Lüdemann, L., Prochnow, D., Rohlfing, T. et al. Simultaneous Quantification of Perfusion and Permeability in the Prostate Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging with an Inversion-Prepared Dual-Contrast Sequence. Ann Biomed Eng 37, 749–762 (2009). https://doi.org/10.1007/s10439-009-9645-x
The aim of the present study was to quantify both perfusion and extravasation in the prostate to discriminate tumor from healthy tissue, which might be achieved by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using a nonspecific low-molecular-weight contrast medium (CM). To determine extravasation as well as tissue perfusion an inversion-prepared dual-contrast sequence employing a parallel acquisition technique (PAT) was designed for interleaved acquisition of T1-weighted images for extravasation measurement and T2𝑇∗2T2∗-weighted images for determination of the highly concentrated bolus with a sufficiently high temporal and spatial resolution at an acceptable signal-to-noise ratio. Thirteen patients with proven prostate cancer were examined with the sequence using a combined body-array prostate coil. Before pharmacokinetic evaluation the images were intensity-corrected and, if required, motion-corrected. The pharmacokinetic model used to calculate perfusion, permeability, blood volume, interstitial volume, transit time, and vessel size index included two compartments and a correction of delay and dispersion of the arterial input function. The information provided by the dual-contrast sequence allowed application of a more elaborate model for evaluation and enabled quantification of all parameters. Peripheral prostate tumors were found to differ from peripheral healthy prostate tissue in perfusion (1.38 mL/(min cm3) vs. 0.23 mL/(min cm3), p = 0.004), mean transit time (2.88 vs. 4.88 s, p = 0.039), and blood volume (1.9 vs. 0.7%, p = 0.019). A inversion-prepared dual-contrast sequence acquiring T1– and 𝑇∗2T2∗-weighted images with sufficient temporal resolution and signal-to-noise ratio was successfully applied in patients with prostate cancer to quantify all pharmacokinetic parameters of inflow and extravasation of a low-molecular-weight inert tracer.