Clinical application of pharmacokinetic analysis as a biomarker of solitary pulmonary nodules: Dynamic contrast-enhanced MR imaging

Hatsuho Mamata, Junichi Tokuda, Ritu R. Gill, Robert F. Padera, Robert E. Lenkinski, David J. Sugarbaker, James P. Butler, Hiroto Hatabu

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

The purpose of this study is to evaluate perfusion indices and pharmacokinetic parameters in solitary pulmonary nodules (SPNs). Thirty patients of 34 enrolled with SPNs (15-30 mm) were evaluated in this study. T1 and T2-weighted structural images and 2D turbo FLASH perfusion images were acquired with shallow free breathing. B-spline nonrigid image registration and optimization by π2 test against pharmacokinetic model curve were performed on dynamic contrast-enhanced MRI. This allowed voxel-by-voxel calculation of kep, the rate constant for tracer transport to and from plasma and the extravascular extracellular space. Mean transit time, time-to-peak, initial slope, and maximum enhancement (Emax) were calculated from time-intensity curves fitted to a gamma variate function. After blinded data analysis, correlation with tissue histology from surgical resection or biopsy samples was performed. Histologic evaluation revealed 25 malignant and five benign SPNs. All benign SPNs had kep < 1.0 min -1. Nineteen of 25 (76%) malignant SPNs showed kep > 1.0 min-1. Sensitivity to diagnose malignant SPNs at a cutoff of kep = 1.0 min-1 was 76%, specificity was 100%, positive predictive value was 100%, negative predictive value was 45%, and accuracy was 80%. Of all indices studied, kep was the most significant in differentiating malignant from benign SPNs.

Original languageEnglish (US)
Pages (from-to)1614-1622
Number of pages9
JournalMagnetic resonance in medicine
Volume68
Issue number5
DOIs
StatePublished - Nov 2012

Keywords

  • biomarker
  • lung tumor
  • perfusion MRI
  • pharmacokinetic parameters

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Mamata, H., Tokuda, J., Gill, R. R., Padera, R. F., Lenkinski, R. E., Sugarbaker, D. J., Butler, J. P., & Hatabu, H. (2012). Clinical application of pharmacokinetic analysis as a biomarker of solitary pulmonary nodules: Dynamic contrast-enhanced MR imaging. Magnetic resonance in medicine, 68(5), 1614-1622. https://doi.org/10.1002/mrm.24150