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Poetter-Lang S, Ambros R, Messner A, Kristic A, Hodge JC, Bastati N, Schima W, Chernyak V, Bashir MR, Ba-Ssalamah A. Are dilution, slow injection and care bolus technique the causal solution to mitigating arterial-phase artifacts on gadoxetic acid-enhanced MRI? A large-cohort study. Eur Radiol 2024:10.1007/s00330-024-10590-1. [PMID: 38243134 DOI: 10.1007/s00330-024-10590-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024]
Abstract
OBJECTIVE Arterial-phase artifacts are gadoxetic acid (GA)-enhanced MRI's major drawback, ranging from 5 to 39%. We evaluate the effect of dilution and slow injection of GA using automated fluoroscopic triggering on liver MRI arterial-phase (AP) acquisition timing, artifact frequency, and lesion visibility. METHODS AND MATERIALS Saline-diluted 1:1 GA was injected at 1 ml/s into 1413 patients for 3 T liver MRI. Initially, one senior abdominal radiologist, i.e., principal investigator (PI), assessed all MR exams and compared them to previous and follow-up images, as well as the radiology report on record, determining the standard of reference for lesion detection and characterization. Then, three other readers independently evaluated the AP images for artifact type (truncation (TA), transient severe motion (TSM) or mixed), artifact severity (on a 5-point scale), acquisition timing (on a 4-point scale) and visibility (on a 5-point scale) of hypervascular lesions ≥ 5 mm, selected by the PI. Artifact score ≥ 4 and artifact score ≤ 3 were considered significant and non-significant artifacts, respectively. RESULTS Of the 1413 exams, diagnostic-quality arterial-phase images included 1100 (77.8%) without artifacts, 220 (15.6%) with minimal, and 77 (5.4%) with moderate artifacts. Only 16 exams (1.1%) had significant artifacts, 13 (0.9%) with severe artifacts (score 4), and three (0.2%) non-diagnostic artifacts (score 5). AP acquisition timing was optimal in 1369 (96.8%) exams. Of the 449 AP hypervascular lesions, 432 (96.2%) were detected. CONCLUSION Combined dilution and slow injection of GA with MR results in well-timed arterial-phase images in 96.8% and a reduction of exams with significant artifacts to 1.1%. CLINICAL RELEVANCE STATEMENT Hypervascular lesions, in particular HCC detection, hinge on arterial-phase hyperenhancement, making well-timed, artifact-free arterial-phase images a prerequisite for accurate diagnosis. Saline dilution 1:1, slow injection (1 ml/s), and automated bolus triggering reduce artifacts and optimize acquisition timing. KEY POINTS • There was substantial agreement among the three readers regarding the presence and type of arterial-phase (AP) artifacts, acquisition timing, and lesion visibility. • Impaired AP hypervascular lesion visibility occurred in 17 (3.8%) cases; in eight lesions due to mistiming and in nine lesions due to significant artifacts. • When AP timing was suboptimal, it was too late in 40 exams (3%) and too early in 4 exams (0.2%) of exams.
