Research Article

Optimization of the Contrast Agent Injection Protocol for Carotid Artery Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Yajie Wang BE

orcid.org/0000-0001-7259-3886

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

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Xiaoming Liu MD,

Xiaoming Liu MD

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China

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Yishi Wang PhD,

Yishi Wang PhD

Philips Healthcare, Beijing, China

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Haikun Qi PhD,

Haikun Qi PhD

School of Biomedical Engineering, ShanghaiTech University, Shanghai, China

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Xian Liu ME,

Xian Liu ME

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

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Xiangchuang Kong MD,

Xiangchuang Kong MD

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China

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Qiang Zhang PhD,

Qiang Zhang PhD

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

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Jiaqi Dou BE,

Jiaqi Dou BE

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

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Jing Wang MD, PhD,

Corresponding Author

Jing Wang MD, PhD

[email protected]

orcid.org/0000-0001-7223-2909

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China

Address reprint requests to: J.W., Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China. 430022. E-mail: [email protected], or H.C., Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Haidian District, Beijing, China. 100084. E-mail: [email protected]

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Huijun Chen PhD,

Corresponding Author

Huijun Chen PhD

[email protected]

orcid.org/0000-0003-1158-5510

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

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Yajie Wang BE,

Yajie Wang BE

orcid.org/0000-0001-7259-3886

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

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Xiaoming Liu MD,

Xiaoming Liu MD

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China

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Yishi Wang PhD,

Yishi Wang PhD

Philips Healthcare, Beijing, China

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Haikun Qi PhD,

Haikun Qi PhD

School of Biomedical Engineering, ShanghaiTech University, Shanghai, China

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Xian Liu ME,

Xian Liu ME

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

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Xiangchuang Kong MD,

Xiangchuang Kong MD

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China

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Qiang Zhang PhD,

Qiang Zhang PhD

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

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Jiaqi Dou BE,

Jiaqi Dou BE

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

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Jing Wang MD, PhD,

Corresponding Author

Jing Wang MD, PhD

[email protected]

orcid.org/0000-0001-7223-2909

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China

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Huijun Chen PhD,

Corresponding Author

Huijun Chen PhD

[email protected]

orcid.org/0000-0003-1158-5510

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

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First published: 24 March 2022

https://doi.org/10.1002/jmri.28175

Citations: 1

Yajie Wang and Xiaoming Liu contributed equally to this work.

Funding information: This study was supported by Beijing Municipal Natural Science Foundation (Z190024), National Natural Science Foundation of China (81930119, 81371540, and 81571667), and Natural Science Foundation of Hubei Province of China (No. 2021CFB442).

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Abstract

Background

The injection protocol used in previous carotid artery dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) studies varied.

Purpose

To investigate the effect of contrast injection protocol and optimize this protocol for carotid artery DCE-MRI.

Study Type

Prospective.

Subjects

Digital phantom and seven patients with carotid atherosclerosis.

Field Strength/Sequence

3 T, spoiled gradient recalled echo sequence.

Assessment

Different injection doses (0.01–0.3 mmol/kg) and effective injection rates (0.01–1 mmol/sec) were tested using a digital carotid plaque phantom considering the contrast pharmacokinetics, DCE-MRI imaging, contrast variation and flow-related imaging artifacts, random time delay between the contrast injection and image acquisition, and pharmacokinetic analysis process. For each injection protocol, combining the root mean square relative error (RMSRE) of the measured $K^{trans}$ and $v_{P}$ maps within the adventitial vasa vasorum from 10 tested time delays by the root mean square produced RMSRE_overall−vv which was used to measure the overall accuracy of the pharmacokinetic parameters. In vivo validation was performed on seven patients with carotid atherosclerosis by imaging them twice using the traditional commonly used protocol and the recommended protocol found by simulation.

Statistical Test

Student's t-test, chi-square test, and paired t-test, P < 0.05 was considered statistically significant.

Results

A low region of RMSRE_overall−vv with the combination of medium injection dose and low effective injection rate was found. The protocol with injection dose of 0.07 mmol/kg and effective injection rate of 0.06 mmol/sec achieved the minimal RMSRE_overall−vv (4.29%), thus was recommended, which showed more accurate arterial input function. Coinciding with the simulation results, this recommended protocol in in vivo experiments produced significantly fewer image artifacts, lower $K^{trans}$ and $v_{P}$ (P all <0.05) than traditional protocol which overestimated these parameters in simulation.

Data Conclusion

The contrast injection protocol influenced the accuracy of the pharmacokinetics parameter estimation in carotid artery DCE-MRI. The injection protocol with injection dose of 0.07 mmol/kg and effective injection rate of 0.06 mmol/sec was recommended.

Level of Evidence

Technical Efficacy Stage

Conflict of Interest

All authors declare no conflict of interest.

Open Research

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Supporting Information

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Citing Literature

Volume56, Issue5

November 2022

Pages 1372-1381

Optimization of the Contrast Agent Injection Protocol for Carotid Artery Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Test

Results

Data Conclusion

Level of Evidence

Technical Efficacy Stage

Conflict of Interest

Open Research

Data Availability Statement

Supporting Information

References

Citing Literature

References

Information

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Optimization of the Contrast Agent Injection Protocol for Carotid Artery Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Test

Results

Data Conclusion

Level of Evidence

Technical Efficacy Stage

Conflict of Interest

Open Research

Data Availability Statement

Supporting Information

References

Citing Literature

References

Related

Information