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Zou J, Jiang Y, Fan F, Yang P, Gan T, Yang T, Li M, Ding Y, Wang S, Zhang J. The application of B1 inhomogeneity-corrected variable flip angle T1 mapping for assessing liver fibrosis. Magn Reson Imaging 2024:110215. [PMID: 39047851 DOI: 10.1016/j.mri.2024.110215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/21/2024] [Accepted: 07/21/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE The aim of this study was to evaluate the diagnostic accuracy of the B1 inhomogeneity-corrected variable flip angle (VFA) method using native T1 values in the staging of liver fibrosis. METHODS Eighty-three patients who presented for liver biopsy due to varying degrees of liver damage, underwent MR examinations and had T1-mapping images of the liver acquired using the B1 inhomogeneity-corrected VFA VIBE method. Among them, 65 patients underwent Fibroscan, and their results were used to evaluate the elasticity of liver tissue. Additionally, T1-mapping images were collected from 19 normal control patients. Independent sample t-tests were used to analyze the correlation between T1 mapping and Fibroscan. The diagnostic efficacy of T1 mapping in patients with different stages of liver fibrosis was evaluated using receiver operating characteristic (ROC) curves. RESULTS The consistency between different observer groups was intraclass correlation coefficient (ICC) =0.802. T1 mapping demonstrated significant differences between mid-stage liver fibrosis (S = 2) and late-stage liver fibrosis (S = 3), as well as moderate inflammation (G = 2) and severe inflammation (G = 3), P < 0.05. The Area Under Curve(AUC) values of T1 mapping for early liver fibrosis (S ≥ 1), significant liver fibrosis (S ≥ 2), advanced liver fibrosis (S ≥ 3), and end-stage liver fibrosis (S = 4) were 0.760, 0.709, 0.790, and 0.768, respectively. T1 mapping combined with Fibroscan had an AUC value of 0.860. CONCLUSIONS The B1 inhomogeneity-corrected VFA T1 mapping may be useful for the staging of liver fibrosis. It has a superior diagnostic efficiency for diagnosing advanced fibrosis (≥S3), while native T1 values combined with Fibroscan have potential value for the staging of liver fibrosis.
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Affiliation(s)
- Jie Zou
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, PR China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China
| | - Yanli Jiang
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, PR China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China
| | - Fengxian Fan
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, PR China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China
| | - Pin Yang
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, PR China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China
| | - Tiejun Gan
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, PR China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China
| | - Tingli Yang
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, PR China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China
| | - Min Li
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, PR China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China
| | - Yuan Ding
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, PR China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China
| | - Shaoyu Wang
- MR Scientific Marketing, Siemens Healthineers, Xi'an 710065, PR China
| | - Jing Zhang
- Department of Magnetic Resonance, The Second Hospital & Clinical Medical School, Lanzhou University, PR China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China.
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2
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Li J. Editorial for "Reference Values for Water-Specific T1 of the Liver at 3T: T2*-Compensation and the Confounding Effects of Fat". J Magn Reson Imaging 2024. [PMID: 38450894 DOI: 10.1002/jmri.29320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
- Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China
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Ren Y, Gao Y, Qiu B, Nan X, Han J. Effects of radiofrequency channel numbers on B 1+ mapping using the Bloch-Siegert shift method. Neuroimage 2023; 279:120308. [PMID: 37544415 DOI: 10.1016/j.neuroimage.2023.120308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/14/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023] Open
Abstract
PURPOSE This paper aims to investigate the impact of the channel numbers on the performance of B1+ mapping, by using the Bloch-Siegert shift (BSS) method. B1+ mapping plays a crucial role in various brain imaging protocols. THEORY AND METHODS We simulated the radiofrequency field of the human head model in six groups of multi-channel receive coil with a range of different channel numbers. MR signals were synthesized according to the standard BSS sequence, with quantified Gaussian added. Next, we combined the signals of each channel to reconstruct the B1+ map by weighted averaging and maximum likelihood estimation strategies and evaluate the bias by relative standard deviation of each coil. RESULTS The simulation results revealed that the accuracy of B1+ maps improved with the increasing of channel numbers, meanwhile the per channel efficiency of B1+maps accuracy gradually decrease. Both trends slowed down when the channel numbers reached 12 or above. CONCLUSION Our finding suggests that increasing the channel numbers can improve the accuracy of B1+map. However, a diminishing efficiency of per channel accuracy improvement was overserved, indicating that the relationship between quality of B1+ map and the channel numbers is nonlinear. Based on these findings, our study provides a reference for determining channel numbers to achieve a balance of coil selection and manufacturing cost. It also provides a theoretical basis for evaluating other B1+ mapping techniques.
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Affiliation(s)
- Yinhao Ren
- School of Biomedical Engineering, Anhui Medical University, Hefei, China
| | - Yunyu Gao
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Bensheng Qiu
- Center for Biomedical Imaging, University of Science and Technology of China, Hefei, China
| | - Xiang Nan
- Department of Anatomy, Anhui Medical University, Hefei, China.
| | - Jijun Han
- School of Biomedical Engineering, Anhui Medical University, Hefei, China.
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Ma B, Xu H, Wu X, Zhu W, Han X, Jiang J, Wang Y, Yang D, Ren H, Yang Z. Evaluation of liver function using Gd-EOB-DTPA-enhanced MRI with T1 mapping. BMC Med Imaging 2023; 23:73. [PMID: 37271809 DOI: 10.1186/s12880-023-01028-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/23/2023] [Indexed: 06/06/2023] Open
Abstract
PURPOSE To evaluate the value of MRI T1 mapping with Gd-EOB-DTPA for assessing liver function. METHODS Seventy-two patients who underwent Gd-EOB-DTPA-enhanced MRI for focal liver lesions at Beijing Friendship Hospital from August 2020 to March 2022 were prospectively enrolled, and variable-flip-angle T1 mapping was performed before and 20 min after enhancement. The Child-Pugh (C-P) score and albumin-bilirubin (ALBI) grade of liver function were assessed using the clinical data of the patients. Correlation analysis was used to evaluate the correlation between T1 mapping parameters and liver function grading and laboratory tests. Nonparametric tests were used to compare the differences among different liver function groups. The liver function classification efficiency of each image index was evaluated with receiver operating characteristic (ROC) curves. RESULTS T1post was positively correlated with the C-P grade and the ALBI grade (r = 0.717 and r = 0.652). ΔT1 was negatively correlated with the C-P grade and the ALBI grade (r = -0.790 and r = -0.658). T1post and ΔT1 significantly differed among different liver function grades (p < 0.05). For the C-P grade, T1post and ΔT1 were significantly different between each pair of groups (p < 0.05), and ΔT1 had a better diagnostic efficiency than T1post. For the ALBI grade, ΔT1 and T1post were significantly different between the NLF and ALBI1 groups (p < 0.05), and ΔT1 had a better diagnostic efficacy than T1post. T1post significantly differed between the ALBI1 and ALBI2 + 3 groups (p < 0.05), while ΔT1 had a weak ability to differentiate between these two groups. CONCLUSION T1post and ΔT1 were strongly correlated with the two liver function grades and can be noninvasive imaging indexes for evaluating liver function.
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Affiliation(s)
- Boyang Ma
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, West District, Beijing, 100050, China
| | - Hui Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, West District, Beijing, 100050, China
| | - Xinru Wu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, West District, Beijing, 100050, China
| | - Wenyan Zhu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, West District, Beijing, 100050, China
| | - Xinjun Han
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, West District, Beijing, 100050, China
| | - Jiahui Jiang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, West District, Beijing, 100050, China
| | - Yuxin Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, West District, Beijing, 100050, China
| | - Dawei Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, West District, Beijing, 100050, China
| | - Hao Ren
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, West District, Beijing, 100050, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, West District, Beijing, 100050, China.
