1
|
Dunn A, Wagner S, Sussman D. Scoping review of magnetic resonance motion imaging phantoms. MAGMA 2024:10.1007/s10334-024-01164-9. [PMID: 38739218 DOI: 10.1007/s10334-024-01164-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/28/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024]
Abstract
To review and analyze the currently available MRI motion phantoms. Publications were collected from the Toronto Metropolitan University Library, PubMed, and IEEE Xplore. Phantoms were categorized based on the motions they generated: linear/cartesian, cardiac-dilative, lung-dilative, rotational, deformation or rolling. Metrics were extracted from each publication to assess the motion mechanisms, construction methods, as well as phantom validation. A total of 60 publications were reviewed, identifying 48 unique motion phantoms. Translational movement was the most common movement (used in 38% of phantoms), followed by cardiac-dilative (27%) movement and rotational movement (23%). The average degrees of freedom for all phantoms were determined to be 1.42. Motion phantom publications lack quantification of their impact on signal-to-noise ratio through standardized testing. At present, there is a lack of phantoms that are designed for multi-role as many currently have few degrees of freedom.
Collapse
Affiliation(s)
- Alexander Dunn
- Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST) at Toronto Metropolitan University and St. Michael's Hospital, Toronto, Canada
| | - Sophie Wagner
- Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST) at Toronto Metropolitan University and St. Michael's Hospital, Toronto, Canada
| | - Dafna Sussman
- Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, Canada.
- Institute for Biomedical Engineering, Science and Technology (iBEST) at Toronto Metropolitan University and St. Michael's Hospital, Toronto, Canada.
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada.
| |
Collapse
|
2
|
Delagnes A, Roux M, Vilgrain V, Guiu B, Laurent V, Sutter O, Bricault I, Trillaud H, Aubé C, Paisant A. Fat-containing hepatocellular carcinoma in patients with cirrhosis: proposal of a diagnostic modification regarding enhancement characteristics. Eur Radiol 2024; 34:2283-2293. [PMID: 37816923 DOI: 10.1007/s00330-023-10236-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVES The aim of this study was to develop and validate an algorithm for the non-invasive diagnosis of these fat-containing HCCs. METHODS Eighty-four cirrhotic patients with 77 fat-containing HCCs and 11 non-HCC fat-containing nodules were retrospectively included. All MRIs were reviewed; nodule characteristics, European Association for the Study of the Liver (EASL) and LI-RADS classifications, and survival were collected. One of the major features of LI-RADS v2018 (non-rim-like arterial phase hyperenhancement [APHE]) was changed to include different enhancing patterns at arterial phase and a new fat-LI-RADS algorithm was created for fat-containing nodules in cirrhosis. Its diagnostic performance was evaluated in both a derivation and external validation cohort (external cohort including 58 fat-containing HCCs and 10 non-HCC fat nodules). Reproducibility of this new algorithm was assessed. RESULTS In the derivation cohort, 54/77 (70.1%) fat-containing HCCs had APHE, 62/77 (80.5%) had enhancement compared to the nodule itself at arterial phase (APE), 43/77 (55.8%) had washout, and 20/77 (26.0%) had an enhancing capsule. EASL and LI-RADS had a sensitivity of 37.7% (29/77) and 36.4% (28/77), respectively, for the diagnosis of fat-containing HCC and both had a specificity of 100% (11/11). The new fat-LI-RADS algorithm increased sensitivity to 50.6% (39/77) without decreasing the specificity of 100% (11/11). The validation cohort confirmed the increased sensitivity, with a slight decrease in specificity. The concordance for the diagnosis of HCC for fat-LR5 was 85.3% (58/68). CONCLUSION The new fat-LI-RADS algorithm proposed here significantly improves the performance of the non-invasive diagnosis of fat-containing HCC and thus could reduce the number of biopsies conducted for fat-containing HCCs. CLINICAL RELEVANCE STATEMENT The European Association for the Study of the Liver and LI-RADS guidelines are poorly sensitive for the diagnosis of fat-containing HCC, mainly because of the low rate of arterial phase hyperenhancement (APHE) displayed by fat-containing HCC. Using all types of enhancement instead of APHE improves sensitivity of LI-RADS. KEY POINTS • Fat-containing HCCs on MRI account for 7.5% of HCCs and have different imaging characteristics from non-fatty HCCs. • The European Association for the Study of the Liver and LI-RADS algorithms for the non-invasive diagnosis of HCC have low sensitivity for the diagnosis of fat-containing HCC with MRI (37.7% and 36.4%, respectively). • The new fat-LI-RADS, which includes a slight modification of the "arterial enhancement" criterion, improves the sensitivity for the diagnosis of fat-containing HCC using MRI, without degrading the specificity.
Collapse
Affiliation(s)
- Anaïs Delagnes
- Department of Radiology, Angers University Hospital, 4 Rue Larrey, 49933, Angers, France.
| | - Marine Roux
- HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
| | - Valérie Vilgrain
- Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
- INSERM U1149, CRI, University Paris Diderot, Paris, France
| | - Boris Guiu
- Department of Radiology, Saint-Eloi Hospital, University Hospital of Montpellier, Montpellier, France
| | - Valérie Laurent
- Department of Radiology, Nancy University Hospital, Lorraine University, 54500, Vandœuvre-Lès-Nancy, France
| | - Olivier Sutter
- Department of Radiology, Avicenne Hospital, Paris-Seine-Saint-Denis University Hospitals, Assistance-Publique Hôpitaux de Paris, 93000, Bobigny, France
| | - Ivan Bricault
- Laboratory of Techniques for Biomedical Engineering and Complexity Management, University Grenoble Alpes, National Center for Scientific Research, Grenoble, France
- Department of Radiology and Medical Imaging, University Hospital, Grenoble, La Tronche, France
| | - Hervé Trillaud
- Department of Diagnostic and Interventional Radiology, University Hospital Bordeaux, 33600, Pessac, France
- EA Imotion, University of Bordeaux, 33076, Bordeaux, France
| | - Christophe Aubé
- Department of Radiology, Angers University Hospital, 4 Rue Larrey, 49933, Angers, France
- HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
| | - Anita Paisant
- Department of Radiology, Angers University Hospital, 4 Rue Larrey, 49933, Angers, France
- HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
| |
Collapse
|
3
|
Ringe KI, Fischbach F, Grenacher L, Juchems MS, Kukuk G, Lauenstein T, Wessling J, Schreyer AG. Application of liver-specific contrast agents for evaluation of focal liver lesions - Expert recommendations from the Gastrointestinal and Abdominal Imaging Workgroup of the German Roentgen Society. ROFO-FORTSCHR RONTG 2023. [PMID: 38113896 DOI: 10.1055/a-2192-9921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PURPOSE Contrast-enhanced MRI is the imaging modality of choice for the detection and differential diagnosis of focal liver lesions. Liver-specific contrast agents (CAs) are now well established in addition to extracellular contrast agents. However, there is a lack of explicit recommendations reflecting the pros and cons of each specific contrast agent in the daily routine. MATERIALS AND METHODS Development of recommendations for the clinical application of liver-specific CAs by members of the Gastrointestinal and Abdominal Imaging Workgroup within the Germany Radiological Society, using methodology comparable to that of an S1 guideline with informal consensus. The diagnostic criteria for the evaluation of liver lesions are intentionally outside the scope of this article, as there are already plenty of excellent publications available. RESULTS AND CONCLUSION The application of liver-specific CAs in the daily routine is associated with advantages and disadvantages due to the specific pharmacokinetic and pharmacodynamic properties and necessitates adjustment of the imaging technique as well consideration during image interpretation. Recommendations for the application of liver-specific CAs are presented based on different clinical scenarios, taking into account current evidence and guidelines. KEY POINTS · Both liver-specific and extracellular contrast agents are established. · Liver-specific contrast agents make it possible to draw conclusions about the hepatocellular function of a lesion. · Recommendations for the use of liver-specific contrast agents in the daily routine are presented. CITATION FORMAT · Ringe KI, Fischbach F, Grenacher L et al. Einsatz leberspezifischer Kontrastmittel in der MRT zur Beurteilung von Leberläsionen - Expertenempfehlungen der AG Gastrointestinal- und Abdominaldiagnostik der Deutschen Röntgengesellschaft. Fortschr Röntgenstr 2023; DOI: 10.1055/a-2192-9921.
