title: DCE-MRI of hepatocellular carcinoma: perfusion quantification with Tofts model versus shutter-speed model--initial experience.
abstract: OBJECTIVE
  To quantify hepatocellular carcinoma (HCC) perfusion and flow with the fast exchange regime-allowed Shutter-Speed model (SSM) compared to the Tofts model (TM).
  
  
  METHODS
  In this prospective study, 25 patients with HCC underwent DCE-MRI. ROIs were placed in liver parenchyma, portal vein, aorta and HCC lesions. Signal intensities were analyzed employing dual-input TM and SSM models. ART (arterial fraction), K (trans) (contrast agent transfer rate constant from plasma to extravascular extracellular space), ve (extravascular extracellular volume fraction), kep (contrast agent intravasation rate constant), and τi (mean intracellular water molecule lifetime) were compared between liver parenchyma and HCC, and ART, K (trans), v e and k ep were compared between models using Wilcoxon tests and limits of agreement. Test-retest reproducibility was assessed in 10 patients.
  
  
  RESULTS
  ART and v e obtained with TM; ART, ve, ke and τi obtained with SSM were significantly different between liver parenchyma and HCC (p < 0.04). Parameters showed variable reproducibility (CV range 14.7-66.5% for both models). Liver K (trans) and ve; HCC ve and kep were significantly different when estimated with the two models (p < 0.03).
  
  
  CONCLUSIONS
  Our results show differences when computed between the TM and the SSM. However, these differences are smaller than parameter reproducibilities and may be of limited clinical significance.
authors.affiliation: Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA.
authors.forename: Guido H
authors.initials: GH
authors.lastname: Jajamovich
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Besa
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Aneela
authors.initials: A
authors.lastname: Afzal
authors.affiliation: Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA.
authors.forename: Hadrien A
authors.initials: HA
authors.lastname: Dyvorne
authors.affiliation: Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA. bachir.taouli@mountsinai.org.
authors.forename: Bachir
authors.initials: B
authors.lastname: Taouli
mesh_terms: D000368:Aged; D000465:Algorithms; D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010477:Perfusion; D011446:Prospective Studies; D015203:Reproducibility of Results; D014867:Water / Q000737:chemistry
chemical_list: D014867:Water
keywords: Hepatocellular carcinoma; Liver; MRI