Michael Vinzenz Knopp MD, PhD, Presenter: Nothing to Disclose

1) To apply the concepts and pathophysiology of quantitative DCE MRI in clinical applications. 2) To review technical and procedure considerations for clinical applications. 3) To familiarize with current and evolving clinical applications of qDCE-MRI. 4) To utilize qDCE-MRI in and interpret clinical applications.

Dynamic contrast enhanced MRI has evolved over the last two decades into a readily available MRI add-on procedure that enables a spatial and time resolved insight into the microcirculation of tissues, both neoplastic as well as benign. While the cinematic display of the temporal contrast enhancement as well as the visual inspection of a signal intensity curve placed over a region of interest enables a ready visual perception of the characteristics of contrast enhancement, a methodological data reduction to a quantitative readout has been more challenging to validate, implement and interpret. Today, the fundamental pathophysiology, appropriate MRI acquisition and post-processing approach are well understood. Quantification is a key enabler to use imaging more as a disease (bio) marker especially for monitoring disease response or progression, as well as putting a more structured interpretation of the dynamic imaging findings into the patient care process. The clinical applications that benefits the most are those were the extent and/or intensity of tissue microcirculation can serve as a marker of biologic characteristics, guide the further diagnostics (tissue biopsies) and/or therapy management. The most common use of applying the fundamental methodologies of DCE-MRI is MR Mammography which is further evolving from a purely morphologic to a semi-quantitative or quantitative imaging procedure. Characterizing malignant tissues, inflammation or angiogenic processes with quantitative approaches is expanding our radiologic toolbox and ability to provide outcome impacting information. Quantitative DCE MRI is evolving to be an increasingly meaningful, clinically relevant and obtainable functional readout of the underlying tissue microcirculation and it will depend on our expansion of radiologic disease insight to truly capitalize on its capabilities.

Knopp, M, Clinical Applications of Quantitative DCE-MRI.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/12020940.html