Collapse
Affiliation(s)
- Kristina I Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Frank Fischbach
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Germany
| | - Lars Grenacher
- Imaging and Prevention Center, Conradia Radiology Munich, Germany
| | - Markus S Juchems
- Diagnostic and Interventional Radiology, Hospital Konstanz, Germany
| | - Guido Kukuk
- Department of Radiology, Hospital Graubünden, Chur, Switzerland
| | | | | | - Andreas G Schreyer
- Institute for Diagnostic and Interventional Radiology, Brandenburg Medical School Theodor Fontane, Brandenburg a.d. Havel, Germany
| |
Collapse
|
4
|
Bouyer T, Roux M, Jacquemin S, Dioguardi Burgio M, Sutter O, Laurent-Croisé V, Lonjon J, Bricault I, Trillaud H, Rode A, Aubé C, Paisant A. Detection of arterial phase hyperenhancement of small hepatocellular carcinoma with MRI: Comparison between single arterial and multi-arterial phases and between extracellular and hepatospecific contrast agents. Diagn Interv Imaging 2023; 104:477-484. [PMID: 37211446 DOI: 10.1016/j.diii.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/21/2023] [Accepted: 04/21/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE The purpose of this study was to compare the detection rate of arterial phase hyperenhancement (APHE) in small hepatocellular carcinoma (HCC) between single arterial phase (single-AP) and triple hepatic arterial (triple-AP) phase MRI and between extracellular (ECA) and hepato-specific (HBA) contrast agents. MATERIALS AND METHODS A total of 109 cirrhotic patients with 136 HCCs from seven centers were included. There were 93 men and 16 women, with a mean age of 64.0 ± 8.9 (standard deviation) years (range: 42-82 years). Each patient underwent both ECA-MRI and HBA (gadoxetic acid)-MRI examination within one month of each other. Each MRI examination was retrospectively reviewed by two readers blinded to the second MRI examination. The sensitivities of triple- and single-AP for the detection of APHE were compared, and each phase of the triple-AP sequence was compared with the other two. RESULTS No differences in APHE detection were found between single-AP (97.2%; 69/71) and triple-AP (98.5%; 64/65) (P > 0.99) at ECA-MRI. No differences in APHE detection were found between single-AP (93%; 66/71) and triple-AP (100%; 65/65) at HBA-MRI (P = 0.12). Patient age, size of the nodules, use of automatic triggering, type of contrast agent, and type of sequence were not significantly associated with APHE detection. The reader was the single variable significantly associated with APHE detection. For triple-AP, best APHE detection rate was found for early and middle-AP images compared to late-AP images (P = 0.001 and P = 0.003). All APHEs were detected with the combination of early-AP and middle-AP images, except one that was detected on late-AP images by one reader. CONCLUSION Our study suggests that both single- and triple-AP can be used in liver MRI for the detection of small HCC especially when using ECA. Early AP and middle-AP are the most efficient phases and should be preferred for detecting APHE, regardless of the contrast agent used.
Collapse
Affiliation(s)
- Thomas Bouyer
- Department of Radiology, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France.
| | - Marine Roux
- Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, 49045 Angers, France
| | - Sarah Jacquemin
- Department of Radiology, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France
| | - Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, APHP Nord, 92110 Clichy, France; Université de Paris, Centre de recherche sur l'inflammation, INSERM, U1149, CNRS, ERL8252, Paris, 75018, France
| | - Olivier Sutter
- Department of Radiology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis (AP-HP), 93140 Bondy, France
| | - Valérie Laurent-Croisé
- Department of Radiology, Centre Hospitalier Universitaire de Nancy, Hôpital de Brabois, 54500 Vandœuvre-lès-Nancy, France
| | - Julie Lonjon
- Department of Radiology, Centre Hospitalier Universitaire Saint Eloi, 34090 Montpellier, France
| | - Ivan Bricault
- Université Grenoble Alpes, CNRS, 38400 Grenoble, France; Department of Radiology, Centre Hospitalier Universitaire Grenoble Alpes, 38700 Grenoble, France
| | - Hervé Trillaud
- Department of Radiology, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France
| | - Agnès Rode
- Department of Radiology, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Centre Hospitalier Universitaire, 69317 Lyon Cedex 04, France
| | - Christophe Aubé
- Department of Radiology, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France; Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, 49045 Angers, France
| | - Anita Paisant
- Department of Radiology, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France; Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, 49045 Angers, France
| |
Collapse
|
5
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
6
|
Sugiura T, Okumura K, Sasaki M, Matsumoto J, Ogi T, Yoneda N, Kitao A, Kozaka K, Koda W, Kobayashi S, Gabata T. A low albumin level as a risk factor for transient severe motion artifact induced by gadoxetate disodium administration: A retrospective observational study with free-breathing dynamic MRI and an experimental study in rats. PLoS One 2022; 17:e0265588. [PMID: 35303023 PMCID: PMC8932582 DOI: 10.1371/journal.pone.0265588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 03/04/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives In the arterial phase of gadoxetate disodium administration for dynamic MRI, transient severe motion (TSM) sometimes occurs, making image evaluation difficult. This study was to identify risk factors for TSM in a clinical study, and confirm them and investigate the cause in an animal study. Methods A retrospective, single-center, observational study included patients who underwent dynamic MRI using gadoxetate disodium for the first time from April 2016 to September 2019 and free-breathing MRI was performed. Differences in clinical characteristics and laboratory tests between the presence and absence of TSM were examined. Animal experiments were conducted in 50 rats; gadoxetate disodium was injected into three sites (distal inferior vena cava (IVC), ascending aorta, and descending aorta) to identify the organ which triggers respiratory irregularities. Phosphate-buffered saline and gadopentetate dimeglumine were also injected into the distal IVC. In addition, to evaluate the effect of albumin, gadoxetate disodium was diluted with phosphate-buffered saline or 5% human serum albumin and injected into the ascending aorta. The time course of the respiratory rate was monitored and evaluated. Results 20 of 51 (39.2%) patients showed TSM. On multivariable analysis, a low albumin level was an independent risk factor (P = .035). Gadoxetate disodium administration caused significant tachypnea compared to gadopentetate dimeglumine or PBS (an elevation of 16.6 vs 3.0 or 4.3 breaths/min; both P < .001) in rats. The starting time of tachypnea was earlier with injection into the ascending aorta than into the descending aorta (10.3 vs 17.9 sec; P < .001) and the distal IVC (vs 15.6 sec; P < .001). With dilution with albumin instead of phosphate-buffered saline, tachypnea was delayed and suppressed (9.9 vs 13.0 sec; P < .001, 24.1 vs 17.0 breaths/min; P = .031). Conclusions A low albumin level is a risk factor for TSM, which could be caused by the effect of gadoxetate disodium on the head and neck region.