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Ringe KI, Yoon JH. Strategies and Techniques for Liver Magnetic Resonance Imaging: New and Pending Applications for Routine Clinical Practice. Korean J Radiol 2023; 24:180-189. [PMID: 36788770 PMCID: PMC9971842 DOI: 10.3348/kjr.2022.0838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 12/22/2022] [Indexed: 02/16/2023] Open
Affiliation(s)
- Kristina I. Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
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Zhao Y, Tan X, Chen J, Tan H, Huang H, Luo P, Liang Y, Jiang X. Preoperative prediction of cytokeratin-19 expression for hepatocellular carcinoma using T1 mapping on gadoxetic acid-enhanced MRI combined with diffusion-weighted imaging and clinical indicators. Front Oncol 2023; 12:1068231. [PMID: 36741705 PMCID: PMC9893005 DOI: 10.3389/fonc.2022.1068231] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/19/2022] [Indexed: 01/20/2023] Open
Abstract
Objectives To explore the value of T1 mapping on gadoxetic acid-enhanced magnetic resonance imaging (MRI) in preoperative predicting cytokeratin 19 (CK19) expression for hepatocellular carcinoma (HCC). Methods This retrospective study included 158 patients from two institutions with surgically resected treatment-native solitary HCC who underwent preoperative T1 mapping on gadoxetic acid-enhanced MRI. Patients from institution I (n = 102) and institution II (n = 56) were assigned to training and test sets, respectively. univariable and multivariable logistic regression analyses were performed to investigate the association of clinicoradiological variables with CK19. The receiver operating characteristic (ROC) curve and precision-recall (PR) curve were used to evaluate the performance for CK19 prediction. Then, a prediction nomogram was developed for CK19 expression. The performance of the prediction nomogram was evaluated by its discrimination, calibration, and clinical utility. Results Multivariable logistic regression analysis showed that AFP>400ng/ml (OR=4.607, 95%CI: 1.098-19.326; p=0.037), relative apparent diffusion coefficient (rADC)≤0.71 (OR=3.450, 95%CI: 1.126-10.567; p=0.030), T1 relaxation time in the 20-minute hepatobiliary phase (T1rt-HBP)>797msec (OR=4.509, 95%CI: 1.301-15.626; p=0.018) were significant independent predictors of CK19 expression. The clinical-quantitative model (CQ-Model) constructed based on these significant variables had the best predictive performance with an area under the ROC curve of 0.844, an area under the PR curve of 0.785 and an F1 score of 0.778. The nomogram constructed based on CQ-Model demonstrated satisfactory performance with C index of 0.844 (95%CI: 0.759-0.908) and 0.818 (95%CI: 0.693-0.902) in the training and test sets, respectively. Conclusions T1 mapping on gadoxetic acid-enhanced MRI has good predictive efficacy for preoperative prediction of CK19 expression in HCC, which can promote the individualized risk stratification and further treatment decision of HCC patients.
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Affiliation(s)
- Yue Zhao
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China,Department of Radiology, Guangzhou First People’s Hospital, Guangzhou, China
| | - Xiaoliang Tan
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jingmu Chen
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hongweng Tan
- Department of Radiology, Central People's Hospital of Zhanjiang, Zhanjiang, China
| | - Huasheng Huang
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Peng Luo
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yongsheng Liang
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xinqing Jiang
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China,Department of Radiology, Guangzhou First People’s Hospital, Guangzhou, China,*Correspondence: Xinqing Jiang,
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Chen D, Zhao X, Xu H, Ren H, Liu T, Wang Y, Yang D, Yang Z. Noninvasive Assessment of APAP (N-acetyl-p-aminophenol)-Induced Hepatotoxicity Using Multiple MRI Parameters in an Experimental Rat Model. J Magn Reson Imaging 2022; 56:1809-1817. [PMID: 35420237 DOI: 10.1002/jmri.28203] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Early detection and accurate assessment of N-acetyl-p-aminophenol (APAP)-induced hepatotoxicity can prevent further aggravation of liver injury and reduce the incidence of liver failure. PURPOSE To evaluate the potential of multiple MRI parameters for assessing APAP-induced hepatotoxicity in an experimental rat model. STUDY TYPE Prospective. ANIMAL MODEL Twenty-one APAP-treated rats and 12 control rats. FIELD STRENGTH/SEQUENCE A 3 T, T1 mapping, Gd-EOB-DTPA-enhanced MRI, and intravoxel incoherent motion (IVIM). ASSESSMENT The severity of histological changes was assessed by a liver pathologist. Rat livers were pathologically classified into three groups: normal (n = 12), mild necrosis (n = 13), and moderate necrosis (n = 8). T1 relaxation time (T1) and diffusion parameters were measured. The reduction rate of T1 (ΔT1%) at different time points, the maximum value of ΔT1%, time period to the maximum value of ΔT1%, and time period from ΔT1max (%) to 2/3 value of ΔT1max (%) (ΔT1-T2/3) were calculated. Transporters activities like organic anion-transporting polypeptide 1 (oatp1) and multidrug resistance-associated protein 2 (mrp2) were compared among different necrotic groups. STATISTICAL TESTS ANOVA/Kruskal-Wallis. Pearson/Spearman correlation. P < 0.05 was considered statistical significance. RESULTS T1 Precontrast and ΔT1-T2/3 were strongly correlated with the severity of necrosis (r = 0.9094; r = 0.7978, respectively) and showed significant differences between the two groups. The apparent diffusion coefficient (ADC) and tissue diffusivity (D) values were significantly lower in the moderate necrosis group than in the normal and mild necrosis groups. The oatp1 activity of the necrosis groups was significantly reduced compared to that of the normal group, but the differences between normal and mild (P = 0.21), normal and moderate group (P = 0.56) were not significant. Meanwhile, enlargement of bile canaliculi and sparse microvilli was observed in the necrotic groups. CONCLUSION MRI parameters such as precontrast T1 and ΔT1-T2/3 had promising potential in assessing the severity of early-stage hepatotoxicity in an APAP overdose rat model. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Dan Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, West District, Beijing, 100050, China.,Department of Radiology, Weihai Municipal Hospital, Heping Road 70, Huancui District, Weihai, 264200, China
| | - Xinyan Zhao
- Department of Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, West District, Beijing, 100050, China
| | - Hui Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, West District, Beijing, 100050, China
| | - Hao Ren
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, West District, Beijing, 100050, China
| | - Tianhui Liu
- Department of Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, West District, Beijing, 100050, China
| | - Yu Wang
- Department of Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, West District, Beijing, 100050, China
| | - Dawei Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, West District, Beijing, 100050, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, West District, Beijing, 100050, China
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Altinmakas E, Bane O, Hectors SJ, Issa R, Carbonell G, Abboud G, Schiano TD, Thung S, Fischman A, Kelly MD, Friedman SL, Kennedy P, Taouli B. Performance of native and gadoxetate-enhanced liver and spleen T 1 mapping for noninvasive diagnosis of clinically significant portal hypertension: preliminary results. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:3758-3769. [PMID: 36085378 DOI: 10.1007/s00261-022-03645-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE In this preliminary study, our aim was to assess the utility of quantitative native-T1 (T1-pre), iron-corrected T1 (cT1) of the liver/spleen and T1 mapping of the liver obtained during hepatobiliary phase (T1-HBP) post-gadoxetate disodium, compared to spleen size/volume and APRI (aspartate aminotransferase-to-platelet ratio index) for noninvasive diagnosis of clinically significant portal hypertension [CSPH, defined as hepatic venous pressure gradient (HVPG) ≥ 10 mm Hg]. METHODS Forty-nine patients (M/F: 27/22, mean age 53y) with chronic liver disease, HVPG measurement and MRI were included. Breath-held T1 and cT1 measurements were obtained using an inversion recovery Look-Locker sequence and a T2* corrected modified Look-Locker sequence, respectively. Liver T1-pre (n = 49), spleen T1 (obtained pre-contrast, n = 47), liver and spleen cT1 (both obtained pre-contrast, n = 30), liver T1-HBP (obtained 20 min post gadoxetate disodium injection, n = 36) and liver T1 uptake (ΔT1, n = 36) were measured. Spleen size/volume and APRI were also obtained. Spearman correlation coefficients were used to assess the correlation between each of liver/spleen T1/cT1 parameters, spleen size/volume and APRI with HVPG. ROC analysis was performed to determine the performance of measured parameters for diagnosis of CSPH. RESULTS There were 12/49 (24%) patients with CSPH. Liver T1-pre (r = 0.287, p = 0.045), liver T1-HBP (r = 0.543, p = 0.001), liver ΔT1 (r = - 0.437, p = 0.008), spleen T1 (r = 0.311, p = 0.033) and APRI (r = 0.394, p = 0.005) were all significantly correlated with HVPG, while liver cT1, spleen cT1 and spleen size/volume were not. The highest AUCs for the diagnosis of CSPH were achieved with liver T1-HBP, liver ΔT1 and spleen T1: 0.881 (95%CI 0.76-1.0, p = 0.001), 0.852 (0.72-0.98, p = 0.002) and 0.781 (0.60-0.95, p = 0.004), respectively. CONCLUSION Our preliminary results demonstrate the potential of liver T1 mapping obtained during HBP post gadoxetate disodium for the diagnosis of CSPH. These results require further validation.
