Reproducibility of Perfusion Parameters in Dynamic Contrast-Enhanced MRI of Lung and Liver Tumors: Effect on Estimates of Patient Sample Size in Clinical Trials and on Individual Patient Responses

• DOI: 10.2214/ajr.09.3116
• Publication Date: 2010-01-21T20:52:58Z
• Authors: Chaan S. Ng; David L. Raunig; Edward F. Jackson; Edward A. Ashton; Frederick Kelcz; Kevin B. Kim; Razelle Kurzrock; Teresa M. McShane
• Keywords: Dynamic Contrast-Enhanced MRI; Dynamic contrast

Dynamic contrast-enhanced MRI (DCE-MRI) is a potentially useful noninvasive technique for assessing tissue perfusion, particularly in the context of solid tumors and targeted antiangiogenic antivascular therapies. Our aim was to determine reproducibility perfusion parameters derived at DCE-MRI lung liver, most common sites metastasis.Patients with liver underwent two sequential examinations 2-7 days apart without any intervening therapy. The volume transfer constant between blood plasma extravascular extracellular space (K(trans)) blood-normalized initial area under signal intensity-time curve (initial AUC(BN)) were computed two-compartment pharmacokinetic model. Differences assessed within-patient coefficients variation.Twenty-three patients had evaluable (12 lung, 11 liver). variation K(trans) AUC(BN) lesions 8.9% 9.9% 17.9% 18.2%. Sample sizes reductions these from 10% 50% estimated range 102 subjects. Estimates confidence that changes observed given patient due therapy rather than variability calculated 71% 87% if 20% reduction parameter observed.The rate 10%-20% influenced by lesion location, being significantly more reproducible lung. These findings provide foundation interpretation results design clinical trials which studies are used assess objective responses.