Collapse
|
7
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| | | |
Collapse
|
8
|
Reig M, Forner A, Ávila MA, Ayuso C, Mínguez B, Varela M, Bilbao I, Bilbao JI, Burrel M, Bustamante J, Ferrer J, Gómez MÁ, Llovet JM, De la Mata M, Matilla A, Pardo F, Pastrana MA, Rodríguez-Perálvarez M, Tabernero J, Urbano J, Vera R, Sangro B, Bruix J. Diagnosis and treatment of hepatocellular carcinoma. Update of the consensus document of the AEEH, AEC, SEOM, SERAM, SERVEI, and SETH. Med Clin (Barc) 2021; 156:463.e1-463.e30. [PMID: 33461840 DOI: 10.1016/j.medcli.2020.09.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/12/2020] [Accepted: 09/15/2020] [Indexed: 12/12/2022]
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver neoplasm and one of the most common causes of death in patients with cirrhosis of the liver. In parallel, with recognition of the clinical relevance of this cancer, major new developments have recently appeared in its diagnosis, prognostic assessment and in particular, in its treatment. Therefore, the Spanish Association for the Study of the Liver (AEEH) has driven the need to update the clinical practice guidelines, once again inviting all the societies involved in the diagnosis and treatment of this disease to participate in the drafting and approval of the document: Spanish Society for Liver Transplantation (SETH), Spanish Society of Diagnostic Radiology (SERAM), Spanish Society of Vascular and Interventional Radiology (SERVEI), Spanish Association of Surgeons (AEC) and Spanish Society of Medical Oncology (SEOM). The clinical practice guidelines published in 2016 and accepted as National Health System Clinical Practice Guidelines were taken as the reference documents, incorporating the most important recent advances. The scientific evidence and the strength of the recommendation is based on the GRADE system.
Collapse
Affiliation(s)
- María Reig
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Hepatología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España
| | - Alejandro Forner
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Hepatología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España
| | - Matías A Ávila
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España; Programa de Hepatología, Centro de Investigación Médica Aplicada, Universidad de Navarra-IDISNA, Pamplona, España
| | - Carmen Ayuso
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España; Servicio de Radiodiagnóstico, Hospital Clínic Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España
| | - Beatriz Mínguez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España; Servicio de Hepatología, Hospital Universitario Vall d́Hebron, Grupo de Investigación en Enfermedades Hepáticas (VHIR), Vall d'Hebron Barcelona Hospital Campus, Universidad Autónoma de Barcelona. Barcelona, España
| | - María Varela
- Sección de Hepatología, Servicio de Aparato Digestivo, Hospital Universitario Central de Asturias. Oviedo, España
| | - Itxarone Bilbao
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España; Servicio de Cirugía Hepatobiliopancreática y Trasplantes Digestivos, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona. Barcelona, España
| | - José Ignacio Bilbao
- Unidad de Radiología Vascular e Intervencionista, Departamento de Radiodiagnóstico, Clínica Universidad de Navarra, Pamplona, España
| | - Marta Burrel
- Servicio de Radiodiagnóstico, Hospital Clínic Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España
| | - Javier Bustamante
- Servicio de Gastroenterología y Hepatología, Sección de Hepatología y Trasplante, Hospital Universitario de Cruces, Baracaldo, España
| | - Joana Ferrer
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Cirugía Hepatobiliopancreática, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Barcelona, España
| | - Miguel Ángel Gómez
- Unidad de Cirugía Hepatobiliopancreática y Trasplantes, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Josep María Llovet
- Grupo de Investigación Traslacional en Oncología Hepática, Servicio de Hepatología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Barcelona, España
| | - Manuel De la Mata
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España; Unidad Clínica de Aparato Digestivo, Hospital Universitario Reina Sofía, Córdoba, España
| | - Ana Matilla
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España; Sección de Hepatología, Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Fernando Pardo
- Servicio de Cirugía Hepatobiliopancreática y Trasplante, Clínica Universidad de Navarra, Pamplona, España
| | - Miguel A Pastrana
- Servicio de Radiodiagnóstico, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, España
| | - Manuel Rodríguez-Perálvarez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España; Unidad Clínica de Aparato Digestivo, Hospital Universitario Reina Sofía, Córdoba, España
| | - Josep Tabernero
- Servicio de Oncología Médica, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España
| | - José Urbano
- Unidad de Radiología Vascular e Intervencionista, Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, España
| | - Ruth Vera
- Servicio de Oncología Médica, Complejo hospitalario de Navarra, Navarrabiomed-IDISNA, Pamplona, España
| | - Bruno Sangro
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España; Unidad de Hepatología y Área de Oncología HBP, Clínica Universidad de Navarra-IDISNA, Pamplona, España.
| | - Jordi Bruix
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Hepatología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España.
| |
Collapse
|
9
|
Feng Z, Zhao H, Guan S, Wang W, Rong P. Diagnostic performance of MRI using extracellular contrast agents versus gadoxetic acid for hepatocellular carcinoma: A systematic review and meta-analysis. Liver Int 2021; 41:1117-1128. [PMID: 33647177 DOI: 10.1111/liv.14850] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/31/2021] [Accepted: 02/13/2021] [Indexed: 02/13/2023]
Abstract
BACKGROUND & AIMS Magnetic resonance imaging (MRI) is the first-line tool for the noninvasive diagnosis of hepatocellular carcinoma (HCC) in patients with chronic liver diseases. We performed a meta-analysis to compare the performance of MRI using extracellular contrast agents (ECA-MRI) with that using gadoxetic acid (EOB-MRI) for diagnosing HCC. METHODS We searched multiple databases for studies comparing the diagnostic performance of ECA-MRI with that of EOB-MRI in patients with suspected HCC until 31 May 2020. The bivariate random-effects model was used to pool the performance and further subgroup analysis was performed. RESULTS Eight studies were included evaluating a total of 1002 patients. ECA-MRI revealed significantly higher per-lesion sensitivity in the diagnosis of HCC than EOB-MRI did (0.76 vs 0.63, P = .002). For modified EOB-MRI (mEOB-MRI) using extended washout to the transitional phase (TP) or hepatobiliary phase (HBP), the sensitivity increased compared with that of EOB-MRI using restrictive washout in the portal venous phase (PVP) (0.74 vs 0.63, P = .07). No significant difference among the specificities of ECA-MRI, EOB-MRI, and mEOB-MRI (0.96, 0.98, and 0.93, respectively) was found. The sensitivity for lesions < 20 mm was significantly lower than that for lesions ≥ 20mm (0.66 vs 0.87, P = .01) only for ECA-MRI, which achieved higher sensitivity in Asian patients or with a 3.0 T scanner. CONCLUSIONS ECA-MRI outperforms EOB-MRI in per-lesion sensitivity for diagnosing HCC, whereas mEOB-MRI shows a trend towards improved sensitivity compared with EOB-MRI with slightly decreased specificity. Registration: Prospero CRD42020189680.
