Faculty Collaboration Database

Dynamic contrast-enhanced MRI model selection for predicting tumor aggressiveness in papillary thyroid cancers. NMR Biomed 2020 Jan;33(1):e4166

Date

11/05/2019

Pubmed ID

31680360

Pubmed Central ID

PMC7687051

DOI

10.1002/nbm.4166

Scopus ID

2-s2.0-85074747271 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

The purpose of this study was to identify the optimal tracer kinetic model from T₁ -weighted dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data and evaluate whether parameters estimated from the optimal model predict tumor aggressiveness determined from histopathology in patients with papillary thyroid carcinoma (PTC) prior to surgery. In this prospective study, 18 PTC patients underwent pretreatment DCE-MRI on a 3 T MR scanner prior to thyroidectomy. This study was approved by the institutional review board and informed consent was obtained from all patients. The two-compartment exchange model, compartmental tissue uptake model, extended Tofts model (ETM) and standard Tofts model were compared on a voxel-wise basis to determine the optimal model using the corrected Akaike information criterion (AICc) for PTC. The optimal model is the one with the lowest AICc. Statistical analysis included paired and unpaired t-tests and a one-way analysis of variance. Bonferroni correction was applied for multiple comparisons. Receiver operating characteristic (ROC) curves were generated from the optimal model parameters to differentiate PTC with and without aggressive features, and AUCs were compared. ETM performed best with the lowest AICc and the highest Akaike weight (0.44) among the four models. ETM was preferred in 44% of all 3419 voxels. The ETM estimates of K^trans in PTCs with the aggressive feature extrathyroidal extension (ETE) were significantly higher than those without ETE (0.78 ± 0.29 vs. 0.34 ± 0.18 min^-1 , P = 0.005). From ROC analysis, cut-off values of K^trans , v_e and v_p , which discriminated between PTCs with and without ETE, were determined at 0.45 min^-1 , 0.28 and 0.014 respectively. The sensitivities and specificities were 86 and 82% (K^trans ), 71 and 82% (v_e ), and 86 and 55% (v_p ), respectively. Their respective AUCs were 0.90, 0.71 and 0.71. We conclude that ETM K^trans has shown potential to classify tumors with and without aggressive ETE in patients with PTC.

Author List

Paudyal R, Lu Y, Hatzoglou V, Moreira A, Stambuk HE, Oh JH, Cunanan KM, Aramburu Nunez D, Mazaheri Y, Gonen M, Ho A, Fagin JA, Wong RJ, Shaha A, Tuttle RM, Shukla-Dave A

Author

Yonggang Lu PhD Assistant Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Contrast Media
Female
Humans
Kinetics
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Invasiveness
Thyroid Neoplasms
Time Factors