Estimation of tissue perfusion by dynamic contrast-enhanced imaging: simulation-based evaluation of the steepest slope method.
OBJECTIVE
Tissue perfusion is frequently determined from dynamic contrast-enhanced CT or MRI image series by means of the steepest slope method. It was thus the aim of this study to systematically evaluate the reliability of this analysis method on the basis of simulated tissue curves.


METHODS
9600 tissue curves were simulated for four noise levels, three sampling intervals and a wide range of physiological parameters using an axially distributed reference model and subsequently analysed by the steepest slope method.


RESULTS
Perfusion is systematically underestimated with errors becoming larger with increasing perfusion and decreasing intravascular volume. For curves sampled after rapid contrast injection with a temporal resolution of 0.72 s, the bias was less than 23% when the mean residence time of tracer molecules in the intravascular distribution space was greater than 6 s. Increasing the sampling interval and the noise level substantially reduces the accuracy and precision of estimates, respectively.


CONCLUSIONS
The steepest slope method allows absolute quantification of tissue perfusion in a computationally simple and numerically robust manner. The achievable degree of accuracy and precision is considered to be adequate for most clinical applications.
Brix
Gunnar
G
Department of Medical and Occupational Radiation Protection, Federal Office for Radiation Protection, Oberschleissheim, Germany. gbrix@bfs.de
Zwick
Stefan
S
Griebel
Jürgen
J
Fink
Christian
C
Kiessling
Fabian
F
D000465:Algorithms; D003198:Computer Simulation; D003287:Contrast Media / Q000493:pharmacokinetics*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008954:Models, Biological; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media
J Appl Physiol (1985). 1987 Oct;63(4):1324-34
3500940
J Magn Reson Imaging. 1995 Mar-Apr;5(2):227-37
7766986
Radiother Oncol. 1999 Nov;53(2):105-11
10665786
Cancer Res. 2001 Mar 15;61(6):2513-6
11289123
Eur Radiol. 2010 Feb;20(2):432-42
19727758
Cancer Imaging. 2008 Oct 04;8 Spec No A:S87-93
18852084
Magn Reson Med. 2002 Mar;47(3):601-6
11870848
Br J Radiol. 1995 May;68(809):471-5
7788231
Eur Radiol. 2006 Nov;16 Suppl 7:M37-43
18655265
Cancer Res. 1989 Dec 1;49(23):6449-65
2684393
Med Phys. 2009 Jul;36(7):2923-33
19673191
Ann Biomed Eng. 1996 May-Jun;24(3):352-72
8734057
Radiology. 1999 Jan;210(1):269-76
9885619
Circ Res. 1989 Oct;65(4):997-1020
2791233
J Cereb Blood Flow Metab. 1998 Dec;18(12):1365-77
9850149
Magn Reson Med. 2003 Feb;49(2):276-87
12541248
Acad Radiol. 2010 Jan;17(1):61-6
19734063
Am J Physiol. 1986 Apr;250(4 Pt 2):H539-45
3963211
J Appl Physiol. 1954 Jun;6(12):731-44
13174454
J Nucl Med. 1995 Mar;36(3):371-7
7884497
Invest Radiol. 1993 Nov;28 Suppl 5:S72-7; discussion S78
8282508
J Magn Reson Imaging. 1997 Jan-Feb;7(1):91-101
9039598
Br J Radiol. 1991 May;64(761):409-12
2036562
J Comput Assist Tomogr. 1995 May-Jun;19(3):424-33
7790553
Eur Radiol. 2005 Jan;15(1):41-6
15351903
Eur J Radiol. 2010 Jun;74(3):e176-80
19540690
Eur Radiol. 2004 Jul;14(7):1226-33
15029450
Eur J Nucl Med Mol Imaging. 2010 Aug;37 Suppl 1:S30-51
20503049
Brain. 1990 Feb;113 ( Pt 1):27-47
2302536