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Affiliation(s)
- Emre Altinmakas
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Koc University School of Medicine, Istanbul, Turkey
| | - Octavia Bane
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefanie J Hectors
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rayane Issa
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
| | - Guillermo Carbonell
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Virgen de La Arrixaca University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Ghadi Abboud
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Thomas D Schiano
- Icahn School of Medicine at Mount Sinai, Recanati/Miller Transplantation Institute, New York, NY, USA
| | - Swan Thung
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aaron Fischman
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
| | | | - Scott L Friedman
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul Kennedy
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bachir Taouli
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA. .,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Wang F, Yang Q, Zhang Y, Liu J, Liu M, Zhu J. 3D variable flip angle T1 mapping for differentiating benign and malignant liver lesions at 3T: comparison with diffusion weighted imaging. BMC Med Imaging 2022; 22:146. [PMID: 35982406 PMCID: PMC9389795 DOI: 10.1186/s12880-022-00873-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Different methods have been used to improve the imaging diagnosis of focal liver lesions (FLL). Among them, magnetic resonance imaging (MRI) has received more attention since it provides significant amount of information without radiation exposure. However, atypical imaging characteristics of FLL on MRI may complicate the differential diagnosis between benign and malignant FLL. This study aimed to compare the diagnostic value of T1 mapping and diffusion-weighted imaging (DWI) for differentiating of benign and malignant FLLs. METHODS This retrospective study enrolled 294 FLLs, including 150 benign and 144 malignant lesions. Whole liver T1 mapping sequences were obtained before and 2 min after the administration of Gd-DTPA to acquire native T1 and enhanced T1 and ΔT1%. Additionally, DWI sequence was conducted to generate apparent diffusion coefficient (ADC) maps. These quantitative parameters were compared using one-way analysis of variance, and the diagnostic accuracy of T1 mapping and ADC for FLLs was calculated by area under the curve (AUC). RESULTS Significant differences were observed regarding the native T1, enhanced T1, ΔT1%, and ADC between benign and malignant FLLs. Furthermore, the sensitivity and specificity of the parameters are as follows: native T1 0.797/0.702 (cut off value 1635.5 ms); enhanced T1, 0.911/0.976 (cutoff value 339.2 ms); ΔT1%, 0.901/0.905 (cutoff value 70.8%); and ADC, 0.975/0.952 (cutoff value 1.21 × 10-3 mm2/s). The ideal cutoff values for native T1 and ADC in identifying cyst and haemangioma were 2422.9 ms (AUC 0.990, P < 0.01) and 2.077 × 10-3 mm2/s (AUC 0.949, P < 0.01), respectively, with a sensitivity and specificity of 0.963/1 and 0.852/0.892, respectively. ADC was significantly positively correlated with T1 and ΔT1%, and significantly negatively correlated with enhanced T1. CONCLUSION The 3D Variable flip angle T1 mapping technique with Gd-DTPA has a high clinical potential for identifying benign and malignant FLLs. The enhanced T1 and ΔT1% values have similar diagnostic accuracy compared with DWI in evaluating FLLs. Native T1 shows better performance than DWI in distinguishing benign liver lesions, specifically, cysts, and haemangioma.
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Affiliation(s)
- Fei Wang
- Department of Medical Imaging, Anqing Hospital Affiliated to Anhui Medical University, 352 Renmin Road, Anqing, 246000, China
| | - Qing Yang
- Department of Medical Imaging, Anqing Hospital Affiliated to Anhui Medical University, 352 Renmin Road, Anqing, 246000, China
| | - Yupei Zhang
- Department of Medical Imaging, Anqing Hospital Affiliated to Anhui Medical University, 352 Renmin Road, Anqing, 246000, China
| | - Jun Liu
- Department of Medical Imaging, Anqing Hospital Affiliated to Anhui Medical University, 352 Renmin Road, Anqing, 246000, China
| | - Mengxiao Liu
- Siemens Healthcare Ltd., Shanghai, 201318, China
| | - Juan Zhu
- Department of Medical Imaging, Anqing Hospital Affiliated to Anhui Medical University, 352 Renmin Road, Anqing, 246000, China.
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10
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Li J, Gao X, Dominik Nickel M, Cheng J, Zhu J. Native T1 mapping for differentiating the histopathologic type, grade, and stage of rectal adenocarcinoma: a pilot study. Cancer Imaging 2022; 22:30. [PMID: 35715848 PMCID: PMC9204907 DOI: 10.1186/s40644-022-00461-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies have indicated that T1 relaxation time could be utilized for the analysis of tissue characteristics. T1 mapping technology has been gradually used on research of body tumor. In this study, the application of native T1 relaxation time for differentiating the histopathologic type, grade, and stage of rectal adenocarcinoma was investigated. Methods One hundred and twenty patients with pathologically confirmed rectal adenocarcinoma were retrospectively evaluated. All patients underwent high-resolution anatomical magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and T1 mapping sequences. Parameters of T1 relaxation time and apparent diffusion coefficient (ADC) were measured between the different groups. The diagnostic power was evaluated though the receiver operating characteristic (ROC) curve. Results The T1 and ADC values varied significantly between rectal mucinous adenocarcinoma (MC) and non-mucinous rectal adenocarcinoma (AC) ([1986.1 ± 163.3 ms] vs. [1562.3 ± 244.2 ms] and [1.38 ± 0.23 × 10−3mm2/s] vs. [1.03 ± 0.15 × 10−3mm2/s], respectively; P < 0.001). In the AC group, T1 relaxation time were significantly different between the low- and high-grade adenocarcinoma cases ([1508.7 ± 188.6 ms] vs. [1806.5 ± 317.5 ms], P < 0.001), while no differences were apparent in the ADC values ([1.03 ± 0.14 × 10−3mm2/s] vs. [1.04 ± 0.18 × 10−3mm2/s], P > 0.05). No significant differences in T1 and ADC values were identified between the different T and N stage groups for both MC and AC (all P > 0.05). Conclusions Native T1 relaxation time can be used to discriminate MC from AC. The T1 relaxation time was helpful for differentiating the low- and high-grade of AC.
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Affiliation(s)
- Juan Li
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Dong Road, Zhengzhou, 450052, China
| | - Xuemei Gao
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Dong Road, Zhengzhou, 450052, China
| | | | - Jingliang Cheng
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Dong Road, Zhengzhou, 450052, China.
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd, Beijing, 100000, China
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11
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Ghavamian A, Liu C, Kang B, Yuan X, Wang X, Gao L, Zhao X. Liver T1 relaxation time of the 'normal liver' in healthy Asians: measurement with MOLLI and B 1-corrected VFA methods at 3T. Br J Radiol 2022; 95:20211008. [PMID: 35324344 PMCID: PMC10993984 DOI: 10.1259/bjr.20211008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/15/2022] [Accepted: 02/02/2022] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Liver T1 is a potential magnetic resonance imaging biomarker for liver diseases. This study aimed to determine the T1 relaxation time of the normal liver (PDFF<5%) in healthy Asian volunteers using modified look-locker inversion recovery (MOLLI) and B1 inhomogeneity-corrected variable flip angle (B1-corrected VFA). METHODS 60 healthy Asian volunteers without focal or diffuse liver disease underwent a liver scan at 3T magnetic resonance. Proton density fat fraction (PDFF) and liver stiffness measurements were applied for the quantification of liver fat and fibrosis. T1 mapping was performed with MOLLI and B1-corrected VFA sequences. Bland-Altman, linear regression, Student t-test, and one-way analysis of variance were used for statistical analysis. RESULTS The mean T1 relaxation times of the whole liver were 901 ± 34 ms by MOLLI, and 948 ± 29 ms by B1-corrected VFA in healthy volunteers. There was a strong correlation (r = 0.86, p < 0.0001) for liver T1 between two T1 mapping methods. There were significant differences between the right and left lobes in liver T1 relaxation times using both methods (p < 0.05). Gender and Asian ethnic disparities had no impact on liver T1 relaxation times. CONCLUSION T1 relaxation times of the normal liver (PDFF<5%) in healthy volunteers were established by MOLLI and B1-corrected VFA T1 mapping methods at 3T. It may provide suitable and robust baseline values for the assessment of liver diseases. ADVANCES IN KNOWLEDGE Gender and Asian ethnic disparities do not impact liver T1 relaxation time measurements.