Collapse
Affiliation(s)
- Zhichao Feng
- Department of Radiology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Huafei Zhao
- Department of Radiology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Shiwei Guan
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Wei Wang
- Department of Radiology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Pengfei Rong
- Department of Radiology, Third Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
10
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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.
| |
Collapse
|
11
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
12
|
Russolillo N, Borello A, Langella S, Casella M, Lo Tesoriere R, Ferrero A. Comparison of laparoscopic ultrasound and liver-specific magnetic resonance imaging for staging colorectal liver metastases. Surg Endosc 2021; 35:3547-53. [PMID: 32710215 DOI: 10.1007/s00464-020-07817-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/10/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Intraoperative liver ultrasound appears superior to liver-specific contrast-enhanced magnetic resonance imaging (MRI) to stage colorectal liver metastases (CRLMs). Most of the data come from studies on open surgery. Laparoscopic ultrasound (LUS) is technically demanding and its reliability is poor investigated. Aim of the study was to assess the accuracy of LUS staging for CRLMs compared to MRI. METHODS All patients with CRLMs scheduled for laparoscopic liver resection (LLR) between 01/2010 and 06/2019 who underwent preoperative MRI were considered for the study. LUS and MRI performance was compared on a patient by patient basis. Reference standards were final pathology and 6 months follow-up results. RESULTS Amongst 189 LLR for CRLMs, 146 met inclusion criteria. Overall, 391 CRLMs were preoperatively detected by MRI. 24 new nodules in 16 (10.9%) patients were found by LUS and resected. Median diameter of new nodules was 5.5 mm (2-10 mm) and 10 (41.6%) were located in the hepatic dome. Pathology confirmed 17 newly detected malignant nodules (median size 4 mm) in 11 (7.5%) patients. Relationships between intrahepatic vessels and tumours differed between LUS and MRI in 9 patients (6.1%). Intraoperative surgical strategy changed according LUS findings in 19 (13%) patients, requiring conversion to open approach in 3 (15.8%) of them. The sensitivity of LUS was superior to MRI (93.1% vs 85.6% whilst specificity was similar (98.6% MRI vs 96.5% LUS). CONCLUSIONS Laparoscopic liver ultrasound improves liver staging for CRLMs compared to liver-specific MRI.
Collapse
|
13
|
Hayoz R, Vietti-Violi N, Duran R, Knebel JF, Ledoux JB, Dromain C. The combination of hepatobiliary phase with Gd-EOB-DTPA and DWI is highly accurate for the detection and characterization of liver metastases from neuroendocrine tumor. Eur Radiol 2020; 30:6593-6602. [PMID: 32601948 DOI: 10.1007/s00330-020-06930-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/28/2020] [Accepted: 04/29/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To compare the diagnostic accuracy of dynamic contrast-enhanced phases, hepatobiliary phase (HBP), and diffusion-weighted imaging (DWI) for the detection of liver metastases from neuroendocrine tumor (NET). METHODS Sixty-seven patients with suspected NET liver metastases underwent gadoxetic acid-enhanced MRI. Three radiologists read four imaging sets separately and independently: DWI, T2W+dynamic, T2WI+HBP, and DWI+HBP. Reference standard included all imaging, histological findings, and clinical data. Sensitivity and specificity were calculated and compared for each imaging set. Interreader agreement was evaluated by intraclass correlation coefficient (ICC). Univariate logistic regression was performed to evaluate lesion characteristics (size, ADC, and enhancing pattern) associated to false positive and negative lesions. RESULTS Six hundred twenty-five lesions (545 metastases, 80 benign lesions) were identified. Detection rate was significantly higher combining DWI+HBP than the other imaging sets (sensitivity 86% (95% confidence interval (CI) 0.845-0.878), specificity 94% (95% CI 0.901-0.961)). The sensitivity and specificity of the other sets were 82% and 65% for DWI, 88% and 69% for T2WI, and 90% and 82% for HBP+T2WI, respectively. The interreader agreement was statistically higher for both HBP sets (ICC = 0.96 (95% CI 0.94-0.97) for T2WI+HBP and ICC = 0.91 (95% CI 0.87-0.94) for DWI+HBP, respectively) compared with that for DWI (ICC = 0.76 (95% CI 0.66-0.83)) and T2+dynamic (ICC = 0.85 (95% CI 0.79-0.9)). High ADC values, large lesion size, and hypervascular pattern lowered the risk of false negative. CONCLUSION Given the high diagnostic accuracy of combining DWI+HBP, gadoxetic acid-enhanced MRI is to be considered in NET patients with suspected liver metastases. Fast MRI protocol using T2WI, DWI, and HBP is of interest in this population. KEY POINTS • The combined set of diffusion-weighted (DW) and hepatobiliary phase (HBP) images yields the highest sensitivity and specificity for neuroendocrine liver metastasis (NELM) detection. • Gadoxetic acid should be the contrast agent of choice for liver MRI in NET patients. • The combined set of HBP and DWI sequences could also be used as a tool of abbreviated MRI in follow-up or assessment of treatment such as somatostatin analogs.
Collapse
Affiliation(s)
- Roschan Hayoz
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Naïk Vietti-Violi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Rafael Duran
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
| | - Jean-François Knebel
- EEG Brain Mapping Core, Centre for Biomedical Imaging (CIBM) and Laboratory for Investigative Neurophysiology (The LINE), Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne, 1011, Switzerland
| | - Jean-Baptiste Ledoux
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Clarisse Dromain
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| |
Collapse
|
14
|
Paisant A, Vilgrain V, Riou J, Oberti F, Sutter O, Laurent V, Rodes A, Guiu B, Cassinotto C, Trillaud H, Bricault I, Michalak S, Bruno O, Ronot M, Aubé C. Comparison of extracellular and hepatobiliary MR contrast agents for the diagnosis of small HCCs. J Hepatol 2020; 72:937-945. [PMID: 31870951 DOI: 10.1016/j.jhep.2019.12.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 12/04/2019] [Accepted: 12/06/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS The aim of this study was to use a head-to-head nodule comparison to compare the performance of extracellular contrast agent MRI (ECA-MRI) with that of hepatobiliary contrast agent MRI (HBA-MRI) for the non-invasive diagnosis of small hepatocellular carcinomas (HCCs). METHODS Between August 2014 and October 2017, 171 patients with cirrhosis, each with 1 to 3 nodules measuring 1-3 cm, were enrolled across 8 centers. All patients underwent both an ECA-MRI and an HBA-MRI within a month. A non-invasive diagnosis of HCC was made when a nodule exhibited arterial phase hyper-enhancement (APHE) with washout at the portal venous phase (PVP) and/or delayed phase (DP) for ECA-MRI, or the PVP and/or HB phase (HBP) for HBA-MRI. The gold standard was defined by using a previously published composite algorithm. RESULTS A total of 225 nodules, of which 153 were HCCs and 72 were not, were included. The sensitivites of both MRI techniques were similar. Specificity was 83.3% (95% CI 72.7-91.1) for ECA-MRI and 68.1% (95% CI 56.0-78.6) for HBA-MRI. In terms of HCC diagnosis on ECA-MRI, 138 nodules had APHE, 84 had washout at PVP, and 104 at DP; on HBA-MRI, 128 nodules had APHE, 71 had washout at PVP, and 99 at HBP. For nodules 2-3 cm in size, sensitivity and specificity were similar between the 2 approaches. For nodules 1-2 cm in size, specificity dropped to 66.1% (95% CI 52.2-78.2) for HBA-MRI vs. 85.7% (95% CI 73.8-93.6) for ECA-MRI. CONCLUSIONS HBA-MRI specificity is lower than that of ECA-MRI for diagnosing small HCCs in patients with cirrhosis. These results raise the question of the proper use of HBA-MRI in algorithms for the non-invasive diagnosis of small HCCs. LAY SUMMARY There are 2 magnetic resonance imaging (MRI)-based approaches available for the non-invasive diagnosis of hepatocellular carcinoma (HCC), using either extracellular or hepatobiliary contrast agents. The current results showed that the sensitivity of MRI with hepatobiliary contrast agents was similar to that with extracellular contrast agents, but the specificity was lower. Thus, hepatobiliary contrast agent-based MRI, although detailed in international guidelines, should be used with caution for the non-invasive diagnosis of HCC. CLINICAL TRIAL NUMBER NCT00848952.