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Affiliation(s)
- Sarah Poetter-Lang
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University, General Hospital of Vienna (AKH), Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Raphael Ambros
- Department of Diagnostic and Interventional Radiology, Clinic Donaustadt, Vienna Healthcare Group, Vienna, Austria
| | - Alina Messner
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University, General Hospital of Vienna (AKH), Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Antonia Kristic
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University, General Hospital of Vienna (AKH), Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Jacqueline C Hodge
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University, General Hospital of Vienna (AKH), Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Nina Bastati
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University, General Hospital of Vienna (AKH), Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Wolfgang Schima
- Department of Diagnostic and Interventional Radiology, Goettlicher Heiland Krankenhaus, Barmherzige Schwestern Krankenhaus, and Sankt Josef Krankenhaus, Vienna, Austria
| | - Victoria Chernyak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Mustafa R Bashir
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
| | - Ahmed Ba-Ssalamah
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University, General Hospital of Vienna (AKH), Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Jang EB, Kim DW, Choi SH, Hong SB, Park T, Ko Y, Ham SJ. Transient severe motion artifacts on gadoxetic acid-enhanced MRI: risk factor analysis in 2230 patients. Eur Radiol 2022; 32:8629-8638. [PMID: 35665846 DOI: 10.1007/s00330-022-08885-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/07/2022] [Accepted: 05/12/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine risk factors for transient severe motion (TSM) artifact on arterial phase of gadoxetic acid-enhanced MRI using a large cohort. METHODS A total of 2230 patients who underwent gadoxetic acid-enhanced MRI was consecutively included. Two readers evaluated respiratory motion artifact on arterial phase images using a 5-point grading scale. Clinical factors including demographic data, underlying disease, laboratory data, presence of ascites and pleural effusion, and previous experience of gadoxetic acid-enhanced MRI were investigated. Univariable and multivariable logistic regression analyses were performed to determine significant risk factors for TSM. Predictive value of TSM was calculated according to the number of significant risk factors. RESULTS Overall incidence of TSM was 5.0% (111/2230). In the multivariable analysis, old age (≥ 65 years; odds ratio [OR] = 2.01 [95% CI, 1.31-3.07]), high body mass index (≥ 25 kg/m2; OR = 1.76 [1.18-2.63]), chronic obstructive pulmonary disease (OR = 6.11 [2.32-16.04]), and moderate to severe pleural effusion (OR = 3.55 [1.65-7.65]) were independent significant risk factors for TSM. Presence of hepatitis B (OR = 0.66 [0.43-0.99]) and previous experience of gadoxetic acid-enhanced MRI (OR = 0.52 [0.33-0.83]) were negative risk factors for TSM. When at least one of the significant factors was present, the predictive risk was 5.7% (109/1916), whereas it was 16.3% (17/104) when at least four factors were present. CONCLUSION Knowing risk factors for transient severe motion artifact on gadoxetic acid-enhanced MRI can be clinically useful for providing diagnostic strategies more tailored to individual patients. KEY POINTS • Old age, high body mass index, chronic obstructive pulmonary disease, and moderate to severe pleural effusion were independent risk factors for transient severe motion artifact on gadoxetic acid-enhanced MRI. • Patients with hepatitis B or previous experience of gadoxetic acid-enhanced MRI were less likely to show transient severe motion artifact. • As the number of risk factors for transient severe motion artifact increased, the predicted risk for it also showed a tendency to increase.
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Affiliation(s)
- Eun Bee Jang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Dong Wook Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Sang Hyun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Seung Baek Hong
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea
| | - Taeyong Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Yousun Ko
- Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Su Jung Ham
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
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Cannella R, Cammà C, Matteini F, Celsa C, Giuffrida P, Enea M, Comelli A, Stefano A, Cammà C, Midiri M, Lagalla R, Brancatelli G, Vernuccio F. Radiomics Analysis on Gadoxetate Disodium-Enhanced MRI Predicts Response to Transarterial Embolization in Patients with HCC. Diagnostics (Basel) 2022; 12:diagnostics12061308. [PMID: 35741118 PMCID: PMC9221802 DOI: 10.3390/diagnostics12061308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives: To explore the potential of radiomics on gadoxetate disodium-enhanced MRI for predicting hepatocellular carcinoma (HCC) response after transarterial embolization (TAE). Methods: This retrospective study included cirrhotic patients treated with TAE for unifocal HCC naïve to treatments. Each patient underwent gadoxetate disodium-enhanced MRI. Radiomics analysis was performed by segmenting the lesions on portal venous (PVP), 3-min transitional, and 20-min hepatobiliary (HBP) phases. Clinical data, laboratory variables, and qualitative features based on LI-RADSv2018 were assessed. Reference standard was based on mRECIST response criteria. Two different radiomics models were constructed, a statistical model based on logistic regression with elastic net penalty (model 1) and a computational model based on a hybrid descriptive-inferential feature extraction method (model 2). Areas under the ROC curves (AUC) were calculated. Results: The final population included 51 patients with HCC (median size 20 mm). Complete and objective responses were obtained in 14 (27.4%) and 29 (56.9%) patients, respectively. Model 1 showed the highest performance on PVP for predicting objective response with an AUC of 0.733, sensitivity of 100%, and specificity of 40.0% in the test set. Model 2 demonstrated similar performances on PVP and HBP for predicting objective response, with an AUC of 0.791, sensitivity of 71.3%, specificity of 61.7% on PVP, and AUC of 0.790, sensitivity of 58.8%, and specificity of 90.1% on HBP. Conclusions: Radiomics models based on gadoxetate disodium-enhanced MRI can achieve good performance for predicting response of HCCs treated with TAE.