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Affiliation(s)
- Armin Ghavamian
- Department of Radiology, Shandong Provincial Hospital, Cheeloo
College of Medicine, Shandong University,
Shandong, China
| | - Cuihong Liu
- Department of Radiology, Shandong Provincial Hospital, Cheeloo
College of Medicine, Shandong University,
Shandong, China
- Shandong Provincial Hospital Affiliated to Shandong First
Medical University, Shandong University,
Shandong, China
| | - Bing Kang
- Shandong Provincial Hospital Affiliated to Shandong First
Medical University, Shandong University,
Shandong, China
| | - Xianshun Yuan
- Shandong Provincial Hospital Affiliated to Shandong First
Medical University, Shandong University,
Shandong, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital, Cheeloo
College of Medicine, Shandong University,
Shandong, China
- Shandong Provincial Hospital Affiliated to Shandong First
Medical University, Shandong University,
Shandong, China
| | - Ling Gao
- Department of Endocrinology, Shandong Provincial Hospital
affiliated to Shandong University, Shandong Clinical Medical Center of
Endocrinology and Metabolism, Institute of Endocrinology and Metabolism,
Shandong Academy of Clinical Medicine,
Shandong, China
| | - Xinya Zhao
- Department of Radiology, Shandong Provincial Hospital, Cheeloo
College of Medicine, Shandong University,
Shandong, China
- Shandong Provincial Hospital Affiliated to Shandong First
Medical University, Shandong University,
Shandong, China
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12
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Río Bártulos C, Senk K, Schumacher M, Plath J, Kaiser N, Bade R, Woetzel J, Wiggermann P. Assessment of Liver Function With MRI: Where Do We Stand? Front Med (Lausanne) 2022; 9:839919. [PMID: 35463008 PMCID: PMC9018984 DOI: 10.3389/fmed.2022.839919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/25/2022] [Indexed: 12/12/2022] Open
Abstract
Liver disease and hepatocellular carcinoma (HCC) have become a global health burden. For this reason, the determination of liver function plays a central role in the monitoring of patients with chronic liver disease or HCC. Furthermore, assessment of liver function is important, e.g., before surgery to prevent liver failure after hepatectomy or to monitor the course of treatment. Liver function and disease severity are usually assessed clinically based on clinical symptoms, biopsy, and blood parameters. These are rather static tests that reflect the current state of the liver without considering changes in liver function. With the development of liver-specific contrast agents for MRI, noninvasive dynamic determination of liver function based on signal intensity or using T1 relaxometry has become possible. The advantage of this imaging modality is that it provides additional information about the vascular structure, anatomy, and heterogeneous distribution of liver function. In this review, we summarized and discussed the results published in recent years on this technique. Indeed, recent data show that the T1 reduction rate seems to be the most appropriate value for determining liver function by MRI. Furthermore, attention has been paid to the development of automated tools for image analysis in order to uncover the steps necessary to obtain a complete process flow from image segmentation to image registration to image analysis. In conclusion, the published data show that liver function values obtained from contrast-enhanced MRI images correlate significantly with the global liver function parameters, making it possible to obtain both functional and anatomic information with a single modality.
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Affiliation(s)
- Carolina Río Bártulos
- Institut für Röntgendiagnostik und Nuklearmedizin, Städtisches Klinikum Braunschweig gGmbH, Braunschweig, Germany
| | - Karin Senk
- Institut für Röntgendiagnostik, Universtitätsklinikum Regensburg, Regensburg, Germany
| | | | - Jan Plath
- MeVis Medical Solutions AG, Bremen, Germany
| | | | | | | | - Philipp Wiggermann
- Institut für Röntgendiagnostik und Nuklearmedizin, Städtisches Klinikum Braunschweig gGmbH, Braunschweig, Germany
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13
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Obmann VC, Catucci D, Berzigotti A, Gräni C, Ebner L, Heverhagen JT, Christe A, Huber AT. T1 reduction rate with Gd-EOB-DTPA determines liver function on both 1.5 T and 3 T MRI. Sci Rep 2022; 12:4716. [PMID: 35304554 PMCID: PMC8933426 DOI: 10.1038/s41598-022-08659-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/01/2022] [Indexed: 11/10/2022] Open
Abstract
Magnetic resonance T1 mapping before and after Gd-EOB-DTPA administration allows quantification of the T1 reduction rate as a non-invasive surrogate marker of liver function. A major limitation of T1 relaxation time measurement is its dependency on MRI field strengths. Since T1 reduction rate is calculated as the relative shortening of T1 relaxation time before and after contrast administration, we hypothesized that the T1 reduction rate is comparable between 1.5 and 3 T. We thus compared liver T1 relaxation times between 1.5 and 3 T in a total of 243 consecutive patients (124, 1.5 T and 119, 3 T) between 09/2018 and 07/2019. T1 reduction rates were compared between patients with no cirrhosis and patients with cirrhosis Child-Pugh A-C. There was no significant difference of T1 reduction rate between 1.5 and 3 T in any patient group (p-value 0.126-0.861). On both 1.5 T and 3 T, T1 reduction rate allowed to differentiate between patients with no cirrhosis and patients with liver cirrhosis Child A-C (p < 0.001). T1 reduction rate showed a good performance to predict liver cirrhosis Child A (AUC = 0.83, p < 0.001), Child B (AUC = 0.83, p < 0.001) and Child C (AUC = 0.92, p < 0.001). In conclusion, T1 reduction rate allows to determine liver function on Gd-EOB-DTPA MRI with comparable values on 1.5 T and 3 T.
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Affiliation(s)
- Verena Carola Obmann
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Damiano Catucci
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Annalisa Berzigotti
- Hepatology, Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lukas Ebner
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Johannes Thomas Heverhagen
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Andreas Christe
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Adrian Thomas Huber
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland.
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Quantitative evaluation of hepatic fibrosis by fibro Scan and Gd-EOB-DTPA-enhanced T1 mapping magnetic resonance imaging in chronic hepatitis B. Abdom Radiol (NY) 2022; 47:684-692. [PMID: 34825269 DOI: 10.1007/s00261-021-03300-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Studies have found that both FibroScan (FS) and Gd-EOB-DTPA-enhanced T1 mapping magnetic resonance imaging (Gd-MRI) could assess liver fibrosis (LF) with high effectiveness. The aim of this study is to compare their accuracy in the quantitative evaluation of LF in patients with chronic hepatitis B (CHB), and to explore the diagnostic accuracy of their combination. METHODS 160 patients with CHB were included in this study. FS and Gd-MRI were performed within 3 months before the pathological LF staging, which was classified according to the Scheuer-Ludwig scale. The liver stiffness measurement (LSM) was obtained by FS. T1 mapping images of the liver before and 20 min after enhancement were obtained by Look-Locker Gd-MRI. RESULTS There were 45, 35, 31 and 49 patients with stage S1, S2, S3 and S4 LF, respectively. LSM increased and the reduction rate of T1 relaxation time of 20 min (rrT120min%) decreased with the severity of LF. The area under curve (AUC) of LSM, rrT120min% and LSM + rrT120min% for the diagnosis of ≥ S2 LF were 0.892, 0.811 and 0.900, respectively. The AUC for ≥ S3 LF was 0.883, 0.838 and 0.899, respectively. The AUC for S4 LF was 0.882, 0.894 and 0.928, respectively. CONCLUSION The diagnostic accuracy of FS is better than that of Gd-MRI in the evaluation of ≥ S2 stage LF. The combination of these two methods significantly improved the diagnostic efficiency in the evaluation of S4 stage LF.
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15
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Fortier V, Levesque IR. Longitudinal relaxation in fat-water mixtures and its dependence on fat content at 3 T. NMR IN BIOMEDICINE 2022; 35:e4629. [PMID: 34636097 DOI: 10.1002/nbm.4629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 08/27/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Longitudinal (T1 ) relaxation of triglyceride molecules and water is of interest for fat-water separation and fat quantification. A better understanding of T1 relaxation could benefit modeling for applications in fat quantification and relaxation mapping. This work investigated T1 relaxation of spectral resonances of triglyceride molecules and water in liquid fat-water mixtures and its dependence on the fat fraction. Dairy cream and a safflower oil emulsion were used. These were diluted with distilled water to produce a variety of fat mass fractions (4.4% to 35% in dairy cream and 6.3% to 52.3% in safflower oil emulsion). T1 was measured at room temperature at 3 T using an inversion recovery STimulated Echo Acquisition Mode (STEAM) MR spectroscopy method with a series of inversion times. T1 variations as a function of fat fraction were investigated for various resonances. A two-component model was developed to describe the relaxation in a fat-water mixture as a function of the fat fraction. The T1 of water and of all fat resonances studied in this work decreased as the fat fraction increased. The relative variation in T1 was different for each fat resonance. The T1 of the methylene resonance showed the least variation as a function of the fat fraction. The proposed two-component model closely fits the observed T1 variations. In conclusion, this work clarifies how the T1 of major and minor fat resonances and of the water resonance varies as a function of the fat fraction in fat-water mixtures. Knowledge of these variations could serve modeling, analysis of MRI measurements in fat-water mixtures, and phantom preparation.
