Feasibility of test-bolus DCE-MRI using CAIPIRINHA-VIBE for the evaluation of pancreatic malignancies

Objectives

To evaluate the feasibility of test-bolus dynamic contrast-enhanced (DCE) MRI with CAIPIRINHA-VIBE for pancreatic malignancies.

Methods

Thirty-two patients underwent DCE-MRI with CAIPIRINHA-VIBE after injection of 2 mL gadolinium. From the resulting time–intensity curve (TIC), we estimated the arterial (AP) and portal venous phase (PVP) scan timing for subsequent multiphasic MRI. DCE-MRI perfusion maps were generated, and perfusion parameters were calculated. The image quality was rated on a 5-point scale (1: poor, 5: excellent). Goodness-of-fit of the TIC was evaluated by Pearson’s χ² test.

Results

Test-bolus DCE-MRIs with high temporal (3 s) and spatial resolution (1?×?1?×?4 mm³) were acquired with good-quality perfusion maps of Ktrans and iAUC (mean score 4.313?±?0.535 and 4.125?±?0.554, respectively). The mean χ² values for fitted TICs were 0.115?±?0.082 for the pancreatic parenchyma and 0.784?±?0.074 for pancreatic malignancies, indicating an acceptable goodness-of-fit. Test-bolus DCE-MRI was highly accurate in estimating the proper timing of AP (90.6 %) and PVP (100 %) of subsequent multiphasic MRI. Between pancreatic adenocarcinomas and neuroendocrine tumours, there were significant differences in the Ktrans (0.073?±?0.058 vs. 0.308?±?0.062, respectively; p?=?0.007) and iAUC (1.501?±?0.828 vs. 3.378?±?0.378, respectively; p?=?0.045).

Conclusions

Test-bolus DCE-MRI using CAIPIRINHA-VIBE is feasible for incorporating perfusion analysis of pancreatic tumours into routine multiphasic MRI.

Key Points

? Test-bolus DCE-MRI using CAIPIRINHA-VIBE is feasible for perfusion analysis of pancreatic tumours. ? CAIPIRINHA-VIBE enables DCE-MRI with high temporal and spatial resolution. ? Test-bolus DCE-MRI is highly accurate in estimating the proper timing of multiphasic MRI.