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Affiliation(s)
- Roberto Cannella
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy; (C.C.); (P.G.); (M.E.); (C.C.)
- Correspondence: (R.C.); (F.V.)
| | - Carla Cammà
- University of Palermo, Piazza Marina, 61, 90133 Palermo, Italy;
| | - Francesco Matteini
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
| | - Ciro Celsa
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy; (C.C.); (P.G.); (M.E.); (C.C.)
- Department of Surgical, Oncological and Oral Sciences (D.C.O.S.), University of Palermo, 90133 Palermo, Italy
| | - Paolo Giuffrida
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy; (C.C.); (P.G.); (M.E.); (C.C.)
| | - Marco Enea
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy; (C.C.); (P.G.); (M.E.); (C.C.)
| | - Albert Comelli
- Ri.MED Foundation, Via Bandiera 11, 90133 Palermo, Italy;
| | - Alessandro Stefano
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Contrada Pietrapollastra-Pisciotto, 90015 Cefalù, Italy;
| | - Calogero Cammà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy; (C.C.); (P.G.); (M.E.); (C.C.)
| | - Massimo Midiri
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
| | - Roberto Lagalla
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
| | - Giuseppe Brancatelli
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
| | - Federica Vernuccio
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
- Department of Radiology, University Hospital of Padova, Via Nicolò Giustiniani, 2, 35128 Padua, Italy
- Correspondence: (R.C.); (F.V.)
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Kim DW, Choi SH, Park T, Kim SY, Lee SS, Byun JH. Transient Severe Motion Artifact on Arterial Phase in Gadoxetic Acid-Enhanced Liver Magnetic Resonance Imaging: A Systematic Review and Meta-analysis. Invest Radiol 2022; 57:62-70. [PMID: 34224484 DOI: 10.1097/rli.0000000000000806] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aims of this study were to determine the incidence of transient severe motion artifact (TSM) on arterial phase gadoxetic acid-enhanced magnetic resonance imaging of the liver and to investigate the causes of heterogeneity in the published literature. MATERIALS AND METHODS Original studies reporting the incidence of TSM were identified in searches of PubMed, Embase, and Cochrane Library databases. The pooled incidence of TSM was calculated using random-effects meta-analysis of single proportions. Subgroup analyses were conducted to explore causes of heterogeneity. RESULTS A total of 24 studies were finally included (single arterial phase, 19 studies with 3065 subjects; multiple arterial phases, 8 studies with 2274 subjects). Studies using single arterial phase imaging reported individual TSM rates varying from 4.8% to 26.7% and a pooled incidence of TSM of 13.0% (95% confidence interval, 10.3%-16.2%), which showed substantial study heterogeneity. The pooled incidence of TSM in the studies using multiple arterial phase imaging was 3.2% (95% confidence interval, 1.9%-5.2%), which was significantly less than in those studies using single arterial phase imaging (P < 0.001). In the subgroup analysis, the geographical region of studies and the definition of TSM were found to be causes of heterogeneity. The incidence of TSM was higher in studies with Western populations from Europe or North America than in those with Eastern (Asia/Pacific) populations (16.0% vs 8.8%, P = 0.005). Regarding the definition of TSM, the incidence of TSM was higher when a 4-point scale was used for its categorization than when a 5-point scale was used (20.0% vs 11.0%, P = 0.008), and a definition considering motion artifact on phases other than arterial phase imaging lowered the incidence of TSM compared with it being defined only on arterial phase imaging (11.3% vs 20.3%, P = 0.018). CONCLUSIONS The incidence of TSM on arterial phase images varied across studies and was associated with the geographical region of studies and the definition of TSM. Careful interpretation of results reporting TSM might therefore be needed.
