Contrast-enhanced 3T MR Perfusion of Musculoskeletal Tumours: T1 Value Heterogeneity Assessment and Evaluation of the Influence of T1 Estimation Methods on Quantitative Parameters
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To evaluate intra-tumour and striated muscle T1 value heterogeneity and the influence of different methods of T1 estimation on the variability of quantitative perfusion parameters.
Material and methods
Eighty-two patients with a histologically confirmed musculoskeletal tumour were prospectively included in this study and, with ethics committee approval, underwent contrast-enhanced MR perfusion and T1 mapping. T1 value variations in viable tumour areas and in normal-appearing striated muscle were assessed. In 20 cases, normal muscle perfusion parameters were calculated using three different methods: signal based and gadolinium concentration based on fixed and variable T1 values.
Tumour and normal muscle T1 values were significantly different (p = 0.0008). T1 value heterogeneity was higher in tumours than in normal muscle (variation of 19.8% versus 13%). The T1 estimation method had a considerable influence on the variability of perfusion parameters. Fixed T1 values yielded higher coefficients of variation than variable T1 values (mean 109.6 ± 41.8% and 58.3 ± 14.1% respectively). Area under the curve was the least variable parameter (36%).
T1 values in musculoskeletal tumours are significantly different and more heterogeneous than normal muscle. Patient-specific T1 estimation is needed for direct inter-patient comparison of perfusion parameters.
• T1 value variation in musculoskeletal tumours is considerable.
• T1 values in muscle and tumours are significantly different.
• Patient-specific T1 estimation is needed for comparison of inter-patient perfusion parameters.
• Technical variation is higher in permeability than semiquantitative perfusion parameters.
KeywordsNeoplasms Striated muscle Musculoskeletal system Perfusion magnetic resonance imaging Quantitative analysis
region of interest
time to 63% longitudinal magnetisation recovery
weighted fast spin-echo
number of excitations
field of view
high power field
arterial input function
intraclass correlation coefficients
coefficient of variation
extravascular extracellular space
signal enhancement ratio
area under the curve
- Max slope
maximum slope of increase
transfer constant from the plasma to the extravascular extracellular space
extravascular extracellular space volume
pigmented villonodular synovitis
giant cell tumour
Compliance with ethical standards
The scientific guarantor of this publication is Prof. Alain Blum.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
This study has received funding by the Société française de radiologie (SFR) and the Collège des enseignants de Radiologie de France (CERF).
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• performed at one institution
- 29.Kim JH, Ko ES, Lim Y, et al. (2016) Breast cancer heterogeneity: MR imaging texture analysis and survival outcomes. Radiology 160261. doi: 10.1148/radiol.2016160261