[Magnetic resonance for evaluating the response to treatment for ovarian hyperstimulation syndrome: comparison of pharmokinetic models.].
OBJECTIVE
To evaluate the response to treatment with cabergoline for ovarian hyperstimulation syndrome (OHS) using mono- and bi-compartmental MRI models.


METHODS
We studied 20 ovum donors with a high risk of developing OHS, divided in two groups (placebo vs. treatment). MRI perfusion studies were performed before and after the beginning of treatment. We compared the monocompartmental model, with the parameters vascular permeability (K(trans)), extraction ratio (k(ep)), and extravascular extracellular space fraction (v(e)), against the bicompartmental model, with the same parameters as in the monocompartmental model and the additional parameter vascular space fraction (v(p)). The differences between groups (placebo vs. treatment) on the two MRI studies and for each pharmacokinetic model were analyzed using t-tests for independent samples. The intraclass correlation coefficient (ICC) was used to assess the variability of the measurements.


RESULTS
In the placebo group, a significant increase in K(trans) was observed with both models (p=0.021 for one compartment; and p<0.001 for two compartments). In the treatment group, no statistically significant differences were found for any parameter in either model. Regarding differences between groups, in the bicompartmental model K(trans) increased 168.6%+/-151.9% in the placebo group versus 43.3%+/-54.5% in the treatment group, p=0.04). In the monocompartmental model, no differences were found between groups. In the variability analysis, the ICC was higher than 0.95 for all parameters except v(p) (ICC=0.89).


CONCLUSIONS
Capillary permeability calculated with bicompartmental pharmacokinetic models after MRI contrast administration is a biomarker of the treatment effect in OHS patients.
Sanz Requena
R
R
Servicio de Radiología, Hospital Quirón, Valencia, España. rsanz.val@quiron.es
Martí Bonmatí
L
L
Alvarez
C
C
García
G
G
Pellicer
A
A
Alberich Bayarri
A
A
Moratal
D
D
D000328:Adult; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D004873:Ergolines / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008962:Models, Theoretical; D016471:Ovarian Hyperstimulation Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome
D018491:Dopamine Agonists; D004873:Ergolines; D000077465:Cabergoline