Quantitative evaluation of dual-flip-angle T-1 mapping on DCE-MRI kinetic parameter estimation in head and neck

Purpose: To quantitatively evaluate the kinetic parameter estimation for head and neck (HN) dynamic contrast-enhanced (DCE) MRI with dual-flip-angle (DFA) T-1 mapping. Materials and methods: Clinical DCE-MRI datasets of 23 patients with HN tumors were included in this study. T-1 maps were generated based on multiple-flip-angle (MFA) method and different DFA combinations. Tofts model parameter maps of k(ep), K-trans and v(p) based on MFA and DFAs were calculated and compared. Fitted parameter by MFA and DFAs were quantitatively evaluated in primary tumor, salivary gland and muscle. Results: T-1 mapping deviations by DFAs produced remarkable kinetic parameter estimation deviations in head and neck tissues. In particular, the DFA of [2 degrees, 7 degrees] overestimated, while [7 degrees, 12 degrees] and [7 degrees, 15 degrees] underestimated K-trans and v(p), significantly (P<0.01). [2 degrees, 15 degrees] achieved the smallest but still statistically significant overestimation for K-trans and v(p) in primary tumors, 32.1% and 16.2% respectively. k(ep) fitting results by DFAs were relatively close to the MFA reference compared to K-trans and v(p). Conclusions: T-1 deviations induced by DFA could result in significant errors in kinetic parameter estimation, particularly Ktrans and vp, through Tofts model fitting. MFA method should be more reliable and robust for accurate quantitative pharmacokinetic analysis in head and neck.