Collapse
Affiliation(s)
- Anita Paisant
- Département de Radiologie, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France; Laboratoire HIFIH, EA 3859, Universitaire d'Angers, 49045 Angers, France.
| | - Valérie Vilgrain
- Département de Radiologie, Hôpital Beaujon, Hôpitaux Paris Nord Val de Seine (AP-HP) 92110, Clichy, France; Université Paris Diderot, Sorbonne Paris Cité, CRI, U1149, 75000 Paris, France
| | - Jérémie Riou
- Université d'Angers, UFR Santé, 49000 Angers, France; MINT UMR INSERM 1066, CNRS 6021, Université d'Angers, 49000 Angers, France
| | - Frédéric Oberti
- Laboratoire HIFIH, EA 3859, Universitaire d'Angers, 49045 Angers, France; Service de Gastroenterologie et Hépatologie, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France
| | - Olivier Sutter
- Service de Radiologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis (AP-HP), 93140 Bondy, France
| | - Valérie Laurent
- Département de Radiologie, Centre Hospitalier Universitaire de Nancy, Hôpital de Brabois, 54500 Vandoeuvre-lès-Nancy, France
| | - Agnès Rodes
- Département de Radiologie, Hôpital de la Croix Rousse, Centre Hospitalier Universitaire de Lyon, 69004 Lyon, France
| | - Boris Guiu
- Département de Radiologie, INSERM U896, CHU Saint-Eloi, Université de Montpellier, 34295 Montpellier, France
| | - Christophe Cassinotto
- CHU Bordeaux Department of Diagnostic and Interventional Radiology, F-33000 Bordeaux, France
| | - Hervé Trillaud
- CHU Bordeaux Department of Diagnostic and Interventional Radiology, F-33000 Bordeaux, France; Universitaire de Bordeaux, EA Imotion, F-33000 Bordeaux, France
| | - Ivan Bricault
- Département d'Imagerie, Radiologie et Imagerie Médicale, CHU, 38000 Grenoble, France; Laboratory of Techniques for Biomedical Engineering and Complexity Management - Informatics, Mathematics and Applications, Université 38000 Grenoble Alpes, Grenoble, France
| | - Sophie Michalak
- Département d'Anatomopatologie, Centre Hospitalier Universitaire d'Angers, Université d'Angers, 49933 Angers, France
| | - Onorina Bruno
- Département de Radiologie, Hôpital Beaujon, Hôpitaux Paris Nord Val de Seine (AP-HP) 92110, Clichy, France
| | - Maxime Ronot
- Département de Radiologie, Hôpital Beaujon, Hôpitaux Paris Nord Val de Seine (AP-HP) 92110, Clichy, France; Université Paris Diderot, Sorbonne Paris Cité, CRI, U1149, 75000 Paris, France
| | - Christophe Aubé
- Département de Radiologie, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France; Laboratoire HIFIH, EA 3859, Universitaire d'Angers, 49045 Angers, France
| |
Collapse
|
15
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
16
|
Lanier H, Wallace A, Khanna G. Rate of gadoxetate disodium (Eovist®) induced transient respiratory motion in children and young adults. Abdom Radiol (NY) 2020; 45:101-6. [PMID: 31701191 DOI: 10.1007/s00261-019-02296-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Gadoxetate disodium (Eovist®, Bayer Healthcare, Wayne, NJ) is the preferred MR contrast agent for pediatric hepatobiliary imaging. A known limitation of this contrast agent is transient severe respiratory artifacts during arterial phase imaging, and some adult studies have raised caution against its use for evaluation of arterial enhancing lesions. The reported rate of transient severe breathing motion is 5-22% in adult studies. This study seeks to evaluate the frequency of transient severe respiratory motion secondary to gadoxetate disodium in a pediatric cohort. MATERIALS AND METHODS This is a retrospective, IRB-approved study with informed consent waiver. The radiology information system of a children's hospital was searched to identify all MRI studies performed with gadoxetate disodium during January 2016-June 2018. Two readers independently evaluated all phases of a dynamic liver protocol for respiratory motion artifact on a 5-point scale (1 none, 2 mild, 3 moderate, 4 severe-still diagnostic, 5 extreme-not diagnostic). Average scores of the 2 readers for each phase were used for analyses. Transient severe respiratory motion was defined as an increase in artifact score of ≥ 1.5 from pre-contrast to arterial phase that returned to < 3 in equilibrium phase of imaging. RESULTS The study cohort consisted of 140 cases (60% female), age range: 1 month-23 years (median 13 years). 102/140 scans were performed non-sedated. Mean respiratory motion score for each phase of scan for the entire cohort were pre-contrast: 2.23, arterial: 2.56, portal venous: 2.39, and equilibrium: 2.31. Transient severe respiratory motion was seen in 8 non-sedated cases and in 0 sedated cases. The rate of transient severe respiratory motion in a non-sedated pediatric cohort was estimated at 7.84% (8/102 cases). CONCLUSION The rate of transient severe respiratory motion in the non-sedated pediatric population is in the lower end of the range reported in adults. Transient severe respiratory motion is not observed in sedated patients.
Collapse
|
17
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.)
| |
Collapse
|
18
|
Tsuboyama T, Jost G, Kim T, Hori M, Onishi H, Pietsch H, Tomiyama N. Experimental studies on artifacts and tumor enhancement on gadoxetic acid-enhanced arterial phase liver MRI in a rabbit VX2 tumor model. Acta Radiol 2018; 59:1029-1037. [PMID: 29235879 DOI: 10.1177/0284185117747134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Rapid injection of gadoxetic acid is reported to produce more frequent artifacts and lower vascular enhancement on arterial phase liver magnetic resonance imaging (MRI). However, its effect on tumor enhancement and the mechanism of the artifacts remain unclear. Purpose To evaluate the effect of rapid injection of gadoxetic acid on artifacts and tumor enhancement during arterial phase liver MRI, and on arterial blood gases (ABGs) which may explain the cause of the artifacts. Material and Methods ABG analysis was performed in 13 free-breathing rabbits after rapid injection (1 mL/s; injection time = 0.6-0.8 s) of gadoxetic acid (0.025 mmol/kg). Dynamic liver MRI was performed in six anesthetized rabbits with VX2 tumors under a ventilation stoppage after rapid and slow injection (0.25 mL/s; injection time = 2.4-3.2 s) of gadoxetic acid. Artifacts and signal enhancement on arterial phase imaging were compared with those obtained after rapid injection of gadopentetic acid (Gd-DTPA, 0.1 mmol/kg) using a Friedman test or Kruskal-Wallis test. Results ABG analysis did not find any significant changes. Artifacts were not related to injection protocols ( P = 0.95). Aortic enhancement with slow injection of gadoxetic acid was significantly higher than that with rapid injection ( P < 0.05), and was comparable to that with Gd-DTPA injection. Tumor enhancement obtained with gadoxetic acid was not significantly different between rapid and slow injection, and was significantly lower than that with Gd-DTPA injection ( P < 0.05). Conclusion Rapid injection of gadoxetic acid did not affect ABGs and may not be the cause of the artifacts. It lowered vascular enhancement but not arterial tumor enhancement.
