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Maung ST, Tanpowpong N, Satja M, Treeprasertsuk S, Chaiteerakij R. MRI for hepatocellular carcinoma and the role of abbreviated MRI for surveillance of hepatocellular carcinoma. J Gastroenterol Hepatol 2024; 39:1969-1981. [PMID: 38899804 DOI: 10.1111/jgh.16643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/16/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION Hepatocellular carcinoma (HCC) constitutes the majority of liver cancers and significantly impacts global cancer mortality. While ultrasound (US) with or without alpha-fetoprotein is the mainstay for HCC surveillance, its limitations highlight the necessity for more effective surveillance tools. Therefore, this review explores evolving imaging modalities and abbreviated magnetic resonance imaging (MRI) (AMRI) protocols as promising alternatives, addressing challenges in HCC surveillance. AREAS COVERED This comprehensive review delves into the evaluation and challenges of HCC surveillance tools, focusing on non-contrast abbreviated MRI (NC-AMRI) and contrast-enhanced abbreviated MRI protocols. It covers the implementation of AMRI for HCC surveillance, patient preferences, adherence, and strategies for optimizing cost-effectiveness. Additionally, the article provides insights into prospects for HCC surveillance by summarizing meta-analyses, prospective studies, and ongoing clinical trials evaluating AMRI protocols. EXPERT OPINION The opinions underscore the transformative impact of AMRI on HCC surveillance, especially in overcoming US limitations. Promising results from NC-AMRI protocols indicate its potential for high-risk patient surveillance, though prospective studies in true surveillance settings are essential for validation. Future research should prioritize risk-stratified AMRI protocols and address cost-effectiveness for broader clinical implementation, alongside comparative analyses with US for optimal surveillance strategies.
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Affiliation(s)
- Soe Thiha Maung
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ma Har Myaing Hospital, Yangon, Myanmar
| | - Natthaporn Tanpowpong
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Minchanat Satja
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Sombat Treeprasertsuk
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Roongruedee Chaiteerakij
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Wang SH, Du J, Xu H, Yang D, Ye Y, Chen Y, Zhu Y, Ba T, Yuan C, Yang ZH. Automatic discrimination of different sequences and phases of liver MRI using a dense feature fusion neural network: a preliminary study. Abdom Radiol (NY) 2021; 46:4576-4587. [PMID: 34057565 DOI: 10.1007/s00261-021-03142-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/16/2021] [Accepted: 05/22/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To develop and validate a dense feature fusion neural network (DFuNN) to automatically recognize different sequences and phases of liver magnetic resonance imaging (MRI). MATERIALS AND METHODS In total, 3869 sequences and phases from 384 liver MRI examinations, divided into training/validation (n = 2886 sequences from 287 patients) and test (n = 983 sequences from 97 patients) sets, were used in this retrospective study. Ten unenhanced sequences and enhanced phases were included. Manual sequence recognition, performed by two radiologists (20 and 10 years of experience) in a consensus reading, was used as the reference standard. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC) were calculated to evaluate the performance of the DFuNN on an identical unseen test set. Finally, we evaluated the factors impacting the model precision. RESULTS A fusion block improved the performance of the DFuNN. DFuNN with a fusion block achieved good recognition performance for both complete and incomplete sequences and phases in the test set. The average sensitivity of recognition performance for complete sequence and phase inputs ranged from 88.06 to 100%, the average specificity ranged from 99.12 to 99.94%, and the median accuracy ranged from 98.02 to 99.95%. The DFuNN prediction accuracy for patients without cirrhosis were significantly higher than those for patients with cirrhosis (P = 0.0153). No significant difference was found in the accuracy across other factors. CONCLUSION DFuNN can automatically and accurately identify specific unenhanced MRI sequences and enhanced MRI phases.
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Affiliation(s)
- Shu-Hui Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China
- Department of Radiology, Weihai Municipal Hospital, Weihai, Shandong Province, China
| | - Jing Du
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Hui Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Dawei Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Yuxiang Ye
- Shanghai SenseTime Intelligent Technology Co. Ltd, Beijing, China
| | - Yinan Chen
- Shanghai SenseTime Intelligent Technology Co. Ltd, Beijing, China
| | - Yajing Zhu
- Shanghai SenseTime Intelligent Technology Co. Ltd, Beijing, China
| | - Te Ba
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Chunwang Yuan
- Center of Interventional Oncology and Liver Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Zheng-Han Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China.
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Shanbhogue K, Tong A, Smereka P, Nickel D, Arberet S, Anthopolos R, Chandarana H. Accelerated single-shot T2-weighted fat-suppressed (FS) MRI of the liver with deep learning-based image reconstruction: qualitative and quantitative comparison of image quality with conventional T2-weighted FS sequence. Eur Radiol 2021; 31:8447-8457. [PMID: 33961086 DOI: 10.1007/s00330-021-08008-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/29/2021] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To compare the image quality of an accelerated single-shot T2-weighted fat-suppressed (FS) MRI of the liver with deep learning-based image reconstruction (DL HASTE-FS) with conventional T2-weighted FS sequence (conventional T2 FS) at 1.5 T. METHODS One hundred consecutive patients who underwent clinical MRI of the liver at 1.5 T including the conventional T2-weighted fat-suppressed sequence (T2 FS) and accelerated single-shot T2-weighted MRI of the liver with deep learning-based image reconstruction (DL HASTE-FS) were included. Images were reviewed independently by three blinded observers who used a 5-point confidence scale for multiple measures regarding the artifacts and image quality. Descriptive statistics and McNemar's test were used to compare image quality scores and percentage of lesions detected by each sequence, respectively. Intra-class correlation coefficient (ICC) was used to assess consistency in reader scores. RESULTS Acquisition time for DL HASTE-FS was 51.23 +/ 10.1 s, significantly (p < 0.001) shorter than conventional T2-FS (178.9 ± 85.3 s). DL HASTE-FS received significantly higher scores than conventional T2-FS for strength and homogeneity of fat suppression; sharpness of liver margin; sharpness of intra-hepatic vessel margin; in-plane and through-plane respiratory motion; other ghosting artefacts; liver-fat contrast; and overall image quality (all, p < 0.0001). DL HASTE-FS also received higher scores for lesion conspicuity and sharpness of lesion margin (all, p < .001), without significant difference for liver lesion contrast (p > 0.05). CONCLUSIONS Accelerated single-shot T2-weighted MRI of the liver with deep learning-based image reconstruction showed superior image quality compared to the conventional T2-weighted fat-suppressed sequence despite a 4-fold reduction in acquisition time. KEY POINTS • Conventional fat-suppressed T2-weighted sequence (conventional T2 FS) can take unacceptably long to acquire and is the most commonly repeated sequence in liver MRI due to motion. • DL HASTE-FS demonstrated superior image quality, improved respiratory motion and other ghosting artefacts, and increased lesion conspicuity with comparable liver-to-lesion contrast compared to conventional T2FS sequence. • DL HASTE- FS has the potential to replace conventional T2 FS sequence in routine clinical MRI of the liver, reducing the scan time, and improving the image quality.
