Dynamic T1 mapping predicts outcome of chemoradiation therapy in primary rectal carcinoma:: Sequence implementation and data analysis

Purpose: To describe details about the implementation of a dynamic T-1-mapping technique and a simple data analysis strategy that can be used to predict therapy outcome in primary rectal carcinoma and to investigate the physiologic meaning of the obtained parameter. Materials and Methods: Contrast-enhanced dynamic T, mapping was achieved with a snapshot fast low-angle shot (FLASH) T, mapping sequence implemented on a 1.5T MR scanner. This method was applied to 58 patients with primary rectal cancer before onset of chemoradiation therapy. A simple data analysis strategy based on the calculation of the maximum slope of the tissue concentration-time curve divided by the maximum of the arterial input function (AIF) was used as a measure of tumor microcirculation (PI values). Results: The snapshot FLASH (SFL) T-1-mapping technique is accurate and sensitive enough to detect inhomogeneous uptake kinetics within tumor tissue. Classifying the patients into two groups according to therapy response showed lower mean PI values for responders as compared to nonresponders. PI was found to combine information about permeability surface area product (PS) and blood volume. Conclusions: The described method based on dynamic T, mapping has the potential to be a clinical tool for predicting therapy outcome of preoperative chemoradiation in patients with primary rectal carcinoma.