The effect of gadolinium-based contrast agent administration on magnetic resonance fingerprinting-based T1 relaxometry in patients with prostate cancer

Nikita Sushentsev,Vincent J Gnanapragasam,Joshua D Kaggie,Rolf F Schulte,Martin J Graves,Tristan Barrett,Guido Buonincontri

doi:10.1038/s41598-020-77331-4

Nikita Sushentsev, Vincent J Gnanapragasam + Show 5 more

Open Access

https://doi.org/10.1038/s41598-020-77331-4

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Abstract

Magnetic resonance fingerprinting (MRF) is a rapidly developing fast quantitative mapping technique able to produce multiple property maps with reduced sensitivity to motion. MRF has shown promise in improving the diagnosis of clinically significant prostate cancer but requires further validation as part of a prostate multiparametric (mp) MRI protocol. mpMRI protocol mandates the inclusion of dynamic contrast enhanced (DCE) imaging, known for its significant T1 shortening effect. MRF could be used to measure both pre- and post-contrast T1 values, but its utility must be assessed. In this proof-of-concept study, we sought to evaluate the variation in MRF T1 measurements post gadolinium-based contrast agent (GBCA) injection and the utility of such T1 measurements to differentiate peripheral and transition zone tumours from normal prostatic tissue. We found that the T1 variation in all tissues increased considerably post-GBCA following the expected significant T1 shortening effect, compromising the ability of MRF T1 to identify transition zone lesions. We, therefore, recommend performing MRF T1 prior to DCE imaging to maintain its benefit for improving detection of both peripheral and transition zone lesions while reducing additional scanning time. Demonstrating the effect of GBCA on MRF T1 relaxometry in patients also paves the way for future clinical studies investigating the added value of post-GBCA MRF in PCa, including its dynamic analysis as in DCE-MRF.

Highlights

Magnetic resonance fingerprinting (MRF) is a rapidly developing fast quantitative mapping technique able to produce multiple property maps with reduced sensitivity to motion
The information about the diagnostic utility of MRF- and multiple spin echo (MSE)-based T 2, variable flip angle (VFA)-based T 1 and apparent diffusion coefficient (ADC) mapping is provided in the Supplementary Information S1. This prospective, proof-of-concept study demonstrates the effect of gadolinium-based contrast agent administration on MRF-based T1 relaxometry in the clinical setting
We have shown that gadolinium-based contrast agent (GBCA) considerably increases MRF T1 variation in both normal and malignant prostate tissues and compromises its diagnostic utility in the transition zone

Summary

Introduction

Magnetic resonance fingerprinting (MRF) is a rapidly developing fast quantitative mapping technique able to produce multiple property maps with reduced sensitivity to motion. We found that the T1 variation in all tissues increased considerably post-GBCA following the expected significant T1 shortening effect, compromising the ability of MRF T1 to identify transition zone lesions. Demonstrating the effect of GBCA on MRF T1 relaxometry in patients paves the way for future clinical studies investigating the added value of post-GBCA MRF in PCa, including its dynamic analysis as in DCE-MRF. MRF has shown promise for identifying both peripheral zone (PZ) and transition zone (TZ) prostate lesions, demonstrating added value to standard mpMRI sequences for differentiating between indolent and clinically significant disease[13,14,15]. Further prospective validation of MRF requires additional evaluation of how it can be incorporated into a standard clinical prostate mpMRI protocol, which includes dynamic contrast enhanced (DCE) imaging[3]. No attempts have been made to investigate the impact of gadolinium-based contrast agents (GBCA) on MRF-based T 1 relaxometry within patients in the clinical setting

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