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Affiliation(s)
- Krishna Shanbhogue
- Department of Radiology, NYU Langone Health, 660 1st Avenue, 3rd Floor, New York, NY, 10016, USA.
| | - Angela Tong
- Department of Radiology, NYU Langone Health, 660 1st Avenue, 3rd Floor, New York, NY, 10016, USA
| | - Paul Smereka
- Department of Radiology, NYU Langone Health, 660 1st Avenue, 3rd Floor, New York, NY, 10016, USA
| | - Dominik Nickel
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Simon Arberet
- Digital Technology & Innovation, Siemens Medical Solutions USA, Inc., Princeton, NJ, USA
| | - Rebecca Anthopolos
- Department of Biostatistics, NYU Langone School of Medicine, New York, NY, 10016, USA
| | - Hersh Chandarana
- Department of Radiology, NYU Langone Health, 660 1st Avenue, 3rd Floor, New York, NY, 10016, USA
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Al-Dahery S, McGee A, Rainford L, Khashoggi K, Misha N. Evaluation of unenhanced axial T1W and T2W liver MR images acquired from institutions within the Republic of Ireland and the Kingdom of Saudi Arabia. Radiography (Lond) 2019; 25:e45-e51. [PMID: 30955698 DOI: 10.1016/j.radi.2018.10.005] [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: 04/07/2018] [Revised: 10/08/2018] [Accepted: 10/20/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION This multi-site study evaluated two breath-hold sequences commonly utilised for liver MRI; non-enhanced T1W-3D-FS-GRE-TRA and T2W-2D-FSE-TRA sequences, using physical measurements of SNR and CNR, and observer perceptions' (Visual Grading Analysis: VGA). METHODS Liver MR image datasets (n = 168) from nine hospitals in the Kingdom of Saudi Arabia (KSA) and 11 hospitals in the Republic of Ireland were evaluated. Images were categorised into two groups per sequence, defined by slice thickness (T2W-2D-FSE, ≤5 mm vs ≥ 6 mm and T1W-3D-GRE-FS, ≤3 mm vs 4 mm). Images were evaluated using visual grading analysis VGA and physical measurements: SNR/CNR. Account was taken of varying patient sizes based on AP/transverse diameter measurements. RESULTS Physical image quality measurements (SNR/CNR) returned no significant findings across Irish and KSA hospitals, for both sequences, despite variations in acquisition parameters. Statistically significant differences were found for some scoring criteria based on the observers' perceptions including spleen parenchyma, and spatial resolution for the non-enhanced T1W-3D-FS-GRE-TRA images, with a preference for images acquired using thin slices (≤3 mm). In addition, statistically significant difference was found for the scoring criteria motion artefact for the axial T2W-2D-FSE-TRA images, with a preference for images acquired using thick slices (≥5 mm). Negligible correlation was noted between SNR/CNR and measured abdominal AP/transverse diameters. CONCLUSION Whilst variations in sequences rendered no statistical differences in SNR/CNR findings, significant differences in observer image criteria scores was noted. The importance of both physical measurements and observers' perceptions evaluation methods for quality assessment of MR images was demonstrated and optimisation of liver sequence parameters is warranted.
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Affiliation(s)
- S Al-Dahery
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland.
| | - A McGee
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - K Khashoggi
- Radiology Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - N Misha
- Radiology Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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Zhou LQ, Wang JY, Yu SY, Wu GG, Wei Q, Deng YB, Wu XL, Cui XW, Dietrich CF. Artificial intelligence in medical imaging of the liver. World J Gastroenterol 2019; 25:672-682. [PMID: 30783371 PMCID: PMC6378542 DOI: 10.3748/wjg.v25.i6.672] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 12/24/2018] [Accepted: 01/09/2019] [Indexed: 02/06/2023] Open
Abstract
Artificial intelligence (AI), particularly deep learning algorithms, is gaining extensive attention for its excellent performance in image-recognition tasks. They can automatically make a quantitative assessment of complex medical image characteristics and achieve an increased accuracy for diagnosis with higher efficiency. AI is widely used and getting increasingly popular in the medical imaging of the liver, including radiology, ultrasound, and nuclear medicine. AI can assist physicians to make more accurate and reproductive imaging diagnosis and also reduce the physicians’ workload. This article illustrates basic technical knowledge about AI, including traditional machine learning and deep learning algorithms, especially convolutional neural networks, and their clinical application in the medical imaging of liver diseases, such as detecting and evaluating focal liver lesions, facilitating treatment, and predicting liver treatment response. We conclude that machine-assisted medical services will be a promising solution for future liver medical care. Lastly, we discuss the challenges and future directions of clinical application of deep learning techniques.
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Affiliation(s)
- Li-Qiang Zhou
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Jia-Yu Wang
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Song-Yuan Yu
- Department of Ultrasound, Tianyou Hospital Affiliated to Wuhan University of Technology, Wuhan 430030, Hubei Province, China
| | - Ge-Ge Wu
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Qi Wei
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - You-Bin Deng
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Xing-Long Wu
- School of Mathematics and Computer Science, Wuhan Textitle University, Wuhan 430200, Hubei Province, China
| | - Xin-Wu Cui
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Christoph F Dietrich
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
- Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Würzburg 97980, Germany
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Kambadakone AR, Fung A, Gupta RT, Hope TA, Fowler KJ, Lyshchik A, Ganesan K, Yaghmai V, Guimaraes AR, Sahani DV, Miller FH. LI-RADS technical requirements for CT, MRI, and contrast-enhanced ultrasound. Abdom Radiol (NY) 2018; 43:56-74. [PMID: 28940042 DOI: 10.1007/s00261-017-1325-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Accurate detection and characterization of liver observations to enable HCC diagnosis and staging using LI-RADS requires a technically adequate imaging exam. To help achieve this objective, LI-RADS has proposed technical requirements for CT, MR, and contrast-enhanced ultrasound of liver. This article reviews the technical requirements for liver imaging, including the description of minimum acceptable technical standards, such as the scanner hardware requirements, recommended dynamic imaging phases, and common technical challenges of liver imaging.
