Feasibility of test-bolus DCE-MRI using CAIPIRINHA-VIBE for the evaluation of pancreatic malignancies

Objectives: To evaluate the feasibility of test-bolus dynamic contrast-enhanced (DCE) MRI with CAIPIRINHA-VIBE for pancreatic malignancies. Methods: Thirty-two patients underwent DCE-MRI with CAIPIRINHA-VIBE after injection of 2 mL gadolinium. From the resulting time–intensity curve (TIC), we estimated the arterial (AP) and portal venous phase (PVP) scan timing for subsequent multiphasic MRI. DCE-MRI perfusion maps were generated, and perfusion parameters were calculated. The image quality was rated on a 5-point scale (1: poor, 5: excellent). Goodness-of-fit of the TIC was evaluated by Pearson’s χ² test. Results: Test-bolus DCE-MRIs with high temporal (3 s) and spatial resolution (1 × 1 × 4 mm³) were acquired with good-quality perfusion maps of Ktrans and iAUC (mean score 4.313 ± 0.535 and 4.125 ± 0.554, respectively). The mean χ² values for fitted TICs were 0.115 ± 0.082 for the pancreatic parenchyma and 0.784 ± 0.074 for pancreatic malignancies, indicating an acceptable goodness-of-fit. Test-bolus DCE-MRI was highly accurate in estimating the proper timing of AP (90.6 %) and PVP (100 %) of subsequent multiphasic MRI. Between pancreatic adenocarcinomas and neuroendocrine tumours, there were significant differences in the Ktrans (0.073 ± 0.058 vs. 0.308 ± 0.062, respectively; p = 0.007) and iAUC (1.501 ± 0.828 vs. 3.378 ± 0.378, respectively; p = 0.045). Conclusions: Test-bolus DCE-MRI using CAIPIRINHA-VIBE is feasible for incorporating perfusion analysis of pancreatic tumours into routine multiphasic MRI. Key Points: • Test-bolus DCE-MRI using CAIPIRINHA-VIBE is feasible for perfusion analysis of pancreatic tumours. • CAIPIRINHA-VIBE enables DCE-MRI with high temporal and spatial resolution. • Test-bolus DCE-MRI is highly accurate in estimating the proper timing of multiphasic MRI.