Assessment of bolus injection protocol with appropriate concentration for quantitative assessment of pulmonary perfusion by dynamic contrast-enhanced MR imaging

Purpose: To determine the appropriate concentration for quantitative assessment of dynamic contrast-enhanced pulmonary MR imaging. Materials and Methods: A total of 40 consecutive patients with small bronchioalveolar carcinoma underwent perfusion single-photon emission tomography (SPECT) and three-dimensional (313) dynamic MR imaging with a 3D radiofrequency spoiled gradient-echo sequence. In each patient. 5 mL of contrast media With 0.1, 0.3, and 0.5 mmol/mL were administered at a rate of 5 mL/second. All patients were divided into two groups (< 70 kg and >= 70 kg) for assessment of appropriate concentration to quantitatively assess regional perfusion parameter in routine clinical practice. Pulmonary blood flow (PBF) in each protocol was calculated from a signal intensity (SI)-time course curve. Differences and limits of agreement of PBF between dynamic MR imaging (PBFMR) using three different concentrations and perfusion SPECT (PBFSPECT) were statistically compared in both patient groups. Results: PBFMR using 0.3 mmol/mL in the < 70-kg group and 0.5 mmol/mL in the >= 70-kg group showed no significant difference compared with PBFSPECT (P > 0.05). Limits of agreements in 0.3 mmol/mL in the < 70-kg group and 0.5 mmol/mL in the >= 70-kg group were smaller than those of the other concentrations and small enough for clinical purposes. Conclusion: Appropriate concentrations provide accurate and reproducible assessments of regional pulmonary perfusion parameters on 3D dynamic MR perfusion imaging. We suggest using 5 mL of contrast media with 0.3 mmol/mL for patients weighing less than 70 kg and 0.5 mmol/mL for patients weighing 70 kg or more.