Improved repeatability of dynamic contrast-enhanced MRI using the complex MRI signal to derive arterial input functions: a test-retest study in prostate cancer patients

Abstract

Purpose: The arterial input function (AIF) is a major source of uncertainty in tracer kinetic (TK) analysis of dynamic contrast-enhanced (DCE)-MRI data. The aim of this study was to investigate the repeatability of AIFs extracted from the complex signal and of the resulting TK parameters in prostate cancer patients. Methods: Twenty-two patients with biopsy-proven prostate cancer underwent a 3T MRI exam twice. DCE-MRI data were acquired with a 3D spoiled gradient echo sequence. AIFs were extracted from the magnitude of the signal (AIFMAGN), phase (AIFPHASE), and complex signal (AIFCOMPLEX). The Tofts model was applied to extract Ktrans, kep and ve. Repeatability of AIF curve characteristics and TK parameters was assessed with the within-subject coefficient of variation (wCV). Results: The wCV for peak height and full width at half maximum for AIFCOMPLEX(7% and 8%) indicated an improved repeatability compared to AIFMAGN (12% and 12%) and AIFPHASE (12% and 7%). This translated in lower wCV values for Ktrans (11%) with AIFCOMPLEXin comparison to AIFMAGN (24%) and AIFPHASE(15%). For kep, the wCV was 16% with AIFMAGN, 13% with AIFPHASE, and 13% with AIFCOMPLEX. Conclusion: Repeatability of AIFPHASE and AIFCOMPLEX is higher than for AIFMAGN, resulting in a better repeatability of TK parameters. Thus, use of either AIFPHASEor AIFCOMPLEX improves the robustness of quantitative analysis of DCE-MRI in prostate cancer.