<book xmlns="http://docbook.org/ns/docbook" xmlns:xl="http://www.w3.org/1999/xlink" version="5.0">
  <title>CP-1524</title>
  <subtitle>More tracer kinetic models</subtitle>
  <chapter>
    <title></title>
    <informaltable rules="all" frame="box">
      <tr>
        <td rowspan="1" colspan="1" valign="top"><para>Status</para></td>
        <td rowspan="1" colspan="1" valign="top"><para>Letter Ballot</para></td>
      </tr>
      <tr>
        <td rowspan="1" colspan="1" valign="top"><para>Date of Last Update</para></td>
        <td rowspan="1" colspan="1" valign="top"><para>2016/01/18</para></td>
      </tr>
      <tr>
        <td rowspan="1" colspan="1" valign="top"><para>Person Assigned</para></td>
        <td rowspan="1" colspan="1" valign="top"><para>David Clunie</para><para><link
          xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="mailto:dclunie@dclunie.com"/></para></td>
      </tr>
      <tr>
        <td rowspan="1" colspan="1" valign="top"><para>Submitter Name</para></td>
        <td rowspan="1" colspan="1" valign="top"><para>David Clunie</para><para><link
          xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="mailto:dclunie@dclunie.com"/></para></td>
      </tr>
      <tr>
        <td rowspan="1" colspan="1" valign="top"><para>Submission Date</para></td>
        <td rowspan="1" colspan="1" valign="top"><para>2015/08/16</para></td>
      </tr>
    </informaltable>
    <informaltable rules="all" frame="box">
      <tr>
        <td rowspan="1" colspan="1" valign="top"><para>Correction Number CP-1524</para></td>
      </tr>
      <tr>
        <td rowspan="1" colspan="1" valign="top"><para>Log Summary: More tracer kinetic models</para></td>
      </tr>
      <tr>
        <td rowspan="1" colspan="1" valign="top">
          <para>Name of Standard</para>
          <para>PS3.16</para>
        </td>
      </tr>
      <tr>
        <td rowspan="1" colspan="1" valign="top">
          <para>Rationale for Correction:</para>
          <para>Review of the recent literature has identified more tracer kinetic models used in perfusion studies (e.g., DCE-MRI).</para>
        </td>
      </tr>
      <tr>
        <td rowspan="1" colspan="1" valign="top">Correction Wording:</td>
      </tr>
    </informaltable>
  </chapter>
  <chapter>
    <title/>
    <section>
      <title/>
      <informaltable rules="all" frame="box">
        <tr>
          <td><para><emphasis role="italic">Amend DICOM PS 3.16 as follows:</emphasis></para></td>
        </tr>
      </informaltable>
    </section>

    <section label="CID 4101" status="3" xml:id="sect_CID_4101">
      <title>Tracer Kinetic Models</title>
      <variablelist spacing="compact">
        <varlistentry>
          <term>
            <emphasis role="bold">Type:</emphasis>
          </term>
          <listitem>
            <para xml:id="para_b3e5e94f-ba3d-48d8-aa77-be2f94b3147f">
              <emphasis role="bold">Extensible</emphasis>
            </para>
          </listitem>
        </varlistentry>
        <varlistentry>
          <term>
            <emphasis role="bold">Version:</emphasis>
          </term>
          <listitem>
            <para xml:id="para_043ff264-0489-4f28-b2ea-b3071359e110">
              <emphasis role="bold"><emphasis role="strikethrough">20141110</emphasis><emphasis role="underline">yyyymmdd</emphasis></emphasis>
            </para>
          </listitem>
        </varlistentry>
      </variablelist>
      <table frame="box" label="CID 4101" rules="all" xml:id="table_CID_4101">
        <caption>Tracer Kinetic Models</caption>
        <thead>
          <tr valign="top">
            <th align="center" colspan="1" rowspan="1">
              <para xml:id="para_59091cd8-1751-42a2-abf9-b5f48e009129">
                <emphasis role="bold">Coding Scheme Designator</emphasis>
              </para>
            </th>
            <th align="center" colspan="1" rowspan="1">
              <para xml:id="para_093d0ad2-83da-4410-b896-b638e3accd91">
                <emphasis role="bold">Code Value</emphasis>
              </para>
            </th>
            <th align="center" colspan="1" rowspan="1">
              <para xml:id="para_482ca155-9d47-4c38-b1a6-3947786c9ca4">