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Affiliation(s)
- Avinash R Kambadakone
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA.
| | - Alice Fung
- Department of Diagnostic Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Rajan T Gupta
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA
| | - Thomas A Hope
- Department of Radiology, University of California San Francisco, San Francisco, CA, USA
| | - Kathryn J Fowler
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Karthik Ganesan
- Department of Radiology, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, India
| | - Vahid Yaghmai
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alexander R Guimaraes
- Department of Diagnostic Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Dushyant V Sahani
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Frank H Miller
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Laader A, Beiderwellen K, Kraff O, Maderwald S, Wrede K, Ladd ME, Lauenstein TC, Forsting M, Quick HH, Nassenstein K, Umutlu L. 1.5 versus 3 versus 7 Tesla in abdominal MRI: A comparative study. PLoS One 2017; 12:e0187528. [PMID: 29125850 PMCID: PMC5695282 DOI: 10.1371/journal.pone.0187528] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 10/21/2017] [Indexed: 01/04/2023] Open
Abstract
Objectives The aim of this study was to investigate and compare the feasibility as well as potential impact of altered magnetic field properties on image quality and potential artifacts of 1.5 Tesla, 3 Tesla and 7 Tesla non-enhanced abdominal MRI. Materials and methods Magnetic Resonance (MR) imaging of the upper abdomen was performed in 10 healthy volunteers on a 1.5 Tesla, a 3 Tesla and a 7 Tesla MR system. The study protocol comprised a (1) T1-weighted fat-saturated spoiled gradient-echo sequence (2D FLASH), (2) T1-weighted fat-saturated volumetric interpolated breath hold examination sequence (3D VIBE), (3) T1-weighted 2D in and opposed phase sequence, (4) True fast imaging with steady-state precession sequence (TrueFISP) and (5) T2-weighted turbo spin-echo (TSE) sequence. For comparison reasons field of view and acquisition times were kept comparable for each correlating sequence at all three field strengths, while trying to achieve the highest possible spatial resolution. Qualitative and quantitative analyses were tested for significant differences. Results While 1.5 and 3 Tesla MRI revealed comparable results in all assessed features and sequences, 7 Tesla MRI yielded considerable differences in T1 and T2 weighted imaging. Benefits of 7 Tesla MRI encompassed an increased higher spatial resolution and a non-enhanced hyperintense vessel signal at 7 Tesla, potentially offering a more accurate diagnosis of abdominal parenchymatous and vasculature disease. 7 Tesla MRI was also shown to be more impaired by artifacts, including residual B1 inhomogeneities, susceptibility and chemical shift artifacts, resulting in reduced overall image quality and overall image impairment ratings. While 1.5 and 3 Tesla T2w imaging showed equivalently high image quality, 7 Tesla revealed strong impairments in its diagnostic value. Conclusions Our results demonstrate the feasibility and overall comparable imaging ability of T1-weighted 7 Tesla abdominal MRI towards 3 Tesla and 1.5 Tesla MRI, yielding a promising diagnostic potential for non-enhanced Magnetic Resonance Angiography (MRA). 1.5 Tesla and 3 Tesla offer comparably high-quality T2w imaging, showing superior diagnostic quality over 7 Tesla MRI.
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Affiliation(s)
- Anja Laader
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Kokereiallee 7, Essen, Germany
- * E-mail:
| | - Karsten Beiderwellen
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Kokereiallee 7, Essen, Germany
| | - Oliver Kraff
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Kokereiallee 7, Essen, Germany
| | - Stefan Maderwald
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Kokereiallee 7, Essen, Germany
| | - Karsten Wrede
- Department of Neurosurgery, University Hospital Essen, Hufelandstr. 55, Essen, Germany
| | - Mark E. Ladd
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Kokereiallee 7, Essen, Germany
- German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, Germany
| | - Thomas C. Lauenstein
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, Essen, Germany
- Institute of Radiology, Evangelisches Krankenhaus Düsseldorf, Kirchfeldstr. 40, Düsseldorf, Germany
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, Essen, Germany
| | - Harald H. Quick
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Kokereiallee 7, Essen, Germany
- High Field and Hybrid MR Imaging, University Hospital Essen, Hufelandstr. 55, Essen, Germany
| | - Kai Nassenstein
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Kokereiallee 7, Essen, Germany
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Zhou ZP, Long LL, Qiu WJ, Cheng G, Huang LJ, Yang TF, Huang ZK. Comparison of 10- and 20-min hepatobiliary phase images on Gd-EOB-DTPA-enhanced MRI T1 mapping for liver function assessment in clinic. Abdom Radiol (NY) 2017; 42:2272-2278. [PMID: 28396918 DOI: 10.1007/s00261-017-1143-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To compare hepatobiliary phase (HBP) images obtained 10 and 20 min after Gd-EOB-DTPA-enhanced MRI for liver function assessment in clinic on 3.0 T MR imaging. METHODS 103 patients were separated into four groups: 38 patients for the normal liver function (NLF) group, 33 patients for the liver cirrhosis with Child-Pugh A (LCA) group, 21 patients for the liver cirrhosis with Child-Pugh B group, and 11 patients for a liver cirrhosis with Child-Pugh C group. T1 relaxation times (T1rt) were measured on T1 mapping and reduction rates of T1rt (rrT1rt) were calculated. HBP images were obtained at the 10- and 20-min mark after Gd-EOB-DTPA enhancement. RESULTS T1rt on pre-enhancement imaging showed no significant difference (p > 0.05) among all four groups. T1rt for both the 10-min HBP and the 20-min HBP showed a significant difference (p < 0.05) among all groups, but showed no significant difference (p > 0.05) between the NLF group and the LCA group. T1rt and rrT1rt showed no significant difference (p > 0.05) between 10-min HBP and 20-min HBP among all groups. The ROC analysis on 10-min HBP and 20-min HBP showed a lower diagnostic performance between NLF group and LCA group (AUC from 0.532 to 0.582), but high diagnostic performance (AUC from 0.788 to 1.000) among others group. CONCLUSIONS In comparing 10-min HBP and 20-min HBP T1 mapping after Gd-EOB-DTPA enhancement, our results suggest that 10-min HBP T1 mapping is a feasible option for quantitatively assessing liver function.