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Affiliation(s)
- Dong Wook Kim
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Ichikawa S, Motosugi U, Sato K, Shimizu T, Wakayama T, Onishi H. Transient Respiratory-motion Artifact and Scan Timing during the Arterial Phase of Gadoxetate Disodium-enhanced MR Imaging: The Benefit of Shortened Acquisition and Multiple Arterial Phase Acquisition. Magn Reson Med Sci 2021; 20:280-289. [PMID: 32863326 PMCID: PMC8424022 DOI: 10.2463/mrms.mp.2020-0064] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose: To investigate whether shortened acquisition or multiple arterial phase acquisition improves image quality of the arterial phase compared with conventional protocol. Methods: This retrospective study was approved by the relevant Institutional Review Board. A total of 615 consecutive patients who underwent gadoxetate disodium-enhanced MRI including one of the following three sequences in three different periods were included: (i) conventional liver acquisition with volume acceleration (LAVA) (between October 2014 and January 2015, n = 149), (ii) Turbo-LAVA (between March and August 2016, n = 216), and (iii) differential sub-sampling with Cartesian ordering (DISCO) (between January and September 2015, n = 250). We monitored the respiratory bellows waveform during breath holding for each patient and recorded breath-hold fidelity of the patients. Two radiologists independently evaluated the degree of respiratory artifact and scan timing on the arterial phase and compared them between the three protocols (i.e., conventional LAVA, Turbo-LAVA, and DISCO), with conventional LAVA as control. Results: The ratio of patients with breath-hold failure was not significantly different among the three protocols (P = 0.6340 and 0.1085). Respiratory artifact was significantly lower in DISCO than in conventional LAVA (P = 0.0424), while there was no significant difference between Turbo-LAVA and conventional LAVA (P = 0.2593). The ratio of adequate scan timing and diagnosable image defined as no or mild artifact and adequate scan timing were higher in DISCO than in conventional LAVA (P = 0.0025 and 0.0019), while there was no significant difference between Turbo-LAVA and conventional LAVA (P = 0.0780 and 0.0657). Conclusion: Compared with conventional protocol, multiple arterial phase acquisition (DISCO) obtained a higher number of diagnosable images by reducing respiratory motion artifact and optimizing the scan timing of arterial phase.
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Affiliation(s)
| | - Utaroh Motosugi
- Department of Radiology, University of Yamanashi.,Department of Diagnostic Radiology, Kofu Kyoritsu Hospital
| | - Kazuyuki Sato
- Division of Radiology, University of Yamanashi Hospital
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Chang SD, Cunha GM, Chernyak V. MR Imaging Contrast Agents: Role in Imaging of Chronic Liver Diseases. Magn Reson Imaging Clin N Am 2021; 29:329-345. [PMID: 34243921 DOI: 10.1016/j.mric.2021.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Contrast-enhanced MR imaging plays an important role in the evaluation of patients with chronic liver disease, particularly for detection and characterization of liver lesions. The two most commonly used contrast agents for liver MR imaging are extracellular agents (ECAs) and hepatobiliary agents (HBAs). In patients with liver disease, the main advantage of ECA-enhanced MR imaging is its high specificity for the diagnosis of progressed HCCs. Conversely, HBAs have an additional contrast mechanism, which results in high liver-to-lesion contrast and highest sensitivity for lesion detection in the hepatobiliary phase. Emerging data suggest that features depicted on contrast-enhanced MR imaging scans are related to tumor biology and are predictive of patients' prognosis, likely to further expand the role of contrast-enhanced MR imaging in the clinical care of patients with chronic liver disease.