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Affiliation(s)
- Véronique Fortier
- Medical Physics Unit, McGill University, Montréal, QC, Canada
- Biomedical Engineering, McGill University, Montréal, QC, Canada
| | - Ives R Levesque
- Medical Physics Unit, McGill University, Montréal, QC, Canada
- Biomedical Engineering, McGill University, Montréal, QC, Canada
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montréal, Canada
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16
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Schmidt VF, Arnone F, Dietrich O, Seidensticker M, Armbruster M, Ricke J, Kazmierczak PM. Artifact reduction of coaxial needles in magnetic resonance imaging-guided abdominal interventions at 1.5 T: a phantom study. Sci Rep 2021; 11:22963. [PMID: 34824361 PMCID: PMC8617285 DOI: 10.1038/s41598-021-02434-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 11/10/2021] [Indexed: 11/12/2022] Open
Abstract
Needle artifacts pose a major limitation for MRI-guided interventions, as they impact the visually perceived needle size and needle-to-target-distance. The objective of this agar liver phantom study was to establish an experimental basis to understand and reduce needle artifact formation during MRI-guided abdominal interventions. Using a vendor-specific prototype fluoroscopic T1-weighted gradient echo sequence with real-time multiplanar acquisition at 1.5 T, the influence of 6 parameters (flip angle, bandwidth, matrix, slice thickness, read-out direction, intervention angle relative to B0) on artifact formation of 4 different coaxial MR-compatible coaxial needles (Nitinol, 16G–22G) was investigated. As one parameter was modified, the others remained constant. For each individual parameter variation, 2 independent and blinded readers rated artifact diameters at 2 predefined positions (15 mm distance from the perceived needle tip and at 50% of the needle length). Differences between the experimental subgroups were assessed by Bonferroni-corrected non-parametric tests. Correlations between continuous variables were expressed by the Bravais–Pearson coefficient and interrater reliability was quantified using the intraclass classification coefficient. Needle artifact size increased gradually with increasing flip angles (p = 0.002) as well as increasing intervention angles (p < 0.001). Artifact diameters differed significantly between the chosen matrix sizes (p = 0.002) while modifying bandwidth, readout direction, and slice thickness showed no significant differences. Interrater reliability was high (intraclass correlation coefficient 0.776–0.910). To minimize needle artifacts in MRI-guided abdominal interventions while maintaining optimal visibility of the coaxial needle, we suggest medium-range flip angles and low intervention angles relative to B0.
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Affiliation(s)
- Vanessa Franziska Schmidt
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
| | - Federica Arnone
- Department of Radiology Sciences, University of Palermo, Palermo, Italy
| | - Olaf Dietrich
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Max Seidensticker
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Marco Armbruster
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Jens Ricke
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
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Jiang J, Cui L, Xiao Y, Zhou X, Fu Y, Xu G, Shao W, Chen W, Hu S, Hu C, Hao S. B 1 -Corrected T1 Mapping in Lung Cancer: Repeatability, Reproducibility, and Identification of Histological Types. J Magn Reson Imaging 2021; 54:1529-1540. [PMID: 34291852 DOI: 10.1002/jmri.27844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND T1 mapping can potentially quantitatively assess the intrinsic properties of tumors. B1 correction can reduce the magnetic field inhomogeneity. PURPOSE To assess the repeatability and reproducibility of B1 -corrected T1 mapping for lung cancer and the ability to identify pathological types. STUDY TYPE Prospective reproducibility study. POPULATION Sixty lung cancer patients (22 with emphysema) with a total of 60 lesions (adenocarcinoma [n = 23], squamous cell carcinoma [n = 19], and small-cell lung cancer [SCLC] [n = 18]). FIELD STRENGTH/SEQUENCE A 3 T/B1 -corrected 3D variable flip angle T1 mapping and free-breathing diffusion-weighted imaging. ASSESSMENT Intraobserver, interobserver, and test-retest reproducibility of minimum, maximum, mean, and SD of lung tumor T1 values were assessed. The correlation between mean T1 and apparent diffusion coefficient (ADC) and differences between different histological types of lung cancer were evaluated. STATISTICAL TESTS Intraclass correlation coefficients (ICCs), within-subject coefficients of variation (WCVs), Bland-Altman plots, Pearson's correlation coefficient (r), and analysis of variance (ANOVA). A P value <0.05 was considered to be statistically significant. RESULTS No significant differences were found in minimum, maximum, mean, and SD T1 values for repeated measurements (intraobserver and interobserver) and repeated examinations (P = 0.103-0.979). All parameters showed good intraobserver, interobserver and test-retest reproducibility (ICC, 0.780-0.978), except the maximum T1 value (ICC, 0.645-0.922). The mean T1 exhibited the best reproducibility and repeatability, with an average difference <6% for repeated measurements, <8% for repeated scans in lung cancer patients, and<10% for repeated scans in those with emphysema. The mean T1 correlated moderately with ADC (r = -0.580, -0.516, and -0.511 for observers A, B, and C). Both mean T1 and mean ADC were significantly different in SCLC patients compared with those in adenocarcinoma and squamous cell carcinoma patients. DATA CONCLUSION The mean T1 from B1 -corrected T1 mapping is a repeatable parameter with the potential to identify histological types of lung cancer and thus may be a promising imaging biomarker for characterizing lung cancer. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Jianqin Jiang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Lei Cui
- Department of Radiology, Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Yong Xiao
- Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Xiao Zhou
- Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Yigang Fu
- Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Gaofeng Xu
- Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Weiwei Shao
- Department of Pathology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Wang Chen
- Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Su Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Medical Imaging, Soochow University, Suzhou, China
| | - Chunhong Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Medical Imaging, Soochow University, Suzhou, China
| | - Shaowei Hao
- Siemens Healthineers Digital Technology Co., Ltd, Shanghai, China
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18
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Evrimler S, Swensson JK, Are VS, Tirkes T, Vuppalanchi R, Akisik F. Quantitative assessment of disease severity of primary sclerosing cholangitis with T1 mapping and extracellular volume imaging. Abdom Radiol (NY) 2021; 46:2433-2443. [PMID: 33135100 DOI: 10.1007/s00261-020-02839-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Assess the relationship between liver T1 relaxation time and extracellular volume (ECV) fraction and the disease severity of primary sclerosing cholangitis (PSC). METHODS This retrospective study included 93 patients with PSC and 66 healthy patients in the control group. T1 relaxation times were measured in the right and left lobe, as well as in the area of stricture. T1PSC and ECVPSC were calculated by averaging T1 and ECV of both lobes and stricture site. T1 and ECV were compared between the two groups and according to PSC phenotypes and severity based on Mayo Risk Score (MRS). We also examined the relationship between T1 and ECV with non-invasive measures of fibrosis such as Fibrosis-4 index (FIB-4) and liver stiffness measurement (LSM) by transient elastography. RESULTS Mean liver T1 (774 ± 111 ms, p < 0.001) and liver ECV (0.40 ± 0.14, p < 0.05) were significantly higher with both large-duct and small-duct-type PSC which may lack classic imaging findings on MRCP compared to the control group (p < 0.001). T1PSC and ECVPSC showed weak-moderate correlation with LSM, FIB-4, and MRS (p < 0.05). Cut-off values of liver T1 to detect patients in low-risk and high-risk MRS groups were 677 ms (AUC: 0.68, sensitivity: 76%, specificity: 53%, p = 0.03) and 743 ms (AUC: 0.83, sensitivity: 79%, specificity: 76%, p < 0.001), respectively. CONCLUSION T1 relaxation time and ECV fraction can be used for quantitative assessment of disease severity in patients with PSC.