Collapse
Affiliation(s)
- Takahiro Tsuboyama
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Gregor Jost
- MR and CT Contrast Media Research, Bayer Pharma AG, Berlin, Germany
| | - Tonsok Kim
- Department of Radiology, Naniwa Ikuno Hospital, Osaka, Japan
| | - Masatoshi Hori
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiromitsu Onishi
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hubertus Pietsch
- MR and CT Contrast Media Research, Bayer Pharma AG, Berlin, Germany
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
19
|
Grazioli L, Faletti R, Frittoli B, Battisti G, Ambrosini R, Romanini L, Gatti M, Fonio P. Evaluation of incidence of acute transient dyspnea and related artifacts after administration of gadoxetate disodium: a prospective observational study. Radiol Med 2018; 123:910-917. [PMID: 30084108 DOI: 10.1007/s11547-018-0927-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 07/25/2018] [Indexed: 12/13/2022]
|
20
|
Ringe KI, von Falck C, Raatschen HJ, Wacker F, Hinrichs J. Evaluation of transient respiratory motion artifact at gadoxetate disodium-enhanced MRI-Influence of different contrast agent application protocols. PLoS One 2018; 13:e0200887. [PMID: 30024930 PMCID: PMC6053213 DOI: 10.1371/journal.pone.0200887] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 07/05/2018] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To evaluate transient severe respiratory motion artifacts (TSM) at gadoxetate disodium-enhanced MRI dependent on the mode of contrast agent application. METHODS 200 patients (71f, 129m; mean 51y) were included in this retrospective IRB-approved study. Contrast application protocols (n = 4) differed with regards to injection rate (2ml or 1ml/sec), dose (weight-based or fixed 10ml) and supplemental oxygen administration (yes/no). SNR measurements were performed in the aorta and portal vein. Qualitatively, three readers assessed arterial phase image quality and TSM independently (4- and 5-point scale, respectively). Quantitative and qualitative results were compared (Kruskal-Wallis test, Dunn's multiple comparison test). The influence of different contrast agent application parameters on the occurrence of respiratory motion artifacts was assessed (univariate analysis). Interrater agreement and reliability were calculated (intraclass correlation coefficient, ICC)). RESULTS Use of a lower contrast injection rate resulted in significantly higher arterial SNR in the aorta and portal vein (p<0.05). TSM was observed in 12% of examinations. Neither injection rate, contrast dose, nor oxygen had a significant influence. Interrater agreement and reliability for evaluation of image quality and respiratory motion were substantial/ almost perfect (ICC = 0.640-0.915). CONCLUSIONS Technical factors regarding the specific mode of contrast application do not seem to significantly reduce the incidence of severe transient respiratory motion artifacts.
Collapse
Affiliation(s)
- Kristina I. Ringe
- Hannover Medical School, Department of Diagnostic and Interventional Radiology, Hannover, Germany
| | - Christian von Falck
- Hannover Medical School, Department of Diagnostic and Interventional Radiology, Hannover, Germany
| | - Hans-Jürgen Raatschen
- Hannover Medical School, Department of Diagnostic and Interventional Radiology, Hannover, Germany
| | - Frank Wacker
- Hannover Medical School, Department of Diagnostic and Interventional Radiology, Hannover, Germany
| | - Jan Hinrichs
- Hannover Medical School, Department of Diagnostic and Interventional Radiology, Hannover, Germany
| |
Collapse
|
21
|
Llovet JM, Mazzaferro V, Piscaglia F, Raoul JL, Schirmacher P, Vilgrain V. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol 2018; 69:182-236. [PMID: 29628281 DOI: 10.1016/j.jhep.2018.03.019] [Citation(s) in RCA: 4962] [Impact Index Per Article: 827.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/20/2018] [Indexed: 02/06/2023]
|
22
|
Yoon JH, Lee JM, Yu MH, Hur BY, Grimm R, Block KT, Chandarana H, Kiefer B, Son Y. Evaluation of Transient Motion During Gadoxetic Acid-Enhanced Multiphasic Liver Magnetic Resonance Imaging Using Free-Breathing Golden-Angle Radial Sparse Parallel Magnetic Resonance Imaging. Invest Radiol 2018; 53:52-61. [PMID: 28902723 DOI: 10.1097/RLI.0000000000000409] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The aims of this study were to observe the pattern of transient motion after gadoxetic acid administration including incidence, onset, and duration, and to evaluate the clinical feasibility of free-breathing gadoxetic acid-enhanced liver magnetic resonance imaging using golden-angle radial sparse parallel (GRASP) imaging with respiratory gating. MATERIALS AND METHODS In this institutional review board-approved prospective study, 59 patients who provided informed consents were analyzed. Free-breathing dynamic T1-weighted images (T1WIs) were obtained using GRASP at 3 T after a standard dose of gadoxetic acid (0.025 mmol/kg) administration at a rate of 1 mL/s, and development of transient motion was monitored, which is defined as a distinctive respiratory frequency alteration of the self-gating MR signals. Early arterial, late arterial, and portal venous phases retrospectively reconstructed with and without respiratory gating and with different temporal resolutions (nongated 13.3-second, gated 13.3-second, gated 6-second T1WI) were evaluated for image quality and motion artifacts. Diagnostic performance in detecting focal liver lesions was compared among the 3 data sets. RESULTS Transient motion (mean duration, 21.5 ± 13.0 seconds) was observed in 40.0% (23/59) of patients, 73.9% (17/23) of which developed within 15 seconds after gadoxetic acid administration. On late arterial phase, motion artifacts were significantly reduced on gated 13.3-second and 6-second T1WI (3.64 ± 0.34, 3.61 ± 0.36, respectively), compared with nongated 13.3-second T1WI (3.12 ± 0.51, P < 0.0001). Overall, image quality was the highest on gated 13.3-second T1WI (3.76 ± 0.39) followed by gated 6-second and nongated 13.3-second T1WI (3.39 ± 0.55, 2.57 ± 0.57, P < 0.0001). Only gated 6-second T1WI showed significantly higher detection performance than nongated 13.3-second T1WI (figure of merit, 0.69 [0.63-0.76]) vs 0.60 [0.56-0.65], P = 0.004). CONCLUSIONS Transient motion developed in 40% (23/59) of patients shortly after gadoxetic acid administration, and gated free-breathing T1WI using GRASP was able to consistently provide acceptable arterial phase imaging in patients who exhibited transient motion.