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Affiliation(s)
- Silvia D Chang
- Department of Radiology, University of British Columbia, Vancouver General Hospital, 899 West 12th Avenue, Vancouver, British Columbia V5Z 1M9, Canada. https://twitter.com/SilviaChangMD
| | - Guilherme Moura Cunha
- Department of Radiology, University of Washington, 1959 NE Pacific Street 2nd Floor, Seattle, WA 98195, USA
| | - Victoria Chernyak
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
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Glessgen CG, Breit HC, Block TK, Merkle EM, Heye T, Boll DT. Respiratory anomalies associated with gadoxetate disodium and gadoterate meglumine: compressed sensing MRI revealing physiologic phenomena during the entire injection cycle. Eur Radiol 2021; 32:346-354. [PMID: 34324024 PMCID: PMC8660712 DOI: 10.1007/s00330-021-08114-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/24/2021] [Accepted: 05/31/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The goal of this study was to investigate the precise timeline of respiratory events occurring after the administration of two gadolinium-based contrast agents, gadoxetate disodium and gadoterate meglumine. MATERIALS AND METHODS This retrospective study examined 497 patients subject to hepatobiliary imaging using the GRASP MRI technique (TR/TE = 4/2 ms; ST = 2.5 mm; 384 × 384 mm). Imaging was performed after administration of gadoxetate (N = 338) and gadoterate (N = 159). All GRASP datasets were reconstructed using a temporal resolution of 1 s. Four regions-of-interest (ROIs) were placed in the liver dome, the right and left cardiac ventricle, and abdominal aorta detecting liver displacement and increasing vascular signal intensities over time. Changes in hepatic intensity reflected respiratory dynamics in temporal correlation to the vascular contrast bolus. RESULTS In total, 216 (67%) and 41 (28%) patients presented with transient respiratory motion after administration of gadoxetate and gadoterate, respectively. The mean duration from start to acme of the respiratory episode was similar (p = 0.4) between gadoxetate (6.0 s) and gadoterate (5.6 s). Its mean onset in reference to contrast arrival in the right ventricle differed significantly (p < 0.001) between gadoxetate (15.3s) and gadoterate (1.8 s), analogously to peak inspiration timepoint in reference to the aortic enhancement arrival (gadoxetate: 0.9s after, gadoterate: 11.2 s before aortic enhancement, p < 0.001). CONCLUSIONS The timepoint of occurrence of transient respiratory anomalies associated with gadoxetate disodium and gadoterate meglumine differs significantly between both contrast agents while the duration of the event remains similar. KEY POINTS • Transient respiratory anomalies following the administration of gadoterate meglumine occurred during a time period usually not acquired in MR imaging. • Transient respiratory anomalies following the administration of gadoxetate disodium occurred around the initiation of arterial phase imaging. • The estimated duration of respiratory events was similar between both contrast agents.
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Affiliation(s)
| | | | - Tobias Kai Block
- Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University Grossman School of Medicine, New York, USA
| | - Elmar Max Merkle
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Tobias Heye
- Department of Radiology, University Hospital Basel, Basel, Switzerland
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Vietti Violi N, Argiriadi P, Rosen A, Cherny M, Weiss A, Hernandez-Meza G, Babb JS, Kihira S, Lewis S, Taouli B. Gadoxetate disodium-enhanced MRI: Assessment of arterial phase artifacts and hepatobiliary uptake in a large series. Eur J Radiol 2020; 132:109313. [PMID: 33053495 DOI: 10.1016/j.ejrad.2020.109313] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/28/2020] [Accepted: 09/24/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To report the quality of gadoxetate disodium MRI in a large series by assessing the prevalence of: 1) arterial phase (AP) artifacts and its predictive factors, 2) decreased hepatic contrast uptake during the hepatobiliary phase (HBP). METHODS This retrospective single center study included 851 patients (M/F:537/314, mean age: 63y) with gadoxetate disodium MRI. The MRI protocol included unenhanced, dual arterial [early and late arterial phases (AP)], portal venous, transitional and hepatobiliary phases. Three radiologists graded dynamic images using a 5-scale score (1: no motion, 5: severe, nondiagnostic) for assessment of transient severe motion (TSM, defined as a score ≥4 during at least one AP with a score ≤3 during other phases). HBP uptake was assessed using a 3-scale score (based on portal vein/hepatic signal). The association between demographic, clinical and acquisition parameters with TSM was tested in uni- and multivariate logistic regression. RESULTS TSM was observed in 103/851 patients (12.1 %): 83 (9.8 %) in one AP and 20 (2.3 %) in both APs. A score of 5 (nondiagnostic) was assigned in 7 patients in one AP (0.8 %) and none in both. Presence of TSM was significantly associated with age (p = 0.002) and liver disease (p = 0.033) in univariate but not in multivariate analysis (p > 0.05). No association was found between acquisition parameters and TSM occurrence. Limited or severely limited HBP contrast uptake was observed in 87 patients (10.2 %), and TSM was never associated with severely limited HBP contrast uptake. CONCLUSION TSM was present in approximately 12 % of gadoxetate disodium MRIs, rarely on both APs (2.3 %), and was poorly predicted. TSM was never associated with severely limited HBP contrast uptake.