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Waterton JC. Survey of water proton longitudinal relaxation in liver in vivo. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 34:779-789. [PMID: 33978944 PMCID: PMC8578172 DOI: 10.1007/s10334-021-00928-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/05/2021] [Accepted: 04/27/2021] [Indexed: 12/13/2022]
Abstract
Objective To determine the variability, and preferred values, for normal liver longitudinal water proton relaxation rate R1 in the published literature. Methods Values of mean R1 and between-subject variance were obtained from literature searching. Weighted means were fitted to a heuristic and to a model. Results After exclusions, 116 publications (143 studies) remained, representing apparently normal liver in 3392 humans, 99 mice and 249 rats. Seventeen field strengths were included between 0.04 T and 9.4 T. Older studies tended to report higher between-subject coefficients of variation (CoV), but for studies published since 1992, the median between-subject CoV was 7.4%, and in half of those studies, measured R1 deviated from model by 8.0% or less. Discussion The within-study between-subject CoV incorporates repeatability error and true between-subject variation. Between-study variation also incorporates between-population variation, together with bias from interactions between methodology and physiology. While quantitative relaxometry ultimately requires validation with phantoms and analysis of propagation of errors, this survey allows investigators to compare their own R1 and variability values with the range of existing literature. Supplementary Information The online version contains supplementary material available at 10.1007/s10334-021-00928-x.
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Affiliation(s)
- John Charles Waterton
- Centre for Imaging Sciences, Division of Informatics Imaging and Data Sciences, School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9PL, UK. .,Bioxydyn Ltd, Rutherford House, Manchester Science Park, Pencroft Way, Manchester, M15 6SZ, UK.
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Lee HJ, Hong SB, Lee NK, Kim S, Seo HI, Kim DU, Han SY, Choo KS. Validation of functional liver imaging scores (FLIS) derived from gadoxetic acid-enhanced MRI in patients with chronic liver disease and liver cirrhosis: the relationship between Child-Pugh score and FLIS. Eur Radiol 2021; 31:8606-8614. [PMID: 33881570 DOI: 10.1007/s00330-021-07955-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 03/15/2021] [Accepted: 03/26/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To validate the functional liver imaging score (FLIS) for prediction of hepatic function in gadoxetic acid-enhanced MRI. METHODS We retrospectively identified 134 patients (88 men, 46 women; mean age, 58.8 years) between January 2015 and December 2018 with the following inclusion criteria: patients diagnosed with liver cirrhosis or chronic liver disease (CLD) who underwent gadoxetic acid-enhanced MRI. Three parameters on hepatobiliary phase images were evaluated for FLIS: liver parenchymal enhancement, biliary excretion, and signal intensity of the portal vein. Patients were classified as CLD (n = 11), Child-Pugh (CP) class A (n = 87), CP B (n = 22), or CP C (n = 14). We assessed the correlation between CP score and both FLIS and its components using Spearman rank correlation. Receiver operating characteristic (ROC) curve analysis was performed to demonstrate the cutoff value of FLIS for differentiating between CP classes. The associations between patient characteristics, serum markers, FLIS, and hepatic decompensation were evaluated with Cox proportional hazard models. RESULTS FLIS and three FLIS parameters showed strong to very strong correlation with CP score (r = -0.60 to 0.82). ROC curve analysis showed that FLIS ≥ 5 was the optimal cutoff for prediction of CP class A or CLD (sensitivity, 83.7%; specificity, 94.4%; area under the curve [AUC], 0.93). FLIS < 5 was independently associated with the development of first hepatic decompensation in patients with CP A (HR, 50.0; 95% confidence interval, 6.2, 400.4). CONCLUSION FLIS showed a strong correlation with hepatic function and can stratify the CP class. In addition, FLIS can help prediction for the development of first decompensation. KEY POINTS • Functional liver imaging scores (FLIS) and its three parameters, derived from hepatobiliary phase image, have strong to very strong correlations with Child-Pugh (CP) scores. • FLIS can stratify patients with chronic liver disease or liver cirrhosis according to CP classification. • Low FLIS is an independent predictor for first hepatic decompensation in patients with CP class A.
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Affiliation(s)
- Ho Jun Lee
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Seung Baek Hong
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea.
| | - Nam Kyung Lee
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Suk Kim
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Hyung Il Seo
- Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Dong Uk Kim
- Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Sung Yong Han
- Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Ki Suk Choo
- Department of Radiology, Biomedical Research Institute, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea
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T2 mapping in gadoxetic acid-enhanced MRI: utility for predicting decompensation and death in cirrhosis. Eur Radiol 2021; 31:8376-8387. [PMID: 33782768 DOI: 10.1007/s00330-021-07805-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/21/2020] [Accepted: 02/17/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To determine whether T2 mapping in liver MRI can predict decompensation and death in cirrhotic patients. METHODS This retrospective study included 292 cirrhotic patients who underwent gadoxetic acid-enhanced MRI, including T1 and T2 mapping at 10-min hepatobiliary phase by using the Look-Locker and radial turbo spin-echo sequences, respectively. T1 and T2 values of the liver and spleen were measured. The association of MR parameters and serum markers with decompensation and death was investigated. Risk models combining T2Liver, serum albumin level, and Model for End-Stage Liver Disease (MELD) score were created for predicting decompensation (T2Liver, < 49.3 versus ≥ 49.3 ms) and death (< 57.4 versus ≥ 57.4 ms). RESULTS In patients with compensated cirrhosis at baseline and in the full patient cohort, 9.6% (19 of 197) and 5.1% (15 of 292) developed decompensation and died during the mean follow-up periods of 18.7 and 19.2 months, respectively. A prolonged T2Liver (hazard ratio (HR), 2.59; 95% confidence interval (CI), 1.26, 5.31) was independently predictive of decompensation along with the serum albumin level (HR, 0.28; 95% CI, 0.12, 0.68) and MELD score (HR, 1.34; 95% CI, 1.08, 1.66). T2Liver (HR, 2.61; 95% CI, 1.19, 5.72) and serum albumin level (HR, 0.46; 95% CI, 0.19, 1.14) were independent predictors of death. The mean times to decompensation (12.9 versus 29.2 months) and death (16.5 versus 29.6 months) were significantly different between the high- and low-risk groups (p < 0.001). CONCLUSION T2Liver from T2 mapping can predict decompensation and death in patients with cirrhosis. KEY POINTS • Liver T2 values from the radial turbo spin-echo (TSE) T2 mapping sequence with tiered echo sharing and pseudo golden-angle (pGA) reordering were significantly higher in decompensated cirrhosis than compensated cirrhosis. • Liver T2 values from the radial TSE T2 mapping sequence with tiered echo sharing and pGA reordering can predict decompensation and death in patients with cirrhosis. • T2 mapping is recommended as part of liver MRI examinations for cirrhotic patients because it can provide a noninvasive prognostic marker for the development of decompensation and death.
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Wang Q, Liu H, Zhu Z, Sheng Y, Du Y, Li Y, Liu J, Zhang J, Xing W. Feasibility of T1 mapping with histogram analysis for the diagnosis and staging of liver fibrosis: Preclinical results. Magn Reson Imaging 2020; 76:79-86. [PMID: 33242591 DOI: 10.1016/j.mri.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/10/2020] [Accepted: 11/14/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare the diagnostic accuracy of parameters derived from the histogram analysis of precontrast, 10-min hepatobiliary phase (HBP) and 20-min HBP T1 maps for staging liver fibrosis (LF). METHODS LF was induced in New Zealand white rabbits by subcutaneous injections of carbon tetrachloride for 4-16 weeks (n = 120), and 20 rabbits injected with saline served as controls. Precontrast, 10-min and 20-min HBP modified Look-Locker inversion recovery (MOLLI) T1 mapping was performed. Histogram analysis of T1 maps was performed, and the mean, median, skewness, kurtosis, entropy, inhomogeneity and 10th/25th/75th/90th percentiles of T1native, T110min and T120min were derived. Quantitative histogram parameters were compared. For significant parameters, further receiver operating characteristic (ROC) analyses were performed to evaluate the potential diagnostic performance in differentiating LF stages. RESULTS Finally, 17, 20, 21, 21 and 20 rabbits were included for the F0, F1, F2, F3, and F4 pathological grades of fibrosis, respectively. The mean/75th of T1native, entropy of T110min and entropy/mean/median/10th of T120min demonstrated a significant good correlation with the LF stage (|r| = 0.543-0.866, all P < 0.05). The 75th of T1native, entropy10min, and entropy20min were the three most reliable imaging markers in reflecting the stage of LF. The area under the ROC curve of entropy20min was larger than that of entropy10min (P < 0.05 for LF ≥ F2, ≥F3, and ≥ F4) and the 75th of T1native (P < 0.05 for LF ≥ F2 and ≥ F3) for staging LF. CONCLUSION Magnetic resonance histogram analysis of T1 maps, particularly the entropy derived from 20-min HBP T1 mapping, is promising for predicting the LF stage.