                <emphasis role="bold">Code Meaning</emphasis>
              </para>
            </th>
          </tr>
        </thead>
        <tbody>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="para_38708450-e6b2-45f3-b9d7-528a1bb78af4">DCM</para>
            </td>
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="para_713cb007-fed7-475b-b297-8b892cf0f85a">
                <link linkend="DCM_126340" xrefstyle="select: nopage">126340</link>
              </para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_193c46be-c3d4-4b26-b7d0-cf4653c0fe0f">Standard Tofts Model</para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="para_bd55dc28-82a1-44d8-8782-44c8106d53c1">DCM</para>
            </td>
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="para_b85d7ab8-1222-4817-b599-82b8c6acc636">
                <link linkend="DCM_126341" xrefstyle="select: nopage">126341</link>
              </para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_c6b0354d-b7f6-4b7a-ba20-8c28b916c2c4">Extended Tofts Model</para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="para_5dd0b820-4e5d-49a6-8a93-7b30a1619c9c">DCM</para>
            </td>
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="para_3819a804-b471-4e03-897a-e57a93e40739">
                <link linkend="DCM_126343" xrefstyle="select: nopage">126343</link>
              </para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_5e2c9918-a173-4a72-98f6-1a99eca5fddd">First Pass Leakage Profile (FPLP)<emphasis role="bold"><emphasis role="underline"> Model</emphasis></emphasis></para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="para_9964cb79-f79d-45f7-b9ff-3c574211e3fd">DCM</para>
            </td>
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="para_d6d31ad5-419b-41b2-a0e2-9127609111b3">
                <link linkend="DCM_126344" xrefstyle="select: nopage">126344</link>
              </para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_e1623436-17be-4877-b394-43ec654100f2">Shutter-Speed Model (SSM)</para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">DCM</emphasis></emphasis></para>
            </td>
            <td align="center" colspan="1" rowspan="1">
              <para>
                <emphasis role="bold"><emphasis role="underline"><link linkend="DCM_ddd001" xrefstyle="select: nopage">ddd001</link></emphasis></emphasis>
              </para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">Gamma Capillary Transit Time (GCTT) Model</emphasis></emphasis></para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">DCM</emphasis></emphasis></para>
            </td>
            <td align="center" colspan="1" rowspan="1">
              <para>
                <emphasis role="bold"><emphasis role="underline"><link linkend="DCM_ddd002" xrefstyle="select: nopage">ddd002</link></emphasis></emphasis>
              </para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">Adiabatic Tissue Homogeneity (ATH) Model</emphasis></emphasis></para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">DCM</emphasis></emphasis></para>
            </td>
            <td align="center" colspan="1" rowspan="1">
              <para>
                <emphasis role="bold"><emphasis role="underline"><link linkend="DCM_ddd003" xrefstyle="select: nopage">ddd003</link></emphasis></emphasis>
              </para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">Two-Compartment Exchange (2CX) Model</emphasis></emphasis></para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">DCM</emphasis></emphasis></para>
            </td>
            <td align="center" colspan="1" rowspan="1">
              <para>
                <emphasis role="bold"><emphasis role="underline"><link linkend="DCM_ddd004" xrefstyle="select: nopage">ddd004</link></emphasis></emphasis>
              </para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline"/></emphasis></para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">DCM</emphasis></emphasis></para>
            </td>
            <td align="center" colspan="1" rowspan="1">
              <para>
                <emphasis role="bold"><emphasis role="underline"><link linkend="DCM_ddd005" xrefstyle="select: nopage">ddd005</link></emphasis></emphasis>
