MRI-CEST assessment of tumour perfusion using X-ray iodinated agents: comparison with a conventional Gd-based agent

Objectives X-ray iodinated contrast media have been shown to generate contrast in MR images when used with the chemical exchange saturation transfer (CEST) approach. The aim of this study is to compare contrast enhancement (CE) capabilities and perfusion estimates between radiographic molecules and a Gd-based contrast agent in two tumour murine models with different vascularization patterns. Methods MRI-CEST and MRI-CE T 1w images were acquired in murine TS/A and 4 T1 breast tumours upon sequential i.v. injection of iodinated contrast media (iodixanol, iohexol, and iopamidol) and of gadoteridol. The signal enhancements observed in the two acquisition modalities were evaluated using Pearson’s correlation, and the correspondence in the spatial distribution was assessed by a voxelwise comparison. Results A significant, positive correlation was observed between iodinated contrast media and gadoteridol for tumour contrast enhancement and perfusion values for both tumour models ( r = 0.51-0.62). High spatial correlations were observed in perfusion maps between iodinated molecules and gadoteridol ( r = 0.68-0.86). Tumour parametric maps derived by iodinated contrast media and gadoteridol showed high spatial similarities. Conclusions A good to strong spatial correlation between tumour perfusion parameters derived from MRI-CEST and MRI-CE modalities indicates that the two procedures provide similar information. Key Points • Gd-based agents are the standard of reference for contrast-enhanced MRI. • Iodinated contrast media provides MRI-CEST contrast enhancement in animal tumour models. • Contrast enhancements were positively correlated between iodinated agents and gadoteridol. • Tumour perfusion map showed similar spatial distribution between iodinated agents and gadoteridol. • MRI-CEST with iodinated agents provide similar information to gadoteridol.