MP39-10 NOVEL CONTRAST MIXTURE ACHIEVES CONTRAST RESOLUTION OF HUMAN BLADDER WALL SUITABLE FOR T1 MAPPING: APPLICATIONS IN INTERSTITIAL CYSTITIS (IC) AND BEYOND

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Interstitial Cystitis1 Apr 2018MP39-10 NOVEL CONTRAST MIXTURE ACHIEVES CONTRAST RESOLUTION OF HUMAN BLADDER WALL SUITABLE FOR T1 MAPPING: APPLICATIONS IN INTERSTITIAL CYSTITIS (IC) AND BEYOND Pradeep Tyagi, Joe Janicki, Chan-Hong Moon, Jonathan Kaufman, and Christopher Chermansky Pradeep TyagiPradeep Tyagi More articles by this author , Joe JanickiJoe Janicki More articles by this author , Chan-Hong MoonChan-Hong Moon More articles by this author , Jonathan KaufmanJonathan Kaufman More articles by this author , and Christopher ChermanskyChristopher Chermansky More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1257AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Instillation of novel contrast mixture (NCM) was recently shown to improve the contrast resolution of rat bladder wall with high contrast-to-noise ratio (CNR). Here, the clinical safety and the feasibility of NCM enhanced MRI to achieve artifact-free visualization of human bladder wall suitable for quantitative measurement of the magnetic resonance (MR) longitudinal relaxation time (T1) was accessed. METHODS Six female subjects [2 controls and 4 IC] consented for MRI at 3T before and after instillation of NCM [4mM Gadobutrol and 5mM Ferumoxytol in 50mL of sterile water for injection]. Respiratory monitoring belt was placed under the receiver coil for monitoring the breath-hold. Single breath hold fast MR acquisition from 5mm thick single slice in large readout bandwidth at variable flip angles was applied to minimize the motion and chemical shift artifacts in the measurements of bladder wall thickness (BWT), CNR and T1 from 20 pixels. RESULTS Subjects did not complain of any pain or discomfort from 50mL NCM instillation, beyond that caused by the catheterization process. Four-fold increase in bladder wall CNR (*p<0.02) and spatial resolution of 0.35mm with minimal influence of artifacts made it feasible to determine the significant bladder wall thinning of ~0.46mm (*p<0.05) from 50mL NCM. Pre-contrast bladder wall T1 of 1544± 34.2ms was shortened by Gadobutrol diffusion into the bladder wall to 860.09 ±13.95 ms in Hunner type IC (*p<0.0001, two way ANOVA) relative to only 1257.42± 20.59 ms and 1258.16 ± 6.16ms in non-Hunner type IC and controls, respectively. Post-contrast pixel-wise T1 mapping differentiated the bladder wall into layers with greater Gadobutrol mediated T1 shortening in pixels representing the urothelium and lamina propria (blue and green) compared to the detrusor region (yellow in attached picture). CONCLUSIONS Recapitulation of the published pre-clinical findings in the clinical setting demonstrates the safety and feasibility of NCM enhanced MRI to achieve artifact-free differential contrast and spatial resolution of human bladder wall, which is suitable for first pixel-wise measurement of T1 in both pre-and post-contrast settings. Quantitative T1 measurement holds promise in the non-invasive characterization of diffuse pathophysiological changes in bladder wall of IC patients. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e513-e514 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Pradeep Tyagi More articles by this author Joe Janicki More articles by this author Chan-Hong Moon More articles by this author Jonathan Kaufman More articles by this author Christopher Chermansky More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...