              </para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline"/></emphasis></para>
            </td>
          </tr>
        </tbody>
      </table>
      <note>
        <para xml:id="para_8f095440-4a4d-4502-8c56-905263add10c"/>
      </note>
    </section>

    <section>
      <table frame="box" label="D-1" rules="all" xml:id="table_D-1">
        <caption>DICOM Controlled Terminology Definitions</caption>
        <thead>
          <tr valign="top">
            <th align="center" colspan="1" rowspan="1">
              <para xml:id="para_f05607a1-90fe-4408-ad56-d194c3203ae5">
                <emphasis role="bold">Code Value</emphasis>
              </para>
            </th>
            <th align="center" colspan="1" rowspan="1">
              <para xml:id="para_022556ee-7c69-4138-a152-b3fa16bb86b2">
                <emphasis role="bold">Code Meaning</emphasis>
              </para>
            </th>
            <th align="center" colspan="1" rowspan="1">
              <para xml:id="para_e0270183-1962-48d5-877f-b63624671b37">
                <emphasis role="bold">Definition</emphasis>
              </para>
            </th>
            <th align="center" colspan="1" rowspan="1">
              <para xml:id="para_5aa10e80-ebb2-45b9-a2a9-fe4b3eb4497c">
                <emphasis role="bold">Notes</emphasis>
              </para>
            </th>
          </tr>
        </thead>
        <tbody>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para>...</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="DCM_126340">126340</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_510d45c2-c06a-4ca9-a205-1987ca03b490">Standard Tofts Model</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_9f028c17-2d09-4fc4-84cd-9fe51635aece">A tracer diffusion kinetic model in which the permeability is assumed to be isodirectional.</para>
              <para xml:id="para_090ddc80-7989-4bf0-a2a3-2ae0eaf16cf3">See P. Tofts, "Modeling tracer kinetics in dynamic Gd-DTPA MR imaging", Journal of Magnetic Resonance Imaging, vol. 7, pp. 91–101, 1997.</para>
              <para><emphasis role="bold"><emphasis role="underline">Mathematically equivalent to the model proposed by Kety in a non-MRI context, hence sometimes refered to as the Tofts-Kety (TK) model. See Kety SS. The Theory and Applications of the Exchange of Inert Gas at the Lungs and Tissues. Pharmacological Reviews. 1951 Mar 1;3(1):1–41.</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_38abd05b-6d77-4bbd-adfa-1b70d5e56eab"/>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="DCM_126341">126341</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_6982af37-f0a8-4963-b2ff-25eed0db0f80">Extended Tofts Model</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_45ffef09-4dba-4fec-8863-70d4f3d30a53">A tracer diffusion kinetic model in which the permeability is not assumed to be isodirectional, and which includes the contribution of tracer in the blood plasma to the total tissue concentration.</para>
              <para xml:id="para_1b09df4e-9bb2-44ce-a21d-2172ec2f5385">See P. Tofts, "Modeling tracer kinetics in dynamic Gd-DTPA MR imaging", Journal of Magnetic Resonance Imaging, vol. 7, pp. 91–101, 1997.</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_c6739c58-435e-4386-906c-c517a02d38a0"/>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para>...</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="DCM_126343">126343</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_c2408a74-c194-4b05-a018-ee58c9159862">First Pass Leakage Profile (FPLP)<emphasis role="bold"><emphasis role="underline"> Model</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_7981142e-db8e-4709-af29-e2a93819a50a">A tracer diffusion kinetic model that accounts for the tumor leakage profile during the first pass of contrast.</para>
