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Figures
- Fig 1.
MR signal intensity is diminished in response to radiation therapy in DCE-MR imaging. A, Representative sagittal and axial T1-weighted MR images and dynamic derived images from DCE-MR imaging, illustrating a chordoma of the sacrum and clivus, pre- and postradiation therapy. B, Individual dynamic MR signal intensity–time curves pre-RT (blue) and post-RT (purple), obtained from corresponding ROIs (red).
- Fig 2.
Perfusion maps of Ktrans and Vp pre- and postradiation therapy. Ktrans and Vp maps corresponding to the representative sacrum and clivus cases in Fig 1. Regions of enhancement are indicated by white arrows, both pre-RT and post-RT.
- Fig 3.
Tumor plasma volume and permeability decreased after radiation therapy. Box-and-whisker plots illustrating a five-number summary for DCE-MR imaging perfusion parameters: A, Vp mean. B, Vp max. C, Ktrans mean. D, Ktrans max (n = 12). Significant differences were observed pre-RT and post-RT in 3 of 4 parameters: Vp mean (pre-RT mean = 0.82, post-RT mean = 0.42, asterisk indicates P = .02), Vp max (pre-RT mean = 3.56, post-RT mean = 2.27, asterisk indicates P = .04), and Ktrans mean (pre-RT mean = 0.046, post-RT mean = 0.028, asterisk indicates P = .03). Differences in Ktrans max values pre-RT (mean = 0.11) and post-RT (mean = 0.092) were not significant (P = .47).
- Fig 4.
Chordoma is distinguished by its unique signature on DCE-MR signal intensity–time curves. A, Averaged dynamic MR signal intensity curves for patients with chordoma (n = 12) pre-RT (blue) and post-RT (purple). Significant differences in areas under the curve pre-RT and post-RT were observed (P = .03). B, Individual dynamic MR signal intensity–time curves from 12 patients (gray) were used to generate an average curve (blue). C, Unlike hypervascular renal cell carcinomas (red) and hypovascular prostate carcinomas (green) spinal metastases,14 chordoma presents with a signal intensity–time curve characterized by slow contrast uptake and lack of peak enhancement, likely due to a slow washout phase. For all graphs, each phase = 1 second.
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