Yoshifumi Sugawara MD, Presenter: Nothing to Disclose

Makoto Kajihara, Abstract Co-Author: Nothing to Disclose

Keiichi Kikuchi MD, Abstract Co-Author: Nothing to Disclose

Hitoshi Miki MD, PhD, Abstract Co-Author: Nothing to Disclose

Teruhito Mochizuki MD, Abstract Co-Author: Nothing to Disclose

Kenya Murase PhD, Abstract Co-Author: Nothing to Disclose

Kenshi Sakayama MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To evaluate if tumor blood flow (TBF) measurement by dynamic contrast-enhanced MRI (DCE-MRI) is useful to differentiate malignant tumors from benign lesions and to evaluate treatment response in musculoskeletal tumors.

We evaluated 29 patients with musculoskeletal tumors (benign 7, malignant 22) in which both DCE-MRI and thallium-201 scintigraphy were performed within one week. DCE-MRI was performed using inversion recovery-preparation fast field echo (IR-FFE) sequence (TR/TE/TI 7.7/3.9/280, flip angle 10, FOV 380 x 190, matrix 256 x 128). Dynamic data were obtained every 3.2 sec for approximately 2 min after a bolus injection of gadolinium. Functional map of TBF (ml/100ml/min) was generated by deconvolution analysis of the signal intensity-time curves obtained from arteries and tumors. Thallium-201 uptake ratios in tumors to normal tissues (T/N ratios) were calculated on the images obtained 10 minutes after 74 MBq injection of thallium-201. In 7 patients who received preoperative chemotherapy, the post-treatment TBF values and T/N ratios were compared with the pathologic response grading.

There was a substantial overlap in the TBF values (ml/100g/min) between the benign and malignant tumors (2.7 to 174.6 vs. 9.6 to 296.3). Although the T/N ratios in the benign tumors were significantly lower than those in the malignant tumors (1 to 3.45, vs. 1.24 to 9.87), there was an overlap. In 7 patients with receiving preoperative chemotherapy, substantial changes of TBF were demonstrated reflecting treatment response. The post-treatment TBF values (ml/100g/min) in the responders (tumor necrosis greater than 90%, n=3) (11.0, 11.7, 17.9) were significantly lower than those in the non-responders (n=4) (31.0, 62.4, 26.9, 86.6). The post-treatment T/N ratios in the responders (n=3) (1.74, 1.42, 1.81) were lower than those in the non-responders (n=4) (2.04, 3.57, 1.51, 4.93), except for one case showing a low T/N ratio in the non-responder (T/N ratio = 1.51).

Quantitative TBF measurement has limitations in differentiating malignant tumors from benign tumors, while it is useful to evaluate treatment response in musculoskeletal tumors.

To evaluate if tumor blood flow (TBF) measurement by dynamic contrast-enhanced MRI (DCE-MRI) is useful to differentiate malignant tumors from benign lesions and to evaluate treatment response in musculoskeletal tumors.

We evaluated 29 patients with musculoskeletal tumors (benign 7, malignant 22) in which both DCE-MRI and thallium-201 scintigraphy were performed within one week. DCE-MRI was performed using inversion recovery-preparation fast field echo (IR-FFE) sequence (TR/TE/TI 7.7/3.9/280, flip angle 10, FOV 380 x 190, matrix 256 x 128). Dynamic data were obtained every 3.2 sec for approximately 2 min after a bolus injection of gadolinium. Functional map of TBF (ml/100ml/min) was generated by deconvolution analysis of the signal intensity-time curves obtained from arteries and tumors. Thallium-201 uptake ratios in tumors to normal tissues (T/N ratios) were calculated on the images obtained 10 minutes after 74 MBq injection of thallium-201. In 7 patients who received preoperative chemotherapy, the post-treatment TBF values and T/N ratios were compared with the pathologic response grading.

There was a substantial overlap in the TBF values (ml/100g/min) between the benign and malignant tumors (2.7 to 174.6 vs. 9.6 to 296.3). Although the T/N ratios in the benign tumors were significantly lower than those in the malignant tumors (1 to 3.45, vs. 1.24 to 9.87), there was an overlap. In 7 patients with receiving preoperative chemotherapy, substantial changes of TBF were demonstrated reflecting treatment response. The post-treatment TBF values (ml/100g/min) in the responders (tumor necrosis greater than 90%, n=3) (11.0, 11.7, 17.9) were significantly lower than those in the non-responders (n=4) (31.0, 62.4, 26.9, 86.6). The post-treatment T/N ratios in the responders (n=3) (1.74, 1.42, 1.81) were lower than those in the non-responders (n=4) (2.04, 3.57, 1.51, 4.93), except for one case showing a low T/N ratio in the non-responder (T/N ratio = 1.51).

Quantitative TBF measurement has limitations in differentiating malignant tumors from benign tumors, while it is useful to evaluate treatment response in musculoskeletal tumors.

Sugawara, Y, Kajihara, M, Kikuchi, K, Miki, H, Mochizuki, T, Murase, K, Sakayama, K, et al, , Tumor Blood Flow Measurement by Dynamic Contrast-enhanced MRI in Musculoskeletal Tumors: Comparison with Thallium-201 Scintigraphy.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4417278.html