The Principal of Dynamic Contrast Enhanced MRI, the Method of Pharmacokinetic Analysis, and Its Application in the Head and Neck Region

Abstract

Many researchers have established the utility of the dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) in the differential diagnosis in the head and neck region, especially in the salivary gland tumors. The subjective assessment of the pattern of the time-intensity curve (TIC) or the simple quantification of the TIC, such as the time to peak enhancement (T peak) and the wash-out ratio (WR), is commonly used. Although the semiquantitative evaluations described above have been widely applied, they do not provide information on the underlying pharmacokinetic analysis in tissue. The quantification of DCE-MRI is preferable; therefore, many compartment model analyses have been proposed. The Toft and Kermode (TK) model is one of the most popular compartment models, which provide information about the influx forward volume transfer constant from plasma into the extravascular-extracellular space (EES) and the fractional volume of EES per unit volume of tissue is used in many clinical studies. This paper will introduce the method of pharmacokinetic analysis and also describe the clinical application of this technique in the head and neck region.

The Correlations Between MRI Perfusion, Diffusion Parameters, and 18F-FDG PET Metabolic Parameters in Primary Head-and-Neck Cancer

“…Using compartmental modeling, DCE-MRI measures the pharmacokinetics of tissue microcirculation and provides data on vascular perfusion and permeability. 13 – 15 …”

Dynamic Contrast-Enhanced MRI Parameters as Biomarkers in Assessing Head and Neck Lesions After Chemoradiotherapy Using a Wide-Bore 3 Tesla Scanner

“…The benign cases demonstrated significantly faster wash-out than the new malignant cases, and the most significantly different parameters between these groups were the RWO and decay. There were some overlap here too, this is mainly due to the pleomorphic adenomas, which according to the literature can have gradual enchancement pattern (6), or as in our study they are very close to the malignant type curves [15]. The main limitation for BTs in our study is the relatively low number of them (n=15) and that the histology and location of benign lesions were quite diverse.…”

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“…Therefore, dynamic MRI has recently gained attention for the subjective and semiquantitative analysis of time-intensity curves. 9 Our institution recently developed an imaging modality that enables evaluation of patients who have undergone dynamic reconstruction (►Video 3). Lastly, for aesthetic evaluation, in the era of mandibular reconstruction, the final facial contour was evaluated.…”