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Affiliation(s)
- Zhi-Peng Zhou
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, People's Republic of China
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, People's Republic of China
| | - Li-Ling Long
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, People's Republic of China
| | - Wei-Jia Qiu
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, People's Republic of China
| | - Ge Cheng
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, People's Republic of China
| | - Li-Juan Huang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, People's Republic of China
| | - Teng-Fei Yang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, People's Republic of China
| | - Zhong-Kui Huang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, People's Republic of China.
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Esses SJ, Lu X, Zhao T, Shanbhogue K, Dane B, Bruno M, Chandarana H. Automated image quality evaluation of T 2 -weighted liver MRI utilizing deep learning architecture. J Magn Reson Imaging 2017; 47:723-728. [PMID: 28577329 DOI: 10.1002/jmri.25779] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 05/15/2017] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To develop and test a deep learning approach named Convolutional Neural Network (CNN) for automated screening of T2 -weighted (T2 WI) liver acquisitions for nondiagnostic images, and compare this automated approach to evaluation by two radiologists. MATERIALS AND METHODS We evaluated 522 liver magnetic resonance imaging (MRI) exams performed at 1.5T and 3T at our institution between November 2014 and May 2016 for CNN training and validation. The CNN consisted of an input layer, convolutional layer, fully connected layer, and output layer. 351 T2 WI were anonymized for training. Each case was annotated with a label of being diagnostic or nondiagnostic for detecting lesions and assessing liver morphology. Another independently collected 171 cases were sequestered for a blind test. These 171 T2 WI were assessed independently by two radiologists and annotated as being diagnostic or nondiagnostic. These 171 T2 WI were presented to the CNN algorithm and image quality (IQ) output of the algorithm was compared to that of two radiologists. RESULTS There was concordance in IQ label between Reader 1 and CNN in 79% of cases and between Reader 2 and CNN in 73%. The sensitivity and the specificity of the CNN algorithm in identifying nondiagnostic IQ was 67% and 81% with respect to Reader 1 and 47% and 80% with respect to Reader 2. The negative predictive value of the algorithm for identifying nondiagnostic IQ was 94% and 86% (relative to Readers 1 and 2). CONCLUSION We demonstrate a CNN algorithm that yields a high negative predictive value when screening for nondiagnostic T2 WI of the liver. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:723-728.
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Affiliation(s)
- Steven J Esses
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | | | - Tiejun Zhao
- Siemens Healthineers, New York, New York, USA
| | - Krishna Shanbhogue
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Bari Dane
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Mary Bruno
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Hersh Chandarana
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
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Asato N, Tsurusaki M, Sofue K, Hieda Y, Katsube T, Kitajima K, Murakami T. Comparison of gadoxetic acid-enhanced dynamic MR imaging and contrast-enhanced computed tomography for preoperative evaluation of colorectal liver metastases. Jpn J Radiol 2017; 35:197-205. [DOI: 10.1007/s11604-017-0622-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 02/15/2017] [Indexed: 12/19/2022]
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11
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Gd-EOB-DTPA-enhanced MRI T1 mapping for assessment of liver function in rabbit fibrosis model: comparison of hepatobiliary phase images obtained at 10 and 20 min. Radiol Med 2017; 122:239-247. [DOI: 10.1007/s11547-016-0719-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/19/2016] [Indexed: 01/13/2023]
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12
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Tsurusaki M, Sofue K, Murakami T. Current evidence for the diagnostic value of gadoxetic acid-enhanced magnetic resonance imaging for liver metastasis. Hepatol Res 2016; 46:853-61. [PMID: 26750497 DOI: 10.1111/hepr.12646] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 12/25/2015] [Accepted: 12/31/2015] [Indexed: 02/08/2023]
Abstract
A variety of imaging techniques, including ultrasonography (US), multidetector computed tomography (MDCT), magnetic resonance imaging (MRI) and positron emission tomography combined with CT scan (PET/CT), are available for diagnosis and treatment planning in liver metastasis. Contrast-enhanced MDCT is a relatively non-invasive, widely available and standardized method for hepatic work-up. Gadoxetic acid (gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid; EOB Primovist®]) is a recently developed liver-specific hepatobiliary MR contrast agent that offers both dynamic imaging as well as liver-specific static hepatocyte imaging, referred to as the hepatobiliary phase. Following contrast injection, this technique reveals dynamic vascular phases (arterial, portal venous and delayed phases), in addition to the hepatobiliary phase upon uptake by functional hepatocytes. The overall sensitivity of gadoxetic acid-enhanced MRI was significantly higher than that of contrast-enhanced CT. Specifically, the higher sensitivity of gadoxetic acid-enhanced MRI was observed in lesions smaller than 1 cm in diameter. Gadoxetic acid-enhanced MRI is considered an extremely useful tool for the diagnosis of liver metastases. Future studies will focus on diagnostic algorithms involving combinations of modalities such as MRI, MDCT and/or (18) F-fluorodeoxyglucose PET/CT, which may impact the treatment plan for these patients.
