Cancer is one of the leading causes of premature deaths across the world today, and there is an urgent need for imaging techniques that can help in early diagnosis and treatment planning for cancer patients. In the last four decades, magnetic resonance imaging (MRI) has emerged as one of the leading modalities for non-invasive imaging of tumours. By using dynamic contrast-enhanced magnetic resonance imaging (DCEMRI), this modality can be used to acquire information about perfusion and vascularity of tumours, which can help in predicting response to treatment. There are many factors that complicate the analysis of DCE-MRI data, and make clinical predictions based on it unreliable. During data acquisition, there are many sources of uncertainties and errors, especially patient motion, which result in the same image position being representative of many different anatomical locations across time. Apart from motion, there are also other inherent uncertainties and noise associated with the measurement of DCE-MRI parameters, which contribute to the model-fitting error observed when trying to apply pharmacokinetic (PK) models to the data. In this thesis, a probabilistic, model-based registration and parameter estimation (MoRPE) framework for motion correction and PK-parameter estimation in DCE-MRI sequences is presented. The MoRPE framework is first compared with conventional motion correction methods on simulated data, and then applied to data from a clinical trial involving twenty colorectal cancer patients. On clinical data, the ability of MoRPE to discriminate between responders and non-responders to combined chemoand radiotherapy is tested, and found to be superior to other methods. The effect of incorporating different arterial input functions within MoRPE is also assessed. Following this, a quantitative analysis of the uncertainties associated with the different PK parameters is performed using a variational Bayes mathematical framework. This analysis provides a quantitative estimate of the extent to which motion correction affects the uncertainties associated with different parameters. Finally, the importance of estimating spatial heterogeneity of PK parameters within tumours is assessed. The efficacy of different measures of spatial heterogeneity, in predicting response to therapy based on the pre-therapy scan alone are compared, and the prognostic value of a new derived PK parameter the 'acceleration constant' is investigated. The integration of uncertainty estimates of different DCE-MRI parameters into the calculation of their heterogeneity measures is also shown to improve the prediction of response to therapy.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:644675 |
| Date | January 2014 |
| Creators | Bhushan, Manav |
| Contributors | Schnabel, Julia; Jenkinson, Mark; Brady, Michael |
| Publisher | University of Oxford |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://ora.ox.ac.uk/objects/uuid:1793b0c1-7f2a-41cb-8427-c6927379056e |
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