title: Pharmacokinetic modeling of delayed gadolinium enhancement in the myocardium.
abstract: Delayed contrast-enhanced magnetic resonance imaging (DCE-MRI) provides prognostic information by delineating regions of myocardial scar. The mechanism of this delayed enhancement in myocardial infarctions (MIs) is hypothesized to result from altered kinetics and changes in the volumes of distribution in the myocardium. Pharmacokinetic models with two and three compartments were fitted to the concentration-time curves of dynamic contrast-enhanced MRI data obtained from five patients with known MI. Furthermore, the parameter stability was investigated in simulations for the two different models. The transfer constants and volumes of distribution showed a good correlation with imaging findings on early and delayed contrast-enhanced MRI. The two compartment model showed higher parameter stability. The three compartment model allows a more in-depth quantification of myocardial scarring. These models have the potential to improve the diagnosis of myocardial pathologies involving scar, with differing kinetics and volumes of distribution such as infarction or cardiomyopathy.
authors.affiliation: King's College London, Division of Imaging Sciences, London, United Kingdom.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Knowles
authors.forename: Philip G
authors.initials: PG
authors.lastname: Batchelor
authors.forename: Victoria
authors.initials: V
authors.lastname: Parish
authors.forename: Matthew
authors.initials: M
authors.lastname: Ginks
authors.forename: Sven
authors.initials: S
authors.lastname: Plein
authors.forename: Reza
authors.initials: R
authors.lastname: Razavi
authors.forename: Tobias
authors.initials: T
authors.lastname: Schaeffter
mesh_terms: D000465:Algorithms; D003198:Computer Simulation; D003287:Contrast Media / Q000493:pharmacokinetics; D005682:Gadolinium / Q000493:pharmacokinetics*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008657:Metabolic Clearance Rate; D008955:Models, Cardiovascular; D017682:Myocardial Stunning / Q000378:metabolism* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D005682:Gadolinium