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Pharmacokinetic modeling of multislice dynamic contrast‐enhanced MRI in normal‐healing radial fractures: A pilot study
Author(s) -
Lewis Mark,
Ebreo Darren,
Malcolm Paul N.,
Greenwood Richard,
Patel Amratlal D.,
Kasmai Bahman,
Johnson Glyn,
Toms Andoni P.
Publication year - 2016
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25039
Subject(s) - medicine , intraclass correlation , magnetic resonance imaging , nuclear medicine , multislice , bone healing , orthopedic surgery , dynamic contrast , pharmacokinetics , radiology , surgery , clinical psychology , psychometrics
Purpose To define the range of quantitative pharmacokinetic parameters in normal‐healing bone with dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI). DCE‐MRI is an established technique for characterizing abnormal tissue microvasculature within solid tumors, but has also shown promise for assessing bone and bone marrow. Materials and Methods In this study ethical approval for eight patients was obtained. Inclusion criteria were an extra‐articular distal radial fracture in patients aged 20–50 years which had united by 6 weeks in plaster cast. This was assessed by an experienced orthopedic surgeon. DCE‐MRI was performed at 1.5T 6 weeks after initial injury. The transfer constant (K trans ), transfer rate (K ep ), and initial area under the curve (IAUC) values for the fracture site and adjacent marrow were obtained for each patient. Results The mean T 1 , K trans , K ep , and IAUC at the fracture site were 1713 (standard deviation [SD] 645), 0.09 (SD 0.07), 0.17 (SD 0.17) and 4.9 (SD 4.4). The relative standard deviation (RSD) for the fracture site ranged from 0.38 to 0.97 and for the adjacent marrow ranged from 0.95–3.88. Within each patient the range of RSDs was 0.04–0.42 for T 1 , 0.26–0.91 for K trans , 0.14–1.06 for K ep , and 0.35–0.96 for the IAUC. Conclusion Pharmacokinetic measures of perfusion can be obtained from healing fractures using DCE‐MRI with “excellent” intraclass correlation coefficients for inter‐ and intrarater reliability. The use of these perfusion parameters is limited by wide patient‐to‐patient variation and slice‐to‐slice variation within patients. J. MAGN. RESON. IMAGING 2016;43:611–619.