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Affiliation(s)
- Naik Vietti Violi
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland.
| | - Pamela Argiriadi
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Ally Rosen
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Mathew Cherny
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Amanda Weiss
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | | | - James S Babb
- Department of Radiology, New York University Langone Medical Center, New York, NY USA.
| | - Shingo Kihira
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Sara Lewis
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Bachir Taouli
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Tanabe M, Higashi M, Iida E, Onoda H, Ihara K, Ariyoshi S, Kameda F, Miyoshi K, Furukawa M, Okada M, Ito K. Transient respiratory motion artifacts in multiple arterial phases on abdominal dynamic magnetic resonance imaging: a comparison using gadoxetate disodium and gadobutrol. Jpn J Radiol 2020; 39:178-185. [PMID: 32959222 DOI: 10.1007/s11604-020-01042-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/07/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE To compare the occurrence of transient respiratory motion artifacts (TRMAs) in multiple arterial phases on abdominal magnetic resonance (MR) images between those obtained using gadobutrol and gadoxetate disodium. MATERIALS AND METHODS Two hundred and fourteen abdominal MR examinations (101 with gadoxetate disodium, 113 with gadobutrol) were evaluated. Dynamic three-dimensional contrast-enhanced T1-weighted imaging (CAIPIRINHA-Dixon-TWIST-VIBE) including single-breath-hold six arterial phase acquisitions was performed on a 3.0-T MRI scanner. The TRMAs frequency and the mean TRMA scores were compared between patients assessed with gadoxetate disodium and those assessed with gadobutrol. In addition, the timing of TRMAs appearing for the first time was also recorded and compared between the two groups. RESULTS The mean TRMA scores in all arterial phases using gadoxetate disodium were significantly worse than in those using gadobutrol (1.49 ± 0.78 vs. 1.18 ± 0.53, P < .001). Regarding the timing of the occurrence of TRMAs, the severe TRMAs frequency after the third arterial phase was significantly higher in patients using gadoxetate disodium (10/101, 10%) than in those using gadobutrol (0/113, 0%) (P < .001). CONCLUSION In multiple-arterial-phase dynamic MRI, the TRMAs frequency when using gadoxetate disodium increased compared with gadobutrol, due to intolerable respiratory suspension after the third arterial phase.
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Affiliation(s)
- Masahiro Tanabe
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
| | - Mayumi Higashi
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Etsushi Iida
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Hideko Onoda
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Kenichiro Ihara
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Shoko Ariyoshi
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Fumi Kameda
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Keisuke Miyoshi
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Matakazu Furukawa
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Munemasa Okada
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Katsuyoshi Ito
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
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10
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Does transient arterial-phase respiratory-motion-related artifact impact on diagnostic performance? An intra-patient comparison of extracellular gadolinium versus gadoxetic acid. Eur Radiol 2020; 30:6694-6701. [DOI: 10.1007/s00330-020-07039-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/03/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
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11
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Wybranski C, Siedek F, Damm R, Gazis A, Wenzel O, Haneder S, Persigehl T, Steinhauser S, Pech M, Fischbach F, Fischbach K. Respiratory motion artefacts in Gd-EOB-DTPA (Primovist/Eovist) and Gd-DOTA (Dotarem)-enhanced dynamic phase liver MRI after intensified and standard pre-scan patient preparation: A bi-institutional analysis. PLoS One 2020; 15:e0230024. [PMID: 32196535 PMCID: PMC7083299 DOI: 10.1371/journal.pone.0230024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/18/2020] [Indexed: 12/15/2022] Open
Abstract
