K Miyazaki

Multi-centre reproducibility of diffusion MRI parameters for clinical sequences in the brain.

The purpose of this work was to assess the reproducibility of diffusion imaging, and in particular the apparent diffusion coefficient (ADC), intra‐voxel incoherent motion (IVIM) parameters and diffusion tensor imaging (DTI) parameters, across multiple centres using clinically available protocols with limited harmonization between sequences.

Dynamic contrast-enhanced MRI of neuroendocrine hepatic metastases: A feasibility study using a dual-input two-compartment model.

Neuroendocrine hepatic metastases exhibit various contrast uptake enhancement patterns in dynamic contrast‐enhanced MRI. Using a dual‐input two‐compartment distributed parameter model, we analyzed the dynamic contrast‐enhanced MRI datasets of seven patient study cases with the aim to relate the tumor contrast uptake patterns to parameters of tumor microvasculature. Simulation studies were also performed to provide further insights into the effects of individual microcirculatory parameter on the tumor concentration‐time curves. Although the tumor contrast uptake patterns can be influenced by many parameters, initial results indicate that hepatic blood flow and the ratio of fractional vascular volume to fractional interstitial volume may potentially distinguish between the patterns of neuroendocrine hepatic metastases. Magn Reson Med, 2010.

Neuroendocrine Tumor Liver Metastases: Use of Dynamic Contrast-enhanced MR Imaging to Monitor and Predict Radiolabeled Octreotide Therapy Response

PURPOSE To evaluate dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging for monitoring and assessing treatment response in patients with neuroendocrine liver metastases treated using yttrium 90 ((90)Y)-labeled octreotide ((90)Y-DOTATOC). MATERIALS AND METHODS The study was approved by the local research and ethics committee and patient informed consent was obtained. Twenty patients with liver metastases from neuroendocrine tumors underwent T1-weighted DCE MR imaging of the liver before and at 2 months after intravenous (90)Y-DOTATOC treatment. Regions of interest were drawn around target lesions, as well as along liver outlines for each patient. A dual-input single-compartment model was used to compute parameters including fractional distribution volume and the arterial flow fraction. Pre- and posttreatment values were compared using Wilcoxon signed rank test. Treatment response was defined as showing a greater than 50% reduction in the nadir chromogranin A level within the 1st year after treatment. Pretreatment values of responders and nonresponders were compared using the Mann-Whitney test. A two-tailed P value of .008 or less, which accounts for multiple testing, was considered to indicate a significant difference. RESULTS In responders, tumor and whole liver distribution volume significantly increased after treatment (median tumor distribution volume, 0.182 vs 0.244; median whole liver distribution volume, 0.175 vs 0.207; P = .008). The pretreatment whole liver distribution volume was significantly lower in responders (median, 0.175 vs 0.248; P = .003), while pretreatment tumor arterial flow fraction was significantly higher in responders (median, 1.000 vs 0.7 ± 1, P = .006). CONCLUSION DCE MR imaging may be used to monitor the effects of peptide receptor radiolabeled targeted therapy in patients with neuroendocrine tumors liver metastases; a lower pretreatment distribution volume and high arterial flow fraction was associated with a better response to treatment.

Optimizing functional parameter accuracy for breath-hold DCE-MRI of liver tumours

Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is a valuable tool for assessing treatment response to novel cancer therapeutics. With appropriate data acquisition, quantitative functional parameter estimates can be obtained by fitting a model to the data. This research focuses on applying a dual-input single-compartment pharmacokinetic model to breath-hold DCE-MRI imaging of the liver. In this paper, the use of two breath-holds, providing greater temporal information, is compared with a single breath-hold approach. Computer simulations are used to assess the accuracy, precision and sensitivity to input function errors obtained for parameters estimated from the two imaging protocols. Data from ten patients were analysed to assess the noise statistics obtained from the two breath-hold protocols. The noise statistics were used with a pharmacokinetic liver model to simulate data, from which the estimation accuracy, precision and sensitivity for the two protocols were assessed. Data from the ten patients were also analysed, and the estimates were compared with literature values. This work demonstrates the feasibility of obtaining functional liver perfusion estimates over a 3D volume using a sequential breath-hold protocol. The simulation results show that the protocol consisting of two images per breath-hold is to be preferred as it requires identical patient co-operation, but provides parameter estimates that have superior accuracy and precision.

Extracranial Soft-Tissue Tumors: Repeatability of Apparent Diffusion Coefficient Estimates from Diffusion-weighted MR Imaging

Purpose To assess the repeatability of apparent diffusion coefficient (ADC) estimates in extracranial soft-tissue diffusion-weighted magnetic resonance imaging across a wide range of imaging protocols and patient populations. Materials and Methods Nine prospective patient studies and one prospective volunteer study, performed between 2006 and 2016 with research ethics committee approval and written informed consent from each subject, were included in this single-institution study. A total of 141 tumors and healthy organs were imaged twice (interval between repeated examinations, 45 minutes to 10 days, depending the on study) to assess the repeatability of median and mean ADC estimates. The Levene test was used to determine whether ADC repeatability differed between studies. The Pearson linear correlation coefficient was used to assess correlation between coefficient of variation (CoV) and the year the study started, study size, and volumes of tumors and healthy organs. The repeatability of ADC estimates from small, medium, and large tumors and healthy organs was assessed irrespective of study, and the Levene test was used to determine whether ADC repeatability differed between these groups. Results CoV aggregated across all studies was 4.1% (range for each study, 1.7%-6.5%). No correlation was observed between CoV and the year the study started or study size. CoV was weakly correlated with volume (r = -0.5, P = .1). Repeatability was significantly different between small, medium, and large tumors (P < .05), with the lowest CoV (2.6%) for large tumors. There was a significant difference in repeatability between studies-a difference that did not persist after the study with the largest tumors was excluded. Conclusion ADC is a robust imaging metric with excellent repeatability in extracranial soft tissues across a wide range of tumor sites, sizes, patient populations, and imaging protocol variations. Online supplemental material is available for this article.

Feasibility and applicability of diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging in routine assessments of children with high-grade gliomas

Diffusion‐weighted (DW) and dynamic contrast‐enhanced (DCE) magnetic resonance imaging (MRI) have been used as imaging biomarkers in adults with high‐grade gliomas (HGGs). We incorporated free‐breathing DW‐MRI and DCE‐MRI, at a single time point, in the routine follow‐up of five children (median age 9 years, range 8–15) with histologically confirmed HGG within a prospective imaging study. It was feasible to incorporate DW‐MRI and DCE‐MRI in routine assessments of children with HGG. DW and DCE parameters were repeatable in paediatric HGG. Higher median ADC100‐1000 significantly correlated with longer survival in our sample.