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Affiliation(s)
| | - Keitaro Sofue
- Department of Radiology, Kinki University Faculty of Medicine, Osaka, Japan
| | - Takamichi Murakami
- Department of Radiology, Kinki University Faculty of Medicine, Osaka, Japan
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Tang Y, Wang H, Wang Y, Li J, Jia R, Ma L, Ye H. Quantitative comparison of MR diffusion-weighted imaging for liver focal lesions between 3.0T and 1.5T: Regions of interest of the minimum-spot ADC, the largest possible solid part, and the maximum diameter in lesions. J Magn Reson Imaging 2016; 44:1320-1329. [PMID: 27080350 DOI: 10.1002/jmri.25277] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/28/2016] [Indexed: 12/16/2022] Open
Affiliation(s)
- Yanhua Tang
- Department of Radiology; Chinese PLA General Hospital; Beijing China
| | - Haiyi Wang
- Department of Radiology; Chinese PLA General Hospital; Beijing China
| | - Yingwei Wang
- Department of Radiology; Chinese PLA General Hospital; Beijing China
| | - Jie Li
- Department of Pathology; Chinese PLA General Hospital; Beijing China
| | - Rui Jia
- Department of Radiology; Chinese PLA General Hospital; Beijing China
| | - Lu Ma
- Department of Radiology; Chinese PLA General Hospital; Beijing China
| | - Huiyi Ye
- Department of Radiology; Chinese PLA General Hospital; Beijing China
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14
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Tsurusaki M, Sofue K, Isoda H, Okada M, Kitajima K, Murakami T. Comparison of gadoxetic acid-enhanced magnetic resonance imaging and contrast-enhanced computed tomography with histopathological examinations for the identification of hepatocellular carcinoma: a multicenter phase III study. J Gastroenterol 2016; 51:71-9. [PMID: 26130441 DOI: 10.1007/s00535-015-1097-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 04/08/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has an important role in preoperative evaluation of hepatocellular carcinoma (HCC). However, no studies have prospectively performed intraindividual comparison of gadoxetic acid-enhanced 3T MRI and multidetector-row computed tomography (MDCT) with histopathological examination for the detection of HCCs. We prospectively compared the efficacies of gadoxetic acid-enhanced MRI and multiphasic contrast-enhanced MDCT with that of histopathological examination, used as a reference standard, for the detection of HCC in surgical candidates. METHODS The study was approved by the institutional review boards at each of four centers. Patients scheduled to undergo multiphasic CT, gadoxetic acid-enhanced MRI, and liver surgery were prospectively included in this study. The diagnostic abilities of MRI and CT were evaluated and compared on the basis of sensitivity and positive predictive value for detection of and differentiation between HCCs and benign lesions. RESULTS Fifty-four patients with 83 histopathologically confirmed HCCs were included in the study. Combined interpretation of the dynamic and hepatobiliary phases of gadoxetic acid-enhanced MRI showed statistically higher sensitivity for lesion detection (83 %) than did interpretation of multiphasic MDCT images (70 %; p < 0.001). The mean area under each alternative free-response receiver operating characteristics curve was significantly higher for MR images (0.927) than for CT images (0.864, p < 0.01). CONCLUSIONS The sensitivity for preoperative detection of HCCs was higher for gadoxetic acid-enhanced MRI than for multiphasic MDCT imaging.
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Affiliation(s)
| | - Keitaro Sofue
- National Cancer Center Hospital-Diagnostic Radiology, 5-1-1, Tsukiji, Chuo-ku, Tokyo, Tokyo, 104-0045, Japan
- Kobe University Graduate School of Medicine-Radiology, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan
| | - Masahiro Okada
- Faculty of Medicine-Radiology, Kinki University, Osakasayama, Osaka, Japan
| | - Kazuhiro Kitajima
- Kobe University Graduate School of Medicine-Radiology, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
- Department of Raiology, Dokkyo Medical School, Mibu, Tochigi, Japan
| | - Takamichi Murakami
- Faculty of Medicine-Radiology, Kinki University, Osakasayama, Osaka, Japan
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Girometti R. 3.0 Tesla magnetic resonance imaging: A new standard in liver imaging? World J Hepatol 2015; 7:1894-1898. [PMID: 26244063 PMCID: PMC4517148 DOI: 10.4254/wjh.v7.i15.1894] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/17/2015] [Accepted: 06/08/2015] [Indexed: 02/06/2023] Open
Abstract
An ever-increasing number of 3.0 Tesla (T) magnets are installed worldwide. Moving from the standard of 1.5 T to higher field strength implies a number of potential advantage and drawbacks, requiring careful optimization of imaging protocols or implementation of novel hardware components. Clinical practice and literature review suggest that state-of-the-art 3.0 T is equivalent to 1.5 T in the assessment of focal liver lesions and diffuse liver disease. Therefore, further technical improvements are needed in order to fully exploit the potential of higher field strength.
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Brink WM, Gulani V, Webb AG. Clinical applications of dual-channel transmit MRI: A review. J Magn Reson Imaging 2015; 42:855-69. [PMID: 25854179 DOI: 10.1002/jmri.24791] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 09/04/2014] [Accepted: 09/04/2014] [Indexed: 11/09/2022] Open
Abstract
This article reviews the principle of dual-channel transmit MRI and highlights current clinical applications which are performed primarily at 3 Tesla. The main benefits of dual-channel transmit compared with single-transmit systems are the increased image contrast homogeneity and the decreased scanning time due to the more accurate local specific absorption ratio estimation, meaning that less conservative safety limits are needed. The dual-transmit approach has been particularly beneficial in body imaging applications, and is also promising in terms of cardiac, spine, and fetal imaging. Future advances in transmit SENSE, the combination of dual-channel transmit with high permittivity pads, as well as the potential increase in the number of transmit channels are also discussed.
