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Abstract #1155

DCEMRI Modelling in the Presence of Ill-perfused Regions

John C Waterton1,2, Josephine H Naish1, Anel Mahmutovic3, Lucy Edwards1, Matthew Heaton1, Marta Tibiletti1, Lars H Nordenmark4, Geoffrey JM Parker1,5, and James W MacKay6
1Bioxydyn, MANCHESTER, United Kingdom, 2Centre for Imaging Sciences, University of Manchester, MANCHESTER, United Kingdom, 3AstraZeneca, Mölndal, Sweden, 4AstraZeneca, Oslo, Norway, 5UCL Hawkes Institute, Department of Medical Imaging and Biomedical Engineering, University College London, LONDON, United Kingdom, 6AstraZeneca, Cambridge, United Kingdom

Synopsis

Keywords: Joint, biomarkers, DCEMRI; Rheumatoid Arthritis; Treatment Response

Motivation: Eliminate physiologically unrealistic results that sometimes arise from extended Tofts (ETM) DCEMRI analyses.

Goal(s): Develop and evaluate a model incorporating an avascular acellular compartment.

Approach: Synovitis and tenosynovitis DCEMRI from a rheumatoid arthritis (RA) clinical trial, measuring repeatability, and pharmacodynamic response to adalimumab.

Results: Despite the additional model parameter in the new model, repeatability, and ability to detect pharmacodynamic responses, were similar to standard ETM. Uptake rate constant repeatability CoV was 35% and pharmacodynamic treatment response ratio was 60% (p=0.027) (cf 39%, 54% and 0.027 for ETM). Extreme unphysiologic extravascular extracellular volumes ve were reported with ETM but not with the new model.

Impact: A robust DCEMRI analysis with better face validity increases confidence in the pathophysiologic interpretation of any pharmacodynamic changes.

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Keywords