Magnetic resonance imaging: Advanced imaging techniques

Abstract

The purpose of this chapter is to review the basic principles and clinical applications of advanced magnetic resonance imaging (MRI) of soft tissue tumors, including dynamic contrast-enhanced MRI (DCE-MRI), diffusion MRI, and proton nuclear magnetic resonance (NMR) spectroscopy. DCE-MRI is a method of physiological imaging, based on ultrafast imaging, with the possibility of following the early enhancement kinetics of a water-soluble contrast agent after intravenous bolus injection. This technique provides clinically useful information, by depicting tissue vascularization and perfusion, capillary permeability, and composition of the interstitial space. Diffusion MRI provides quantitative and qualitative information on tissue cellularity, cell membrane integrity, and the interstitial space. NMR spectroscopy characterizes molecules in soft tissue tumors. The most important advantages of these techniques are their abilities to monitor response to preoperative chemotherapy, to identify areas of viable tumor before biopsy, to differentiate tumor tissue from peritumoral edema, and to provide physiological information for improved tissue characterization and detection of residual or recurrent tumor tissue after therapy.