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Affiliation(s)
- Wyger M Brink
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Vikas Gulani
- Department of Radiology, Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Andrew G Webb
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Low b-value (black blood) respiratory-triggered fat-suppressed single-shot spin-echo echo-planar imaging (EPI) of the liver: Comparison of image quality at 1.5 and 3 T. Clin Radiol 2014; 69:1136-41. [DOI: 10.1016/j.crad.2014.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 06/17/2014] [Accepted: 06/21/2014] [Indexed: 01/27/2023]
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18
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Jiang L, Zhou Y, Zhou C, Chen M, Dai Y, Fu Y, Zhao X. Dual-source parallel radiofrequency transmission for magnetic resonance breast imaging at 3T: any added clinical value? Magn Reson Imaging 2014; 32:523-8. [PMID: 24582548 DOI: 10.1016/j.mri.2014.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 01/12/2014] [Accepted: 01/14/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the influence of dual-source parallel radiofrequency (RF) excitation on clinical breast MR images. METHODS A 3T MR system with both dual-source and conventional single-source RF excitations was used to examine 22 patients. Axial TSE-T2WI with fat suppression, TSE-T1WI without fat suppression, THRIVE (3D field echo) and DWI (SE-EPI) were obtained by using both excitation techniques. Image homogeneity, image contrast and lesion conspicuity were measured or independently scored by two radiologists and were compared by paired-sample t test or Wilcoxon test. RESULTS Both excitations revealed 24 lesions. For SE sequences using dual-source mode, image homogeneity was improved (P=0.00), scan time was reduced, and ghost artifacts on DWI were significantly reduced (P=0.00). However, image contrast was not increased and lesion conspicuity had no significant difference between two modes, except DWI on which lesion conspicuity was significantly improved (P=0.00), due to less ghost artifacts. For field-echo sequence, image homogeneity, acquisition time, image contrast and lesion conspicuity had no significant difference between the two modes. CONCLUSIONS Dual-source parallel RF transmission has some added value for improving breast image quality. However, its value is limited in terms of improving lesion detection and characterization.
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Affiliation(s)
- Lei Jiang
- Radiology Department, Beijing Hospital, the Fifth Affiliated College of Peking University, Beijing, China
| | - Yiming Zhou
- Radiology Department, Beijing Chaoyang Hospital, the Affiliated College of Capital Medical University, Beijing, China
| | - Cheng Zhou
- Radiology Department, Beijing Hospital, the Fifth Affiliated College of Peking University, Beijing, China
| | - Min Chen
- Radiology Department, Beijing Hospital, the Fifth Affiliated College of Peking University, Beijing, China.
| | | | - Yuan Fu
- Radiology Department, Beijing Hospital, the Fifth Affiliated College of Peking University, Beijing, China
| | - Xuna Zhao
- Philips Healthcare, Andover, MA, USA
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Takayama Y, Nishie A, Asayama Y, Ushijima Y, Fujita N, Shimamoto D, Yoshiura T, Obara M, Takemura A, Yoneyama M, Honda H. Three-dimensional T2-weighted imaging for liver MRI: clinical values of tissue-specific variable refocusing flip-angle turbo spin echo imaging. J Magn Reson Imaging 2014; 41:339-46. [PMID: 24399511 DOI: 10.1002/jmri.24554] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 11/25/2013] [Indexed: 01/05/2023] Open
Abstract
PURPOSE To assess the clinical utility of tissue-specific variable refocusing flip-angle (VRFA) turbo-spin echo imaging for three-dimensional T2-weighted imaging (3D-T2WI) of the liver. MATERIALS AND METHODS Fifty-nine patients were scanned with three types of fat-suppressed T2WI for the comparison: two-dimensional single-shot turbo spin echo T2WI (ssT2WI), 3D-T2WI with tissue-specific VRFA (VISTA-TSV), and 3D-T2WI with low-constant VRFA (VISTA). Qualitatively, artifacts in the left and right lobes of the liver and black-blood effects in the liver were compared using the Wilcoxon signed-rank test with the Bonferroni correction. The detection and correct characterization rates of liver lesions were compared using McNemar's test. RESULTS VISTA-TSV showed reduced artifacts in the left and right lobes of the liver compared with VISTA (P < 0.017). The artifacts shown by VISTA-TSV were equivalent to those shown by ssT2WI. The black-blood effects of VISTA-TSV and VISTA were better than that of ssT2WI (P < 0.017). VISTA-TSV showed the best detection and correct characterization rate of liver lesions among the three imaging techniques (P < 0.05). CONCLUSION 3D-T2WI with tissue-specific VRFA can reduce artifacts of the liver, sufficiently suppress the signal in blood vessels, and has a potential to improve the detection and correct characterization rates of liver lesions.
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Affiliation(s)
- Yukihisa Takayama
- Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka City, Fukuoka, Japan
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Liver MRI at 3.0 tesla: comparison of image quality and lesion detectability between single-source conventional and dual-source parallel radiofrequency transmissions. J Comput Assist Tomogr 2012; 36:546-53. [PMID: 22992605 DOI: 10.1097/rct.0b013e318264e4a7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To prospectively and intraindividually compare liver magnetic resonance imaging (MRI) using single-source and dual-source parallel radiofrequency (RF) transmissions at 3.0-T for image quality, lesion detectability, and lesion contrast. METHODS Ninety-nine patients with 139 liver lesions underwent liver MRI at 3.0-T. Two radiologists performed a consensus review of T2-weighted images (T2WI), heavily T2WI (HT2WI), gadoxetic acid-enhanced hepatobiliary images, and diffusion-weighted imaging using single-source and dual-source RF transmissions with regard to image quality and lesion detectability. Contrast ratios between liver lesions and liver parenchyma were also calculated. RESULTS Image quality was better with dual-source than with single-source at T2WI and HT2WI (P < 0.05), but lesion detectabilities were similar for all sequences. There was no significant difference in mean contrast ratios for all sequences (P > 0.05). CONCLUSION Dual-source RF transmission provides a better image quality with T2WI and HT2WI than with single-source. However, 2 techniques showed similar lesion detectability.
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Umutlu L, Forsting M, Ladd ME. Ultrahigh-field magnetic resonance imaging: the clinical potential for anatomy, pathogenesis, diagnosis and treatment planning in neck and spine disease. Neuroimaging Clin N Am 2012; 22:363-71, xii. [PMID: 22548937 DOI: 10.1016/j.nic.2012.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An increase of the magnetic field strength to ultrahigh-field yields advantageous as well as disadvantageous changes in physical effects. The beneficial increase in signal/noise ratio can be leveraged into higher spatiotemporal resolution, and an exacerbation of artifacts can impede ultrahigh-field imaging. With the successful introduction of intracranial and musculoskeletal imaging at 7 T, recent advances in coil design have created opportunities for further applications of ultrahigh-field magnetic resonance (MR) imaging in other parts of the body. Initial studies in 7 T neck and spine MR imaging have revealed promising insights and new challenges, demanding further research and methodological optimization.
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Affiliation(s)
- Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45122 Essen, Germany.