Collapse
|
23
|
Cohen-hallaleh V, Guo L, Hosseini-nik H, Razaghi Kashani N, Menezes R, Jhaveri K. Does injection flow rate have an impact on arterial phase image degradation in liver MRI? A comparison of gadoxetic acid versus gadobutrol. Clin Radiol 2017; 72:994.e1-8. [DOI: 10.1016/j.crad.2017.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 05/12/2017] [Accepted: 06/06/2017] [Indexed: 12/22/2022]
|
24
|
Song JS, Choi EJ, Park EH, Lee JH. Comparison of transient severe motion in gadoxetate disodium and gadopentetate dimeglumine-enhanced MRI: effect of modified breath-holding method. Eur Radiol 2017; 28:1132-1139. [DOI: 10.1007/s00330-017-5070-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/13/2017] [Accepted: 09/11/2017] [Indexed: 01/07/2023]
|
25
|
Im WH, Song JS, Park EH, Kwak HS. Transient severe motion in the arterial phase during gadoxetate disodium-enhanced MR imaging: evaluation of patients with multiple MR examinations. Abdom Radiol (NY) 2017; 42:2393-2401. [PMID: 28396919 DOI: 10.1007/s00261-017-1145-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE To determine whether patients undergoing multiple gadoxetate disodium-enhanced magnetic resonance (MR) examinations who experienced transient severe motion (TSM) in the arterial phase were affected by the TSM noted in the first examination. MATERIALS AND METHODS 214 patients who underwent three or more repeated gadoxetate disodium-enhanced MR imaging were retrospectively analyzed. Three radiologists scored all of the examinations demonstrating a motion artifact using a five-point rating scale. Risk factor analysis and comparison of TSM recurrence rates were performed in the whole study population as well as in a subpopulation of patients with TSM. RESULTS The overall incidence of TSM was 5.9% (54/922), which was observed in 40 patients. Thirty-two patients had one episode of TSM, and eight patients had recurrent TSM. Although TSM in the first examination increased the risk of recurrent TSM in the whole population (OR 24.45; P < 0.001), the incidence of recurrent TSM was low (2.4%, 22/922). On subpopulation analysis, TSM in the first examination did not influence recurrent TSM (OR 0.36; P = 0.250). CONCLUSION Patients undergoing multiple gadoxetate disodium-enhanced MR examinations who experienced recurrent TSM were not affected by TSM in the first examination. Therefore, a single episode of TSM should not be considered a risk factor of recurrent TSM.
Collapse
Affiliation(s)
- Won Hyeong Im
- Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea
| | - Ji Soo Song
- Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea.
- Research Institute of Clinical Medicine of Chonbuk National University, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea.
- Biomedical Research Institute of Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea.
| | - Eun Hae Park
- Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea
- Research Institute of Clinical Medicine of Chonbuk National University, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea
- Biomedical Research Institute of Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea
| | - Hyo Sung Kwak
- Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea
- Research Institute of Clinical Medicine of Chonbuk National University, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea
- Biomedical Research Institute of Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea
| |
Collapse
|
26
|
Akai H, Yasaka K, Nojima M, Kunimatsu A, Inoue Y, Abe O, Ohtomo K, Kiryu S. Gadoxetate disodium-induced tachypnoea and the effect of dilution method: a proof-of-concept study in mice. Eur Radiol 2017; 28:692-697. [PMID: 28894937 DOI: 10.1007/s00330-017-5037-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/06/2017] [Accepted: 08/16/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To directly investigate the rapid respiratory effect of gadoxetate disodium in an experimental study using mice. METHODS After confirming the steady respiratory state under general anaesthesia, eight mice were injected with all test agents in the following order: phosphate-buffered saline (A, control group), 1.25 mmol/kg of gadoteridol (B) or gadopentetate dimeglumine (C), or 0.31 mmol/kg of gadoxetate disodium (D, E). The experimenter was not blinded to the agents. The injection dose was fixed as 100 μL for Groups A-D and 50 μL for Group E. We continuously monitored and recorded respiratory rate (RR), peripheral oxygen saturation (SpO2), and heart rate. The time-series changes from 0 to 30 s were compared by the linear mixed method RESULTS: Groups D and E showed the largest RR increase (20.6 and 20.3 breaths/min, respectively) and were significantly larger compared to Group A (3.36 breaths/min, both P<0.001). RR change of Groups D and E did not differ. RR change of Groups B and C was smaller (0.72 and 12.4 breaths/min, respectively) and did not differ statistically with Group A. Significant bradycardia was observed only in Group C (P<0.001). SpO2 was constant in all groups. CONCLUSIONS Gadoxetate disodium causes a rapid tachypnoea without significant change of SpO2 and heart rate regardless of the dilution method. KEY POINTS • Injection of gadoxetate disodium causes tachypnoea. • Dilution method did not alter the rapid respiratory effect of gadoxetate disodium. • The respiratory effect of gadoxetate disodium was larger than other contrast agents.
Collapse
Affiliation(s)
- Hiroyuki Akai
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Koichiro Yasaka
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Masanori Nojima
- Division of Advanced Medicine Promotion, The Advanced Clinical Research Centre, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Akira Kunimatsu
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Yusuke Inoue
- Department of Diagnostic Radiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kuni Ohtomo
- International University of Health and Welfare, 2600-1 Kitakanemaru, Ohtawara, Tochigi, 324-8501, Japan
| | - Shigeru Kiryu
- Department of Radiology, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan.
| |
Collapse
|
27
|
Davenport MS, Malyarenko DI, Pang Y, Hussain HK, Chenevert TL. Effect of Gadoxetate Disodium on Arterial Phase Respiratory Waveforms Using a Quantitative Fast Fourier Transformation–Based Analysis. AJR Am J Roentgenol 2017; 208:328-36. [DOI: 10.2214/ajr.16.16860] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
28
|
Gutzeit A, Matoori S, Froehlich J, Koh D. Reduction in Respiratory Motion Artifacts on Gadoxetate Acid-enhanced MR Images after Training Technicians. Radiology 2016; 279:981-2. [PMID: 27183413 DOI: 10.1148/radiol.2016152605] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Andreas Gutzeit
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria *,Department of Radiology, Klinik St. Anna, St Anna Strasse 32, 6006 Luzern, Switzerland †
| | - Simon Matoori
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria *,Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland ‡
| | - Johannes Froehlich
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria *
| | - DowMu Koh
- Department of Radiology, Royal Marsden Hospital, Downs Rd, Sutton, Surrey, SM2 5PT, England §
| |
Collapse
|
29
|
McClellan TR, Motosugi U, Middleton MS, Allen BC, Jaffe TA, Miller CM, Reeder SB, Sirlin CB, Bashir MR. Intravenous Gadoxetate Disodium Administration Reduces Breath-holding Capacity in the Hepatic Arterial Phase: A Multi-Center Randomized Placebo-controlled Trial. Radiology 2016; 282:361-368. [PMID: 27509544 DOI: 10.1148/radiol.2016160482] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Purpose To determine, in a multicenter double-blinded placebo-controlled trial, whether maximal hepatic arterial phase breath-holding duration is affected by gadoxetate disodium administration. Materials and Methods Institutional review board approval was obtained for this prospective multi-institutional HIPAA-compliant study; written informed consent was obtained from all subjects. At three sites, a total of 44 volunteers underwent a magnetic resonance (MR) imaging examination in which images were acquired before and dynamically after bolus injection of gadoxetate disodium, normal saline, and gadoterate meglumine, administered in random order in a single session. The technologist and volunteer were blinded to the agent. Arterial phase breath-holding duration was timed after each injection, and volunteers reported subjective symptoms. Heart rate (HR) and oxygen saturation were monitored. Images were independently analyzed for motion artifacts by three radiologists. Arterial phase breath-holding duration and motion artifacts after each agent were compared by using the Mann-Whitney U test and the McNemar test. Factors affecting the above outcomes were assessed by using a univariate, multivariable model. Results Arterial phase breath holds were shorter after gadoxetate disodium (mean, 32 seconds ± 19) than after saline (mean, 40 seconds ± 17; P < .001) or gadoterate meglumine (43 seconds ± 21, P < .001) administration. In 80% (35 of 44) of subjects, arterial phase breath holds were shorter after gadoxetate disodium than after both saline and gadoterate meglumine. Three (7%) of 44 volunteers had severe arterial phase motion artifacts after gadoxetate disodium administration, one (2%; P = .62) had them after gadoterate meglumine administration, and none (P = .25) had them after saline administration. HR and oxygen saturation changes were not significantly associated with contrast agent. Conclusion Maximal hepatic arterial phase breath-holding duration is reduced after gadoxetate disodium administration in healthy volunteers, and reduced breath-holding duration is associated with motion artifacts. © RSNA, 2016.
