assessment, the CV was <5%, with the exception of concentrations under 0.07 mmol/L. In the range of 0.07-0.99 mmol/L, the mean CV was 1.5 ± 1.2%. For application to brain metastases, the maximum estimated GBCA concentration in the metastases was 0.73 mmol/L, which was under the upper limit evaluated in the phantom study (i.e. -0.99 mmol/L).

CONCLUSION

The concentration of Gd-HP-DO3A in the range of 0.07-0.99 mmol/L can be measured in a clinically applicable scan time using quantitative synthetic MRI, even though this study's results are only preliminary due to several limitations.