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Guo L, Liang C, Yu T, Wang G, Li N, Sun H, Gao F, Liu C. 3 T MRI of hepatocellular carcinomas in patients with cirrhosis: does T2-weighted imaging provide added value? Clin Radiol 2011; 67:319-28. [PMID: 22099524 DOI: 10.1016/j.crad.2011.08.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 07/31/2011] [Accepted: 08/12/2011] [Indexed: 01/08/2023]
Abstract
AIM To assess whether T2-weighted imaging (T2WI) provides any added value for the detection of hepatocellular carcinoma (HCC) in patients with cirrhosis, especially for lesions smaller than 2 cm. MATERIALS AND METHODS Sixty-five patients with cirrhosis underwent liver 3 T MRI. Images were qualitatively analysed independently by two observers in two separate sessions, including a dynamic enhanced session and a combination of dynamic and T2WI. The diagnostic accuracy was evaluated using the alternating free-response receiver operating characteristic. Sensitivity and positive predictive values were calculated for all HCCs and for the subgroup of HCCs that were smaller than 2 cm. Additionally, artefacts on T2WI were evaluated by two observers in consensus. RESULTS Ninety HCCs (>2 cm n = 36; ≤2 cm n = 54) were detected in 46 patients. For all HCCs and for lesions smaller than 2 cm, the sensitivities were significantly higher for the combined session than the dynamic session alone (p < 0.05). Conversely, for the Az and positive predictive values, there was no significant difference between the two sessions. For smaller HCC, 9% (5/54) and 7% (4/54) of the 54 HCCs were correctly interpreted by observers 1 and 2, respectively, only when T2WI was included. Three false-positive lesions (≤2 cm) were correctly diagnosed by one of the observers after combining T2WI. Conspicuity of only one large HCC was severely reduced by the artefacts from massive ascites. CONCLUSION At 3 T liver imaging, combining with T2WI can improve the sensitivity of detection of HCC compared with dynamic MRI alone by increasing observer confidence, especially for lesions smaller than 2 cm. Additionally, T2 image quality was not significantly affected by artefacts.
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Affiliation(s)
- L Guo
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, PR China
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Gd-EOB-DTPA-enhanced 3.0 T MR imaging: quantitative and qualitative comparison of hepatocyte-phase images obtained 10 min and 20 min after injection for the detection of liver metastases from colorectal carcinoma. Eur Radiol 2011; 21:2336-43. [DOI: 10.1007/s00330-011-2197-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 05/08/2011] [Accepted: 05/12/2011] [Indexed: 12/27/2022]
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Rosenkrantz A, Mannelli L, Mossa D, Babb J. Breath-hold T2-weighted MRI of the liver at 3T using the BLADE technique: impact upon image quality and lesion detection. Clin Radiol 2011; 66:426-33. [DOI: 10.1016/j.crad.2010.10.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 10/12/2010] [Accepted: 10/17/2010] [Indexed: 10/18/2022]
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Abstract
Clinical hepatobiliary magnetic resonance (MR) imaging continues to evolve at a fast rate. However, three basic requirements must still be satisfied if novel high-field MR imaging techniques are to be included in the hepatobiliary imaging routine: improvement of parenchymal contrast, suppression of respiratory motion artifact, and anatomic coverage of the entire hepatobiliary system. This article outlines the various arenas involved in MR imaging of the hepatobiliary system at 3 Tesla (T) compared with 1.5 T by (1) highlighting magnetic field-dependent MR contrast phenomena that contribute to the overall appearance of high-field hepatobiliary imaging; (2) summarizing the biodistributions of different gadolinium chelates used as MR contrast agents and their effectiveness regarding the static magnetic field; (3) showing the implementation of advanced imaging techniques such as three-dimensional acquisition schemes and parallel acceleration techniques used in T1-, T2-, and diffusion-weighted hepatobiliary imaging; and (4) addressing artifact mechanisms exacerbated by, or originating from, increase of the static magnetic field.
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Kukuk GM, Gieseke J, Weber S, Hadizadeh DR, Nelles M, Träber F, Schild HH, Willinek WA. Focal liver lesions at 3.0 T: lesion detectability and image quality with T2-weighted imaging by using conventional and dual-source parallel radiofrequency transmission. Radiology 2011; 259:421-8. [PMID: 21330565 DOI: 10.1148/radiol.11101429] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To prospectively compare T2-weighted single-shot turbo spin-echo (TSE) sequences performed with parallel and conventional radiofrequency (RF) transmission at 3.0 T for liver lesion detection, image quality, lesion conspicuity, and lesion contrast. MATERIALS AND METHODS After written informed consent and institutional review board approval, 52 consecutive patients (32 men, 20 women; mean age, 56.6 years ± 13.7 [standard deviation]) underwent routine magnetic resonance (MR) imaging with a clinical 3.0-T unit. Two independent readers reviewed images acquired with conventional and dual-source parallel RF transmission for detection of focal liver lesions, with separate reading of a third radiologist, including all available imaging findings, clinical history, and histopathologic findings, as reference. Image quality and lesion conspicuity were rated on five- and three-point evaluation scales, respectively. Contrast ratios between focal liver lesions and adjacent liver parenchyma were calculated. Significance was determined by using nonparametric Wilcoxon signed-rank and marginal homogeneity tests. RESULTS With the reference standard, 106 index lesions were identified in 22 patients. Detection rate significantly improved from 87% (92 of 106) to 97% (103 of 106) (reader 1) and from 85% (90 of 106) to 96% (102 of 106) (reader 2) with parallel RF transmission (reader 1, P = .0078; reader 2, P = .002). Quality of parallel RF transmission images was assigned scores significantly higher, compared with quality of conventional RF transmission images (mean for reader 1, 2.88 ± 0.73 vs 4.04 ± 0.44; mean for reader 2, 2.81 ± 0.72 vs 4.04 ± 0.39; P < .0001 for both). Lesion conspicuity scores were significantly higher on parallel RF transmission images, compared with conventional RF transmission images (mean for reader 1, 2.02 ± 0.64 vs 2.92 ± 0.27; mean for reader 2, 2.06 ± 0.67 vs 2.90 ± 0.30; P < .0001 for both). Contrast ratios were significantly higher with parallel RF transmission (P < .05). CONCLUSION Compared with conventional RF transmission, parallel RF transmission significantly improved liver lesion detection rate, image quality, lesion conspicuity, and lesion contrast. SUPPLEMENTAL MATERIAL http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101429/-/DC1.
