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Reproducibility of quantitative dynamic contrast-enhanced MRI in newly presenting glioma

¹ Division of Imaging Science and Biomedical Engineering, Stopford Medical School, University of Manchester, Manchester M13 9PT, ² Cancer Research Campaign Department Medical Oncology, Christie Hospital, Wilmslow Road, Withington, Manchester M20 4BX and ³ AstraZeneca, Alderley Park, Macclesfield, Cheshire SK10 4TG, UK

Correspondence: Professor Alan Jackson, Imaging Science and Biomedical Engineering, Stopford Medical School, Oxford Road, Manchester M13 9PT, UK

We have investigated the reproducibility of dynamic contrast enhanced imaging techniques in nine patients with cerebral glioma. Patients were imaged twice with a 2 day interval between scans. Maps were produced of the time taken to achieve 90% enhancement (T90), the maximal intensity change per time interval ratio (MITR), the volume transfer coefficient between plasma and the extravascular extracellular space (K^trans) and the extravascular extracellular contrast distribution volume, v_e. Measurements of K^trans greater than 1.2 min^-1 were used to exclude pixels where first pass perfusion effects dominated the measurement. Measures of the test–retest coefficient of variation (CoV) and intraclass correlation coefficients were used to assess reproducibility for measurements from a volume of interest containing enhancing tissue from the whole tumour. MITR showed poor reproducibility (mean CoV 17.9%, 95% confidence limits for group comparisons 20.2%). T90 showed good reproducibility (mean CoV 7.1%, 95% confidence limits for group comparisons 5.2%). Calculated values of K^trans and v_e also showed good reproducibility (mean CoV 7.7% and 6.2% respectively, 95% confidence limits for group comparisons 6.2% and 4.8%, respectively). We conclude that the measurements of K^trans and v_e derived from pharmacokinetic analysis are sufficiently reproducible to support their use as a biological markers in therapeutic trials.

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