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Affiliation(s)
- Qing Wang
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China.
| | - HaiFeng Liu
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China
| | - ZuHui Zhu
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China
| | - Ye Sheng
- Department of Interventional Radiology, Third Affiliated Hospital of Soochow University & Changzhou First People's Hospital, Changzhou, Jiangsu 213200, China
| | - YaNan Du
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China
| | - YuFeng Li
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China
| | - JianHong Liu
- Department of Pathology, The Third People's Hospital of Changzhou, Changzhou, Jiangsu 213200, China
| | | | - Wei Xing
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China.
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Quantification of liver function using gadoxetic acid-enhanced MRI. Abdom Radiol (NY) 2020; 45:3532-3544. [PMID: 33034671 PMCID: PMC7593310 DOI: 10.1007/s00261-020-02779-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/20/2020] [Accepted: 09/21/2020] [Indexed: 02/06/2023]
Abstract
The introduction of hepatobiliary contrast agents, most notably gadoxetic acid (GA), has expanded the role of MRI, allowing not only a morphologic but also a functional evaluation of the hepatobiliary system. The mechanism of uptake and excretion of gadoxetic acid via transporters, such as organic anion transporting polypeptides (OATP1,3), multidrug resistance-associated protein 2 (MRP2) and MRP3, has been elucidated in the literature. Furthermore, GA uptake can be estimated on either static images or on dynamic imaging, for example, the hepatic extraction fraction (HEF) and liver perfusion. GA-enhanced MRI has achieved an important role in evaluating morphology and function in chronic liver diseases (CLD), allowing to distinguish between the two subgroups of nonalcoholic fatty liver diseases (NAFLD), simple steatosis and nonalcoholic steatohepatitis (NASH), and help to stage fibrosis and cirrhosis, predict liver transplant graft survival, and preoperatively evaluate the risk of liver failure if major resection is planned. Finally, because of its noninvasive nature, GA-enhanced MRI can be used for long-term follow-up and post-treatment monitoring. This review article aims to describe the current role of GA-enhanced MRI in quantifying liver function in a variety of hepatobiliary disorders.
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Validation and feasibility of liver T1 mapping using free breathing MOLLI sequence in children and young adults. Sci Rep 2020; 10:18390. [PMID: 33110134 PMCID: PMC7591907 DOI: 10.1038/s41598-020-74717-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022] Open
Abstract
We investigated the feasibility of free-breathing modified Look-Locker inversion recovery (MOLLI) sequence for measuring hepatic T1 values in children and young adults. To investigate the accuracy and the reproducibility of the T1 maps, a phantom study was performed with 12 different gadoterate meglumine concentrations and the T1 relaxation times of phantoms measured with the MOLLI sequence were compared against those measured with three different sequences: spin-echo inversion recovery, variable flip angle (VFA), and VFA with B1 correction. To evaluate the feasibility of free-breathing MOLLI sequence, hepatic T1 relaxation times obtained by free-breathing and breath-hold technique in twenty patients were compared. The phantom study revealed the excellent accuracy and reproducibility of MOLLI. In twenty patients, the mean value of hepatic T1 values obtained by free-breathing (606.7 ± 64.5 ms) and breath-hold (609.8 ± 64.0 ms) techniques showed no significant difference (p > 0.05). The Bland–Altman plot between the free-breathing and breath-hold revealed that the mean difference of T1 values was − 3.0 ms (− 0.5%). Therefore, T1 relaxation times obtained by MOLLI were comparable to the values obtained using the standard inversion recovery method. The hepatic T1 relaxation times measured by MOLLI technique with free-breathing were comparable to those obtained with breath-hold in children and young adults.
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Intracellular accumulation capacity of gadoxetate: initial results for a novel biomarker of liver function. Sci Rep 2020; 10:18104. [PMID: 33093649 PMCID: PMC7582909 DOI: 10.1038/s41598-020-75145-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 10/05/2020] [Indexed: 11/09/2022] Open
Abstract
Previous studies have shown gadoxetate disodium’s potential to represent liver function by its retention in the hepatobiliary phase. Additionally, in cardiac imaging, quantitative characterization of altered parenchyma is established by extracellular volume (ECV) calculation with extracellular contrast agents. Therefore, the purpose of our study was to evaluate whether intracellular accumulation capacity (IAC) of gadoxetate disodium derived from ECV calculation provides added scientific value in terms of liver function compared to the established parameter reduction rate (RR). After local review board approval, 105 patients undergoing standard MR examination with gadoxetate disodium were included. Modified Look-Locker sequences were obtained before and 20 min after contrast agent administration. RR and IAC were calculated and correlated with serum albumin, as a marker of synthetic liver function. Correlation was higher between IAC and albumin, than between RR and albumin. Additionally, capacity of both RR and IAC to distinguish between patients with or without liver cirrhosis was investigated, and differed significantly in their respective means between patients with cirrhosis and those without. We concluded, that the formula to calculate ECV can be transferred to calculate IAC of gadoxetate disodium in hepatocytes, and, thereby, IAC may possibly qualify as an imaging-based parameter to estimate synthetic liver function.
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Yang L, Ding Y, Rao S, Chen C, Zeng M. T 1 Mapping on Gd-EOB-DTPA-Enhanced MRI for the Prediction of Oxaliplatin-Induced Liver Injury in a Mouse Model. J Magn Reson Imaging 2020; 53:896-902. [PMID: 32979019 DOI: 10.1002/jmri.27377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Oxaliplatin-induced liver injury (OILI) not only impairs hepatic regeneration but also increases postoperative morbidity and mortality. Therefore, noninvasive, accurate, and early diagnosis of OILI is mandatory. PURPOSE To evaluate the potential of T1 mapping on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI for assessing OILI in a mouse model. STUDY TYPE Case control, animal model. ANIMAL MODEL Thirty oxaliplatin-treated mice and 10 control mice were included. FIELD STRENGTH Volumetric interpolated breath-hold examination sequence: 3T scanner with a phased-array animal 8-channel coil. T1 mapping before and at hepatobiliary phase (HBP) after injection of Gd-EOB-DTPA were undertaken. ASSESSMENT T1 relaxation times of the liver parenchyma were measured and the reduction rate (ΔT1 %) was calculated. Histological findings were used as a standard reference. STATISTICAL TESTS The Kruskal-Wallis test with pairwise comparisons using the Mann-Whitney U-test were applied to compare the parameters across groups. Spearman's rank correlation test and receiver operating characteristics (ROC) analyses were performed. Areas under the curves (AUCs) were compared using the DeLong method. RESULTS Histologically, mice were classified as normal (n = 10), hepatocellular degeneration without fibrosis (n = 16), and hepatocellular degeneration with fibrosis (n = 14). HBP T1 relaxation time increased with the severity of OILI (rho = 0.60, P < 0.05), and ΔT1 % decreased with the severity of OILI (rho = -0.78, P < 0.05). AUC was 0.92 for ΔT1 % in differentiating hepatocellular degeneration without fibrosis from normal liver, but HBP T1 relaxation time could not distinguish them (P = 0.09). AUCs were 0.96 and 0.95 for HBP T1 relaxation time, and 0.90 and 0.84 for ΔT1 % in discriminating OILI with fibrosis from normal liver and OILI without fibrosis. DATA CONCLUSION HBP T1 relaxation time and ΔT1 % of Gd-EOB-DTPA enhanced MRI was useful for assessing OILI. ΔT1 % may be more sensitive than HBP T1 relaxation time in detecting early stage of liver injury. LEVEL OF EVIDENCE 2. TECHNICAL EFFICACY STAGE 5.