              <para xml:id="para_4ef49cf1-184f-4d9c-b183-e564c8be1599">See Li, Ka-Loh, Xiao Ping Zhu, John Waterton, and Alan Jackson. "Improved 3D Quantitative Mapping of Blood Volume and Endothelial Permeability in Brain Tumors." Journal of Magnetic Resonance Imaging 12, no. 2 (2000): 347–357. doi:​10.1002/​1522-2586(200008)12:​2&lt;347::AID-JMRI19&gt;​3.0.CO;2-7.</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_64172716-cb6c-492a-a12c-1e8c643ad24b"/>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="DCM_126344">126344</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_5fc9ed9b-4562-4b82-aaf4-482422e45589">Shutter-Speed Model (SSM)</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_86445dfd-1796-4234-bb07-1451379d6ed4">A tracer diffusion kinetic model that does not assume that intercompartmental water molecule exchange is infinitely fast.</para>
              <para xml:id="para_61bb17b4-9c18-4239-af00-ab084c3784e6">See Li, Xin, Wei Huang, Thomas E. Yankeelov, Alina Tudorica, William D. Rooney, and Charles S. Springer. “Shutter-Speed Analysis of Contrast Reagent Bolus-Tracking Data: Preliminary Observations in Benign and Malignant Breast Disease.” Magnetic Resonance in Medicine 53, no. 3 (2005): 724–29. doi:10.1002/mrm.20405.</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para xml:id="para_892f2f39-8681-4882-b8d7-b7310ee667a9"/>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para>...</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="DCM_ddd001"><emphasis role="bold"><emphasis role="underline">DCM_ddd001</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">Gamma Capillary Transit Time (GCCT) Model</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">A tracer diffusion kinetic model that mathematically unifies the Tofts, Extended Tofts, Adiabatic Tissue Homogeneity, and Two Compartment Exchange models</emphasis></emphasis></para>
              <para><emphasis role="bold"><emphasis role="underline">See Schabel MC. A unified impulse response model for DCE-MRI. Magnetic Resonance in Medicine. 2012;68(5):1632–46. doi:10.1002/mrm.24162.</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="DCM_ddd002"><emphasis role="bold"><emphasis role="underline">DCM_ddd002</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">Adiabatic Tissue Homogeneity (ATH) Model</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">An adiabatic approximation to the tissue homogeneity tracer diffusion kinetic model, which assumes that the tracer concentration in parenchymal tissue changes slowly relative to that in capillaries.</emphasis></emphasis></para>
              <para><emphasis role="bold"><emphasis role="underline">See St. Lawrence KS, Lee T-Y. An Adiabatic Approximation to the Tissue Homogeneity Model for Water Exchange in the Brain: I. Theoretical Derivation. J Cereb Blood Flow Metab. 1998 Dec;18(12):1365–77. doi:10.1097/00004647-199812000-00011.</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="DCM_ddd003"><emphasis role="bold"><emphasis role="underline">DCM_ddd003</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">Two Compartment Exchange (2CX) Model</emphasis></emphasis></para>
                </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">A tracer diffusion kinetic  that incorporates the extracellular space of the lesion as a peripheral compartment, connected to the central (plasma) compartment by linear exchange processes in both directions.</emphasis></emphasis></para>
              <para><emphasis role="bold"><emphasis role="underline">See Brix G, Semmler W, Port R, Schad LR, Layer G, Lorenz WJ. Pharmacokinetic Parameters in CNS Gd-DTPA Enhanced MR Imaging. Journal of Computer Assisted Tomography. 1991;15(4):621–8.</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="DCM_ddd004"><emphasis role="bold"><emphasis role="underline">DCM_ddd004</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">...</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">...</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
          </tr>
          <tr valign="top">
            <td align="center" colspan="1" rowspan="1">
              <para xml:id="DCM_ddd005"><emphasis role="bold"><emphasis role="underline">DCM_ddd005</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">...</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para><emphasis role="bold"><emphasis role="underline">...</emphasis></emphasis></para>
            </td>
            <td align="left" colspan="1" rowspan="1">
              <para>...</para>
            </td>
          </tr>
        </tbody>
      </table>
    </section>

  </chapter>
</book>
