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DOI: 10.1148/radiol.2491071936
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(Radiology 2008;248:901-909.)
© RSNA, 2008

Gastrointestinal Imaging

Colorectal Liver Metastases: Contrast Agent Diffusion Coefficient for Quantification of Contrast Enhancement Heterogeneity at MR Imaging1

Guang Jia, PhD, Craig O'Dell, BS, Johannes T. Heverhagen, MD, PhD, Xiangyu Yang, BS, Jiachao Liang, MS, Richard V. Jacko, BS, Steffen Sammet, MD, PhD, Theodore Pellas, VMD, PhD, Patricia Cole, MD, PhD, and Michael V. Knopp, MD, PhD

1 From the Department of Radiology and the Wright Center of Innovation in Biomedical Imaging, the Ohio State University, Columbus, OH 43210 (G.J., C.O., J.T.H., X.Y., J.L., R.V.J., S.S., M.V.K.); and Novartis Pharmaceuticals, East Hanover, NJ (T.P., P.C.). Received November 6, 2007; revision requested January 18, 2008; revision received February 17; accepted March 18; final version accepted April 3. Supported by the Wright Center of Innovation in Biomedical Imaging. Address correspondence to M.V.K. (e-mail: knopp.16{at}osu.edu).

Purpose: To describe and determine the reproducibility of a simplified model to quantitatively measure heterogeneous intralesion contrast agent diffusion in colorectal liver metastases.

Materials and Methods: This HIPAA-compliant retrospective study received institutional review board approval, and written informed consent was obtained from 14 patients (mean age, 61 years ± 9 [standard deviation]; range, 41–78 years), including 10 men (mean age, 65 years ± 8; range, 47–78 years) and four women (mean age, 54 years ± 9; range, 41–59 years), with colorectal liver metastases. Magnetic resonance (MR) imaging was performed twice (first baseline MR image [B1] and second baseline MR image [B2]) in a single target lesion prior to therapy. Dynamic contrast material–enhanced MR imaging was performed by using a saturation-recovery fast gradient-echo sequence. A simplified contrast agent diffusion model was proposed, and a contrast agent diffusion coefficient (CDC) was calculated. The reproducibility of the CDC measurement was evaluated by using the Bland-Altman plot and a linear regression model.

Results: The mean CDC was 0.22 mm2/sec (range, 0.01–0.73 mm2/sec) on B1 and 0.24 mm2/sec (range, 0.01–0.71 mm2/sec) on B2, with an intraclass correlation coefficient of 0.91 (P < .0001). Bland-Altman plot showed good agreement, with a mean difference in measurement pairs of 0.017 mm2/sec ± 0.096. The slope from the linear regression model was 0.89 (95% confidence interval: 0.63, 1.15) and the intercept was 0.01 (95% confidence interval: –0.08, 0.09).

Conclusion: The CDC enables a quantitative description of contrast enhancement heterogeneity in lesions. Given the high reproducibility of the CDC metric, CDC appears promising for further qualification as an imaging biomarker of change measurement in response assessment.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/248/3/901/DC1

© RSNA, 2008