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Dynamic contrast-enhanced MRI in oncology: how we do it

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Abstract

Magnetic resonance imaging (MRI) is particularly attractive for clinical application in perfusion imaging thanks to the absence of ionizing radiation and limited volumes of contrast agent (CA) necessary. Dynamic contrast-enhanced MRI (DCE–MRI) involves sequentially acquiring T1-weighted images through an organ of interest during the passage of a bolus administration of CA. It is a particularly flexible approach to perfusion imaging as the signal intensity time course allows not only rapid qualitative assessment, but also quantitative measures of intrinsic perfusion and permeability parameters. We examine aspects of the T1-weighted image series acquisition, CA administration, post-processing that constitute a DCE–MRI study in clinical practice, before considering some heuristics that may aid in interpreting the resulting contrast enhancement time series. While qualitative DCE–MRI has a well-established role in the diagnostic assessment of a range of tumours, and a central role in MR mammography, clinical use of quantitative DCE–MRI remains limited outside of clinical trials. The recent publication of proposals for standardized acquisition and analysis protocols for DCE–MRI by the Quantitative Imaging Biomarker Alliance may be an opportunity to consolidate and advance clinical practice.

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Authors and Affiliations

  1. Unità di Imaging di Precisione e Ricerca, Dipartimento di Immagini e Scienze Radiologiche, IEO, Istituto Europeo di Oncologia IRCCS, Via Ripamonti 435, 20141, Milan, Italy

    Giuseppe Petralia

  2. Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy

    Giuseppe Petralia

  3. Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Università Politecnica delle Marche, Via Lodovico Menicucci 6, 60121, Ancona, Italy

    Andrea Agostini

  4. Divisione of Radiologia Pediatrica e Specialistica, Dipartimento di Scienze Radiologiche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Ancona “Umberto I, G. Salesi, G.M. Lancisi”, Via Conca 71, 60126, Ancona, Italy

    Andrea Agostini

  5. 1° Radiologia Diagnostica ed Interventistica, Azienda Ospedaliera-Universitaria, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123, Brescia, BS, Italy

    Roberta Ambrosini

  6. Dipartimento di Neuroscienze, Imaging e Scienze Cliniche, Istituto di Radiologia, Università Gabriele d’Annunzio, Ospedale SS. Annunziata, Via dei Vestini, 66100, Chieti, Italy

    Roberta Cianci

  7. Unità operativa di Radiologia, Ospedale San Raffaele IRCCS, Via Olgettina 60, 20132, Milan, Italy

    Giulia Cristel

  8. Struttura Complessa di Radiodiagnostica Universitaria (SOD 2), Dipartimento di Scienze Biomediche Sperimentali e Cliniche, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy

    Linda Calistri & Stefano Colagrande

  9. Divisione di Radiologia, IEO, Istituto Europeo di Oncologia IRCCS, Via Ripamonti 435, 20141, Milan, Italy

    Paul E. Summers

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  1. Giuseppe Petralia
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  2. Paul E. Summers
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Contributions

Drs. SC and GP proposed the topic of this review. Drs. PES and GP performed the literature search and initial draft. All authors contributed to the critical revision of the work and approved the final manuscript.

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Correspondence to Stefano Colagrande.

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Petralia, G., Summers, P.E., Agostini, A. et al. Dynamic contrast-enhanced MRI in oncology: how we do it. Radiol med 125, 1288–1300 (2020). https://doi.org/10.1007/s11547-020-01220-z

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