Objective The objective of this study is to evaluate if intensified pre-scan patient preparation (IPPP) that comprises custom-made educational material on dynamic phase imaging and supervised pre-imaging breath-hold training in addition to standard informative conversation with verbal explanation of breath-hold commands (standard pre-scan patient preparation–SPPP) might reduce the incidence of gadoxetate disodium (Gd-EOB-DTPA)-related transient severe respiratory motion (TSM) and severity of respiratory motion (RM) during dynamic phase liver MRI. Material and methods In this bi-institutional study 100 and 110 patients who received Gd-EOB-DTPA for dynamic phase liver MRI were allocated to either IPPP or SPPP at site A and B. The control group comprised 202 patients who received gadoterate meglumine (Gd-DOTA) of which each 101 patients were allocated to IPPP or SPPP at site B. RM artefacts were scored retrospectively in dynamic phase images (1: none– 5: extensive) by five and two blinded readers at site A and B, respectively, and in the hepatobiliary phase of the Gd-EOB-DTPA-enhanced scans by two blinded readers at either site. Results The incidence of TSM was 15% at site A and 22.7% at site B (p = 0.157). IPPP did not reduce the incidence of TSM in comparison to SPPP: 16.7% vs. 21.6% (p = 0.366). This finding was consistent at site A: 12% vs. 18% (p = 0.401) and site B: 20.6% vs. 25% (p = 0.590). The TSM incidence in patients with IPPP and SPPP did not differ significantly between both sites (p = 0.227; p = 0.390). IPPP did not significantly mitigate RM in comparison to SPPP in any of the Gd-EOB-DTPA-enhanced dynamic phases and the hepatobiliary phase in patients without TSM (all p≥0.072). In the Gd-DOTA control group on the other hand, IPPP significantly mitigated RM in all dynamic phases in comparison to SPPP (all p≤0.031). Conclusions We conclude that Gd-EOB-DTPA-related TSM cannot be mitigated by education and training and that Gd-EOB-DTPA-related breath-hold difficulty does not only affect the subgroup of patients with TSM or exclusively the arterial phase as previously proposed.
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Affiliation(s)
- Christian Wybranski
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Florian Siedek
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- * E-mail:
| | - Robert Damm
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Angelos Gazis
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Ortrud Wenzel
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Susanne Steinhauser
- Institute of Medical Statistics and Computational Biology, University Hospital of Cologne, Cologne, Germany
| | - Maciej Pech
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Frank Fischbach
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Katharina Fischbach
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
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12
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Glessgen CG, Moor M, Stieltjes B, Winkel DJ, Block TK, Merkle EM, Heye TJ, Boll DT. Gadoxetate Disodium versus Gadoterate Meglumine: Quantitative Respiratory and Hemodynamic Metrics by Using Compressed-Sensing MRI. Radiology 2019; 293:317-326. [DOI: 10.1148/radiol.2019190187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Carl G. Glessgen
- From the Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (C.G.G., M.M., B.S., D.J.W., E.M.M., T.J.H., D.T.B.); and Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY (T.K.B.)
| | - Manuela Moor
- From the Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (C.G.G., M.M., B.S., D.J.W., E.M.M., T.J.H., D.T.B.); and Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY (T.K.B.)
| | - Bram Stieltjes
- From the Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (C.G.G., M.M., B.S., D.J.W., E.M.M., T.J.H., D.T.B.); and Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY (T.K.B.)
| | - David J. Winkel
- From the Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (C.G.G., M.M., B.S., D.J.W., E.M.M., T.J.H., D.T.B.); and Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY (T.K.B.)
| | - Tobias K. Block
- From the Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (C.G.G., M.M., B.S., D.J.W., E.M.M., T.J.H., D.T.B.); and Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY (T.K.B.)
| | - Elmar M. Merkle
- From the Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (C.G.G., M.M., B.S., D.J.W., E.M.M., T.J.H., D.T.B.); and Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY (T.K.B.)
| | - Tobias J. Heye
- From the Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (C.G.G., M.M., B.S., D.J.W., E.M.M., T.J.H., D.T.B.); and Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY (T.K.B.)
| | - Daniel T. Boll
- From the Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (C.G.G., M.M., B.S., D.J.W., E.M.M., T.J.H., D.T.B.); and Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY (T.K.B.)