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Affiliation(s)
- Li Yang
- Department of Radiology, Zhongshan, Hospital of Fudan University, Shanghai, China
| | - Ying Ding
- Department of Radiology, Zhongshan, Hospital of Fudan University, Shanghai, China
| | - Shengxiang Rao
- Department of Radiology, Zhongshan, Hospital of Fudan University, Shanghai, China
| | - Caizhong Chen
- Department of Radiology, Zhongshan, Hospital of Fudan University, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan, Hospital of Fudan University, Shanghai, China
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Fahlenkamp UL, Ziegeler K, Adams LC, Böker SM, Engel G, Makowski MR. Native T1 mapping for assessment of the perilesional zone in metastases and benign lesions of the liver. Sci Rep 2020; 10:12889. [PMID: 32733016 PMCID: PMC7393097 DOI: 10.1038/s41598-020-69819-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/20/2020] [Indexed: 11/21/2022] Open
Abstract
Adjacent to hepatic metastases, liver parenchyma is often histopathologically altered even if its visual appearance on native magnetic resonance (MR) images is blunt. Yet, relaxation properties in MR imaging may show structural changes prior to visual alteration, and therefore, the aim of this study was to investigate whether T1 relaxation times in the perilesional zone differ between metastases and benign lesions. A total of 113 patients referred for MRI were included prospectively. Images were assessed for metastases, solid benign lesions and cysts, and regions-of-interest were drawn on T1 maps including the focal lesion and a close (inner perilesional zone = IPZ) and a larger perilesional zone (outer perilesional zone = OPZ). Simple ratios between these zones, as well as a gradient ratio between the IPZ and the entire perilesional zone (EPZ) were calculated. Within the collective, 44 patients had lesions of one or two entities. For metastases, the simple ratio between IPZ and OPZ as well as the mean EPZ gradient was significantly higher than for both solid benign lesions and cysts. Lesion size was not a significant covariate. We conclude, that native T1 properties of the perilesional zones differ significantly between malignant and both solid and cystic benign lesions.
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Affiliation(s)
- Ute Lina Fahlenkamp
- Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Katharina Ziegeler
- Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Lisa Christine Adams
- Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Sarah Maria Böker
- Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Günther Engel
- Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Marcus Richard Makowski
- Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Department of Radiology, Klinikum rechts der Isar der TU München, Ismaninger Straße 22, 81675, Munich, Germany
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Prediction of post-hepatectomy liver failure using gadoxetic acid-enhanced magnetic resonance imaging for hepatocellular carcinoma with portal vein invasion. Eur J Radiol 2020; 130:109189. [PMID: 32784077 DOI: 10.1016/j.ejrad.2020.109189] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Accurate prediction of post-hepatectomy liver failure (PHLF) is important in advanced hepatocellular carcinoma (HCC). We aimed to retrospectively evaluate the utility of gadoxetic acid-enhanced MRI for predicting PHLF in patients who underwent anatomic hepatectomy for HCC with portal vein invasion. METHODS Forty-one patients (32 men, 9 women) were included. Hepatobiliary-phase MR images were acquired 20 min after injection of gadoxetic acid using a 3D fat-suppressed T1-weighted spoiled gradient-echo sequence. Liver-spleen ratio (LSR), remnant hepatocellular uptake index (rHUI), and HUI were calculated. The severity of PHLF was defined according to the International Study Group of Liver Surgery. Differences in LSR between the resected liver and the remnant liver, and HUI and rHUI/HUI between no/mild and severe PHLF were compared using the Wilcoxon signed-rank test and Wilcoxon rank-sum test, respectively. Univariate and multivariate logistic regression analyses were performed to identify predictors of severe PHLF. Areas under the receiver operating characteristic curves (AUCs) of rHUI and rHUI/HUI were calculated for predicting severe PHLF. RESULTS Nine patients developed severe PHLF. LSR of the remnant liver was significantly higher than that of the resected liver (P < 0.001). Severe PHLF demonstrated significantly lower rHUI (P < 0.001) and rHUI/HUI (P < 0.001) compared with no/mild PHLF. Multivariate logistic regression analysis showed that decreased rHUI (P = 0.012, AUC=0.885) and rHUI/HUI (P = 0.002, AUC=0.852) were independent predictors of severe PHLF. CONCLUSION Gadoxetic acid-enhanced MRI can be a promising noninvasive examination for assessing global and regional liver function, allowing estimation of the functional liver remnant and accurate prediction of severe PHLF before hepatic resection.
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Winkelmann MT, Gohla G, Kübler J, Weiß J, Clasen S, Nikolaou K, Hoffmann R. MR-Guided High-Power Microwave Ablation in Hepatic Malignancies: Initial Results in Clinical Routine. Cardiovasc Intervent Radiol 2020; 43:1631-1638. [PMID: 32699978 PMCID: PMC7591402 DOI: 10.1007/s00270-020-02584-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/26/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Evaluation of technique effectiveness, patient safety and ablation parameters of MR-guided microwave ablation in hepatic malignancies using an MR-conditional high-power microwave ablation system. MATERIALS AND METHODS Institutional review board approval and informed patient consent were obtained. Patients who underwent MR-guided microwave ablation of hepatic malignancies in a 1.5T wide-bore scanner using a perfusion-cooled high-power microwave ablation system with a maximum generator power of 150 W were included. Ablation parameters comprising procedure durations, net ablation duration, applicator positions and ablation zone dimensions were recorded. Adverse events were classified according to the CIRSE classification system. Technique effectiveness was assessed after 1 month. Follow-up was conducted with contrast-enhanced MRI and ranged from 1 to 20 months (mean: 6.1 ± 5.4 months). RESULTS Twenty-one consecutive patients (age: 63.4 ± 10.5 years; 5 female) underwent 22 procedures for 28 tumours (9 hepatocellular carcinomas, 19 metastases) with a mean tumour diameter of 14.6 ± 5.4 mm (range: 6-24 mm). Technique effectiveness was achieved in all lesions. Tumours were treated using 1.7 ± 0.7 applicator positions (range: 1-3). Mean energy and ablation duration per tumour were 75.3 ± 35.4 kJ and 13.3 ± 6.2 min, respectively. Coagulation zone short- and long-axis diameters were 29.1 ± 6.4 mm and 39.9 ± 7.4 mm, respectively. Average procedure duration was 146.4 ± 26.2 min (range: 98-187 min). One minor complication was reported. Five patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed during initial follow-up. CONCLUSION MR-guided high-power microwave ablation provides safe and effective treatment of hepatic malignancies with short ablation times and within acceptable procedure durations.
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Affiliation(s)
- Moritz T Winkelmann
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Georg Gohla
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Jens Kübler
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Jakob Weiß
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Stephan Clasen
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Rüdiger Hoffmann
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
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Yang S, Shan F, Yan Q, Shen J, Ye P, Zhang Z, Shi Y, Zhang R. A pilot study of native T1-mapping for focal pulmonary lesions in 3.0 T magnetic resonance imaging: size estimation and differential diagnosis. J Thorac Dis 2020; 12:2517-2528. [PMID: 32642159 PMCID: PMC7330293 DOI: 10.21037/jtd.2020.03.42] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background To investigate the accuracy of size estimation and potential diagnosis efficacy of native T1-mapping in focal pulmonary lesion, compared to T1-star 3D-volumetric interpolated breath-hold sequence (VIBE), T2-fBLADE turbo-spin echo (TSE), and computed tomography (CT). Methods Thirty-nine patients with CT-detected focal pulmonary lesions underwent thoracic 3.0-T magnetic resonance imaging (MRI) using axial free-breathing 3D T1-star VIBE, respiratory triggered T2-fBLADE TSE, breath-hold T1-Turbo fast low angle shot (FLASH) and T1-FLASH 3D. Native T1-mapping images were generated by T1-FLASH 3D with B1-filed correction by T1-Turbo FLASH. The intraclass correlation coefficient (ICC) and Bland-Altman plots were used to evaluate intra-observer agreement and inter-method reliability of diameter measurements. Native T1-values were measured and compared among the malignancy, tuberculosis, non-tuberculosis benign groups using Mann-Whitney U tests. Results Forty-five focal pulmonary lesions were displayed by CT, native T1-mapping, T1-star VIBE, and T2-fBLADE TSE. T1-mapping-based diameter measurements yielded an intra-observer ICC of 0.995. Additionally, inter-method measurements were highly consistent (T1-mapping & T1-star VIBE: ICC 0.982, T1-mapping & T2-fBLADE TSE: ICC 0.978, T1-mapping & CT: ICC 0.972). For lesions <3.00 cm, T1-mapping intra-observer (ICC 0.982) and inter-method diameter measurements were also highly consistent (T1-mapping & CT: ICC 0.823). Native T1-values of malignant tumors were lower than those of the non-tuberculosis benign lesions (P=0.003). Native T1-values of tuberculosis were lower than those of the non-tuberculosis benign lesions (P=0.002). Native T1-values showed no statistically significant differences between malignant tumors and tuberculosis (P=0.059). Conclusions Native T1-mapping enable accurate and reliable diameter measurement. Native T1-values potentially differentiate malignant tumors or tuberculosis from non-tuberculosis benign lesions.
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Affiliation(s)
- Shuyi Yang
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Fei Shan
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Qinqin Yan
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Jie Shen
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Peiyan Ye
- Department of Hepatopathy, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Zhiyong Zhang
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.,Fudan University, Shanghai 200433, China
| | - Yuxin Shi
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Rengyin Zhang
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
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