Collapse
Affiliation(s)
- Taylor R McClellan
- From the Department of Radiology (T.R.M., B.C.A., T.A.J., C.M.M., M.R.B.) and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, DUMC 3808, Durham, NC 27710; Departments of Radiology (U.M., S.B.R.), Medical Physics (S.B.R.), Biomedical Engineering (S.B.R.), Medicine (S.B.R.), and Emergency Medicine (S.B.R.), University of Wisconsin, Madison, Wis; and Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (M.S.M., C.B.S.)
| | - Utaroh Motosugi
- From the Department of Radiology (T.R.M., B.C.A., T.A.J., C.M.M., M.R.B.) and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, DUMC 3808, Durham, NC 27710; Departments of Radiology (U.M., S.B.R.), Medical Physics (S.B.R.), Biomedical Engineering (S.B.R.), Medicine (S.B.R.), and Emergency Medicine (S.B.R.), University of Wisconsin, Madison, Wis; and Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (M.S.M., C.B.S.)
| | - Michael S Middleton
- From the Department of Radiology (T.R.M., B.C.A., T.A.J., C.M.M., M.R.B.) and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, DUMC 3808, Durham, NC 27710; Departments of Radiology (U.M., S.B.R.), Medical Physics (S.B.R.), Biomedical Engineering (S.B.R.), Medicine (S.B.R.), and Emergency Medicine (S.B.R.), University of Wisconsin, Madison, Wis; and Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (M.S.M., C.B.S.)
| | - Brian C Allen
- From the Department of Radiology (T.R.M., B.C.A., T.A.J., C.M.M., M.R.B.) and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, DUMC 3808, Durham, NC 27710; Departments of Radiology (U.M., S.B.R.), Medical Physics (S.B.R.), Biomedical Engineering (S.B.R.), Medicine (S.B.R.), and Emergency Medicine (S.B.R.), University of Wisconsin, Madison, Wis; and Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (M.S.M., C.B.S.)
| | - Tracy A Jaffe
- From the Department of Radiology (T.R.M., B.C.A., T.A.J., C.M.M., M.R.B.) and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, DUMC 3808, Durham, NC 27710; Departments of Radiology (U.M., S.B.R.), Medical Physics (S.B.R.), Biomedical Engineering (S.B.R.), Medicine (S.B.R.), and Emergency Medicine (S.B.R.), University of Wisconsin, Madison, Wis; and Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (M.S.M., C.B.S.)
| | - Chad M Miller
- From the Department of Radiology (T.R.M., B.C.A., T.A.J., C.M.M., M.R.B.) and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, DUMC 3808, Durham, NC 27710; Departments of Radiology (U.M., S.B.R.), Medical Physics (S.B.R.), Biomedical Engineering (S.B.R.), Medicine (S.B.R.), and Emergency Medicine (S.B.R.), University of Wisconsin, Madison, Wis; and Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (M.S.M., C.B.S.)
| | - Scott B Reeder
- From the Department of Radiology (T.R.M., B.C.A., T.A.J., C.M.M., M.R.B.) and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, DUMC 3808, Durham, NC 27710; Departments of Radiology (U.M., S.B.R.), Medical Physics (S.B.R.), Biomedical Engineering (S.B.R.), Medicine (S.B.R.), and Emergency Medicine (S.B.R.), University of Wisconsin, Madison, Wis; and Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (M.S.M., C.B.S.)
| | - Claude B Sirlin
- From the Department of Radiology (T.R.M., B.C.A., T.A.J., C.M.M., M.R.B.) and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, DUMC 3808, Durham, NC 27710; Departments of Radiology (U.M., S.B.R.), Medical Physics (S.B.R.), Biomedical Engineering (S.B.R.), Medicine (S.B.R.), and Emergency Medicine (S.B.R.), University of Wisconsin, Madison, Wis; and Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (M.S.M., C.B.S.)
| | - Mustafa R Bashir
- From the Department of Radiology (T.R.M., B.C.A., T.A.J., C.M.M., M.R.B.) and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, DUMC 3808, Durham, NC 27710; Departments of Radiology (U.M., S.B.R.), Medical Physics (S.B.R.), Biomedical Engineering (S.B.R.), Medicine (S.B.R.), and Emergency Medicine (S.B.R.), University of Wisconsin, Madison, Wis; and Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (M.S.M., C.B.S.)
| |
Collapse
|
30
|
Gutzeit A, Matoori S, Froehlich JM, von Weymarn C, Reischauer C, Kolokythas O, Goyen M, Hergan K, Meissnitzer M, Forstner R, Soyka JD, Doert A, Koh DM. Reduction in respiratory motion artefacts on gadoxetate-enhanced MRI after training technicians to apply a simple and more patient-adapted breathing command. Eur Radiol 2016; 26:2714-22. [PMID: 26573682 DOI: 10.1007/s00330-015-4086-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 09/23/2015] [Accepted: 10/23/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate whether a trained group of technicians using a modified breathing command during gadoxetate-enhanced liver MRI reduces respiratory motion artefacts compared to non-trained technicians using a traditional breathing command. MATERIALS AND METHODS The gadoxetate-enhanced liver MR images of 30 patients acquired using the traditional breathing command and the subsequent 30 patients after training the technicians to use a modified breathing command were analyzed. A subgroup of patients (n = 8) underwent scans both by trained and untrained technicians. Images obtained using the traditional and modified breathing command were compared for the presence of breathing artefacts [respiratory artefact-based image quality scores from 1 (best) to 5 (non-diagnostic)]. RESULTS There was a highly significant improvement in the arterial phase image quality scores in patients using the modified breathing command compared to the traditional one (P < 0.001). The percentage of patients with severe and extensive breathing artefacts in the arterial phase decreased from 33.3 % to 6.7 % after introducing the modified breathing command (P = 0.021). In the subgroup that underwent MRI using both breathing commands, arterial phase image quality improved significantly (P = 0.008) using the modified breathing command. CONCLUSION Training technicians to use a modified breathing command significantly improved arterial phase image quality of gadoxetate-enhanced liver MRI. KEY POINTS • A modified breathing command reduced respiratory artefacts on arterial-phase gadoxetate-enhanced MRI (P < 0.001). • The modified command decreased severe and extensive arterial-phase breathing artefacts (P = 0.021). • Training technicians to use a modified breathing command improved arterial-phase images.
Collapse
Affiliation(s)
- Andreas Gutzeit
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria.
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Simon Matoori
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Johannes M Froehlich
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zurich, Vladimir-Prelog-Weg 1-5 / 10, 8093, Zurich, Switzerland
| | | | - Carolin Reischauer
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Orpheus Kolokythas
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Matthias Goyen
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Klaus Hergan
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Matthias Meissnitzer
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Rosemarie Forstner
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Jan D Soyka
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Aleksis Doert
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Dow-Mu Koh
- Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton, Surrey, SM2 5PT, Great Britain, UK
| |
Collapse
|