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Affiliation(s)
- Guido M Kukuk
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany.
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Bashir MR, Merkle EM, Smith AD, Boll DT. Hepatic MR imaging for in vivo differentiation of steatosis, iron deposition and combined storage disorder: single-ratio in/opposed phase analysis vs. dual-ratio Dixon discrimination. Eur J Radiol 2011; 81:e101-9. [PMID: 21330083 DOI: 10.1016/j.ejrad.2011.01.067] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 01/05/2011] [Accepted: 01/17/2011] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To assess whether in vivo dual-ratio Dixon discrimination can improve detection of diffuse liver disease, specifically steatosis, iron deposition and combined disease over traditional single-ratio in/opposed phase analysis. METHODS Seventy-one patients with biopsy-proven (17.7 ± 17.0 days) hepatic steatosis (n = 16), iron deposition (n = 11), combined deposition (n = 3) and neither disease (n = 41) underwent MR examinations. Dual-echo in/opposed-phase MR with Dixon water/fat reconstructions were acquired. Analysis consisted of: (a) single-ratio hepatic region-of-interest (ROI)-based assessment of in/opposed ratios; (b) dual-ratio hepatic ROI assessment of in/opposed and fat/water ratios; (c) computer-aided dual-ratio assessment evaluating all hepatic voxels. Disease-specific thresholds were determined; statistical analyses assessed disease-dependent voxel ratios, based on single-ratio (a) and dual-ratio (b and c) techniques. RESULTS Single-ratio discrimination succeeded in identifying iron deposition (I/O(Ironthreshold)<0.88) and steatosis (I/O(Fatthreshold>1.15)) from normal parenchyma, sensitivity 70.0%; it failed to detect combined disease. Dual-ratio discrimination succeeded in identifying abnormal hepatic parenchyma (F/W(Normalthreshold)>0.05), sensitivity 96.7%; logarithmic functions for iron deposition (I/O(Irondiscriminator)<e((0.01-F/W(Iron))/0.48)) and for steatosis (I/O(Fatdiscriminator)>e((F/W(Fat)-0.01)/0.48)) differentiated combined from isolated diseases, sensitivity 100.0%; computer-aided dual-ratio analysis was comparably sensitive but less specific, 90.2% vs. 97.6%. CONCLUSION MR two-point-Dixon imaging using dual-ratio post-processing based on in/opposed and fat/water ratios improved in vivo detection of hepatic steatosis, iron deposition, and combined storage disease beyond traditional in/opposed analysis.
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Affiliation(s)
- Mustafa R Bashir
- Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC 27710, United States
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Morita K, Namimoto T, Awai K, Komi M, Hashida M, Tsuji T, Hirai T, Yamashita Y. Enhancement effects of hepatic dynamic MR imaging at 3.0 T and 1.5 T using gadoxetic acid in a phantom study: comparison with gadopentetate dimeglumine. Magn Reson Med 2011; 66:213-8. [DOI: 10.1002/mrm.22770] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 10/27/2010] [Accepted: 11/24/2010] [Indexed: 01/22/2023]
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Herrmann KA, Paspulati RM, Lauenstein T, Reiser MF. Benefits and challenges in bowel MR imaging at 3.0 T. Top Magn Reson Imaging 2010; 21:165-175. [PMID: 21847036 DOI: 10.1097/rmr.0b013e31822a3294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Abdominal imaging at 3.0 T has shown to be challenging because of a number of artifacts and effects related to the physics at higher field strength. For bowel imaging at 3.0 T, artifacts due to magnetic field inhomogeneities, standing waves, increased susceptibility, and greater chemical shift effects are of particular concern because they are likely to affect the assessment of relevant structures and counterbalance the benefits of higher signal-to-noise ratio. Regarding small- and large-bowel magnetic resonance imaging, the benefits of higher field strengths translate mainly in better contrast-to-noise ratio of contrast-enhanced T1-weighted gradient echo and T2-weighted imaging, whereas steady-state free precession sequences seem to suffer from serious degradation of image quality. The present article summarizes the technical challenges in bowel imaging at 3.0 T, provides an overview of performance compared with 1.5 T in small- and large-bowel diseases including the rectum, and revises the current literature.
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Affiliation(s)
- Karin A Herrmann
- Institute of Clinical Radiology, Ludwig-Maximilians-University Munich, University Hospitals Munich, Munich, Germany.
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Marin D, Husarik DB, Boll DT, Merkle EM. Abdominal magnetic resonance imaging at 3 T: oncological applications. Top Magn Reson Imaging 2010; 21:149-156. [PMID: 21847034 DOI: 10.1097/rmr.0b013e3181e8fb7a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The gain in signal-to-noise ratio at 3 T magnetic resonance (MR) imaging produces many benefits for abdominal imaging applications, including the capability to reduce acquisition times and/or improve spatial resolution for a variety of pulse sequences, the potential for broader application of parallel imaging techniques, and an increased sensitivity to gadolinium-based contrast media. These advances have the potential of improving the accuracy of MR imaging in the detection, staging, treatment planning, and follow-up of patients with abdominal tumors. At the same time, because certain high-field-strength-related drawbacks could not be compensated for, abdominal 3 T MR imaging should be clinically implemented with caution in some patients (eg, patients with massive ascites).
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Affiliation(s)
- Daniele Marin
- Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
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Pilot Study Assessing Differentiation of Steatosis Hepatis, Hepatic Iron Overload, and Combined Disease Using Two-Point Dixon MRI at 3 T: In Vitro and In Vivo Results of a 2D Decomposition Technique. AJR Am J Roentgenol 2010; 194:964-71. [DOI: 10.2214/ajr.09.3011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Liver MRI at 3 T Using a Respiratory-Triggered Time-Efficient 3D T2-Weighted Technique: Impact on Artifacts and Image Quality. AJR Am J Roentgenol 2010; 194:634-41. [DOI: 10.2214/ajr.09.2994] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Rha SE. High field strength magnetic resonance imaging of abdominal diseases. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2010. [DOI: 10.5124/jkma.2010.53.12.1065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sung Eun Rha
- Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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