Can Dynamic Contrast-Enhanced MRI (DCE-MRI) and Diffusion-Weighted MRI (DW-MRI) Evaluate Inflammation Disease

Abstract

The aim of the study was to investigate diagnosis efficacy of dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted MRI (DW-MRI) in Crohn's disease (CD). To find out the correlations between functional MRI parameters including Ktrans, Kep, Ve, Vp, and apparent diffusion coefficient (ADC) with a serologic biomarker. The relationships between pharmacokinetic parameters and ADC were also studied.Thirty-two patients with CD (22 men, 10 women; mean age: 30.5 years) and 18 healthy volunteers without any inflammatory disease (10 men, 8 women; mean age, 34.11 years) were enrolled into this approved prospective study. Pearson analysis was used to evaluate the correlation between Ktrans, Kep, Ve, Vp, and C-reactive protein (CRP), ADC, and CRP respectively. The diagnostic efficacy of the functional MRI parameters in terms of sensitivity and specificity were analyzed by receiver operating characteristic (ROC) curve analyses. Optimal cut-off values of each functional MRI parameters for differentiation of inflammatory from normal bowel were determined according to the Youden criterion.Mean value of Ktrans in the CD group was significantly higher than that of normal control group. Similar results were observed for Kep and Ve. On the contrary, the ADC value was lower in the CD group than that in the control group. Ktrans and Ve were shown to be correlated with CRP (r = 0.725, P < 0.001; r = 0.533, P = 0.002), meanwhile ADC showed negative correlation with CRP (r = −0.630, P < 0.001). There were negative correlations between the pharmacokinetic parameters and ADC, such as Ktrans to ADC (r = −0.856, P < 0.001), and Ve to ADC (r = −0.451, P = 0.01). The area under the curve (AUC) was 0.994 for Ktrans (P < 0.001), 0.905 for ADC (P < 0.001), 0.806 for Ve (P < 0.001), and 0.764 for Kep (P = 0.002). The cut-off point of the Ktrans was found to be 0.931 min–1. This value provided the best trade-off between sensitivity (93.8%) and specificity (100%). The best cut-off point of ADC was 1.11 × 10–3 mm2/s. At this level, sensitivity was 100% and specificity was 68.8%.DCE-MRI and DW-MRI were helpful in the diagnosis of CD. Quantitative MRI parameters could be used to assess the severity of inflammation. The relationships between pharmacokinetic parameters (Ktrans and Ve) and ADC reflected microstructure and microcirculation of CD to some extent.

Assessment of therapeutic response in Crohn's disease using quantitative dynamic contrast enhanced MRI (DCE-MRI) parameters

“…[ 15 ] Meanwhile, studies have employed this technique to assess neovascularization in inflammatory diseases. [ 16 , 17 ] We have assessed the role of DCE-MRI in diagnosis and assessment for CD, [ 18 ] such findings are similar to other researches. [ 19 – 21 ] In this paper, we present a preliminary study of CD by DCE-MRI and hypothesize that the parameters of DCE-MRI can be used to evaluate the therapeutic response.…”

“…In this study, K trans and BV decreased significantly after treatment and good correlation was shown between Δ K trans , ΔBV, and changes of clinical indicators. In our prior study, [ 18 ] we have found the parameters of DCE-MRI including K trans had significant correlation with CRP. Sinha et al [ 37 ] concluded that the contrast agent rapidly passed from the vascular space into the EES, resulting in mural enhancement in CD patients.…”

“…Jia et al [ 27 ] used pathological complete response and major histological response as references to identify the capability of DCE-MRI in predicting treatment response among 48 breast cancer patients. In the current study, choosing CRP and HBI as reference was based on following reasons: (1) surgery is not the preferred treatment for CD, so it is difficult to obtain pathological samples; (2) MVD reports only a morphologic index of vasculature and cannot differentiate between functional vessels, whereas DCE-MRI parameters reflect those vessels with active perfusion [ 28 ] ; (3) CRP and clinical scores have been set as gold-standard in previous DCE-MRI researches [ 16 , 18 ] ; (4) CRP and HBI are important monitoring tools in the clinical management of CD. [ 29 , 30 ]…”

Dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted imaging in the activity staging of terminal ileum Crohn's disease

“…Conventional Magnetic Resonance Index of Activity (MaRIA) is calculated by multiple embedded formulas by wall thickness, relative contrast enhancement (RCE) and two qualitative variables, edema and ulceration, to identify inactive and active disease[ 10 ]. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been widely accepted as a tool to monitor disease progression in other organs[ 11 - 13 ] and can provide quantitative perfusion and permeability information on the bowel wall to accurately localize lesions, monitor disease activity and evaluate treatment responses[ 14 - 17 ]. Menys et al [ 18 ] proposed grading CD with MRE on the basis of magnetic resonance (MR) contrast enhancement, indicating that DCE-MRI may be useful in grading CD.…”

Quantitative DCE-MRI : An efficient diagnostic technique for evaluating early micro-environment permeability changes in ankylosing spondylitis

“…Compared with morphological imaging, quantitative dynamic contrast enhanced magnetic resonance imaging(DCE-MRI),basing on a pharmacokinetic model, have been successfully used to assess changes in different diseases [3,[15][16] .It can provide su cient information on microenvironment changes and could be used to assess the severity of in ammation quantitatively [17] .In the management of early AS joint, there is also a need for reliable noninvasive quantitative monitoring biomarker to closely assess status of in ammatory progression. In 2019, the ASAS-MRI work group have pointed out that increased signal on contrast-enhanced images of the joint space of the cartilaginous portion of the SIJ re ected in ammation at the osteochondral interface, as this would be consistent with the understanding of early histopathological feature of AS [18] .Cognizant to this, studies geared on improving techniques for quantitative evaluation of micro-environment permeability of the joint space before edema and in ammation visualized in adjacent bone marrow of SIJ are necessary.…”