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13
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Respiratory motion in children and young adults undergoing liver magnetic resonance imaging with intravenous gadoxetate disodium contrast material. Pediatr Radiol 2019; 49:1171-1176. [PMID: 31203405 DOI: 10.1007/s00247-019-04437-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/29/2019] [Accepted: 05/21/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Gadoxetate disodium, utilized in hepatobiliary magnetic resonance (MR) imaging, has been associated with transient respiratory motion during the arterial phase in adults. OBJECTIVE The purpose of this study was to determine the presence and severity of this phenomenon in children imaged awake versus under general anesthesia. MATERIALS AND METHODS This retrospective cohort study was approved by the institutional review board; informed consent was waived. One hundred thirty exams of children ≤18 years old who underwent dynamic liver MR imaging with gadoxetate disodium between October 2010 and January 2018 were reviewed. Three pediatric radiologists scored respiratory motion artifacts on all imaging phases using a 5-point Likert scale. Differences in mean motion scores were assessed with analysis of variance and Tukey's multiple comparisons test, and multivariable regression was used to identify predictors of arterial phase motion in awake patients. RESULTS One hundred thirty patients (50% [n=65] female; mean age: 9.8±3.7 years, 48.5% [n=63] awake) were included. There were significant differences in mean motion scores between phases in the awake cohort (P<0.0001) but not in the general anesthesia cohort (P=0.051). In the awake cohort, arterial phase motion score (mean: 3.52±0.83) was significantly higher than mean motion score in all other phases (P≤0.0003). There were no significant patient-specific predictors of arterial phase motion score in the awake cohort. CONCLUSION Significantly increased arterial phase respiratory motion artifact in awake children undergoing dynamic liver MR imaging with gadoxetate disodium suggests that transient respiratory motion occurs in children. General anesthesia may suppress this phenomenon.
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14
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Chernyak V, Fowler KJ, Heiken JP, Sirlin CB. Use of gadoxetate disodium in patients with chronic liver disease and its implications for liver imaging reporting and data system (LI-RADS). J Magn Reson Imaging 2019; 49:1236-1252. [DOI: 10.1002/jmri.26540] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/23/2018] [Accepted: 09/26/2018] [Indexed: 12/17/2022] Open
Affiliation(s)
- Victoria Chernyak
- Department of Radiology, Montefiore Medical Center; Bronx New York USA
| | - Kathryn J. Fowler
- Liver Imaging Group, Department of Radiology; University of California - San Diego; California USA
| | - Jay P. Heiken
- Department of Radiology; Mayo Clinic; Rochester Minnesota USA
| | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology; University of California - San Diego; California USA
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15
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Continuous Hepatic Arterial Multiphase Magnetic Resonance Imaging During Free-Breathing. Invest Radiol 2018; 53:596-601. [DOI: 10.1097/rli.0000000000000459] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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16
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Namimoto T, Shimizu K, Nakagawa M, Kikuchi Y, Kidoh M, Oda S, Nakaura T, Utsunomiya D, Yamashita Y. Reducing artifacts of gadoxetate disodium-enhanced MRI with oxygen inhalation in patients with prior episode of arterial phase motion: intra-individual comparison. Clin Imaging 2018; 52:11-15. [PMID: 29494992 DOI: 10.1016/j.clinimag.2018.01.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/17/2018] [Accepted: 01/31/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine whether oxygen inhalation reducing artifacts in patients with previous transient severe motion (TSM) on gadoxetate-disodium-enhanced MRI. MATERIALS AND METHODS Fifty-one patients with TSM on previous gadoxetate-disodium-enhanced MRI (Baseline examination) were evaluated. Image quality in the examination with oxygen inhalation (Oxygen examination) and that in Baseline examination and the examination before Baseline examination without oxygen inhalation (Past examination) were qualitatively compared in dynamic study. RESULTS Image quality was significantly higher in Oxygen examination than Baseline examination in arterial phase, but there was no statistical difference between Baseline and Past examinations. CONCLUSION Oxygen inhalation improved image quality in patients with a prior episode of arterial phase TSM.
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Affiliation(s)
- Tomohiro Namimoto
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuoku, Kumamoto, 860-8556, Japan.
| | - Kie Shimizu
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Masataka Nakagawa
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Yoko Kikuchi
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuoku, Kumamoto, 860-8556, Japan
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