Model-based, semiquantitative and time intensity curve shape analysis of dynamic contrast-enhanced MRI: A comparison in patients undergoing antiangiogenic treatment for recurrent glioma

Abstract

Purpose: To compare time intensity curve (TIC)-shape analysis of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data with model-based analysis and semiquantitative analysis in patients with high-grade glioma treated with the antiangiogenic drug bevacizumab. Materials and Methods: Fifteen patients had a pretreatment and at least one posttreatment DCE-MRI. We applied a pixel-by-pixel TIC shape analysis, where TICs are classified into five different types according to their shape, and calculated the occurrence of each TIC type in the region of interest (ROI). The results were compared to the pharmacokinetic model (PKM) parameters Ktrans, Kep, V e, and Vi, and with the semiquantitative parameters maximum enhancement (ME) and initial slope of increase (ISI). Results: The relative amount of type 2 and 4 TIC shape significantly correlated with the parameter Kep but not with Ktrans or Ve. The PKM parameter Ve and the semiquantitative parameters ME and ISI showed significant changes after treatment. None of the TIC shapes individually showed significant changes. Conclusion: The semiquantitative parameters ME and ISI are more sensitive to the effect of the bevacizumab than Ktrans and Ve. The pixel-by-pixel TIC shape analysis parameters are not sensitive to the effect of bevacizumab, although they can be seen as surrogates for the PKM parameter Kep. Copyright © 2011 Wiley Periodicals, Inc.