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MRI for hepatocellular carcinoma: a primer for magnetic resonance imaging interpretation. Abdom Radiol (NY) 2018; 43:1143-1151. [PMID: 28780680 DOI: 10.1007/s00261-017-1280-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hepatocellular carcinoma is among the most prevalent solid organ cancers, and, unlike many cancers, may be diagnosed non-invasively by imaging criteria [1] with the preferred modality recently shifting from multiphasic computed tomography (MDCT) to magnetic resonance imaging (MRI). The purpose of this article is to help facilitate radiologists and radiology trainees in the transition to MRI by providing a step-wise approach to exam interpretation to improve the MRI detection of HCC. A methodical, consistent approach to navigating a HCC screening MRI exam, in conjunction with the LI-RADS framework for characterization, should lead to improved HCC detection and diagnosis.
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2
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Jones RH, Taylor AJ, Rostambeigi N, Spilseth B. Small hepatocellular carcinomas displayed as a ring enhancing mass on arterial phase MRI in the chronically diseased liver. Clin Radiol 2017; 72:995.e1-995.e9. [PMID: 28751038 DOI: 10.1016/j.crad.2017.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 06/20/2017] [Accepted: 07/03/2017] [Indexed: 01/05/2023]
Abstract
AIM To assess the prevalence of arterial phase (AP) ring-enhancing small hepatocellular carcinomas (HCC) on magnetic resonance imaging (MRI); detail additional MRI features that enable HCC diagnosis; and examine arterial timing as one possible cause of this appearance. MATERIALS AND METHODS Patients undergoing HCC screening with both computed tomography (CT) and MRI within 40 days were examined at a single institution over a 7- year time period ending in 2013. From this initial group, small (1-3 cm), (AP) ring-enhancing HCC on MRI were studied. RESULTS From the initial group of 64 patients with 129 HCC, 20 patients with 78 HCCs had a small diameter with 32 (41%) having an AP ring at MRI. The mean age of this latter group was 63-years old, with the average tumour diameter of 1.9 cm. Histopathology and secondary imaging supported a diagnosis of HCC in 20 (100%) patients and 31 (97%) lesions. Most of the ringed lesions had early AP timing. CONCLUSION This study revealed a high prevalence (41%) of small, AP ring HCC with MRI. The use of other MRI sequences adds support in making the proper diagnosis with this appearance. Early AP timing may help create this pattern.
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Affiliation(s)
- R H Jones
- Department of Radiology, University of Minnesota, 420 Delaware Street S.E, Mayo Memorial Building, Minneapolis, MN 55455, USA
| | - A J Taylor
- Department of Radiology, University of Minnesota, 420 Delaware Street S.E, Mayo Memorial Building, Minneapolis, MN 55455, USA.
| | - N Rostambeigi
- Department of Radiology, University of Minnesota, 420 Delaware Street S.E, Mayo Memorial Building, Minneapolis, MN 55455, USA
| | - B Spilseth
- Department of Radiology, University of Minnesota, 420 Delaware Street S.E, Mayo Memorial Building, Minneapolis, MN 55455, USA
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Matos AP, Semelka RC, Herédia V, AlObaidiy M, Gomes FV, Ramalho M. Modified approach to the characterization of adrenal nodules using a standard abdominal magnetic resonance imaging protocol. Radiol Bras 2017; 50:19-25. [PMID: 28298728 PMCID: PMC5347499 DOI: 10.1590/0100-3984.2015.0102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To describe a modified approach to the evaluation of adrenal nodules using a
standard abdominal magnetic resonance imaging protocol. Materials and Methods Our sample comprised 149 subjects (collectively presenting with 132 adenomas
and 40 nonadenomas). The adrenal signal intensity index was calculated.
Lesions were grouped by pattern of enhancement (PE), according to the phase
during which the wash-in peaked: arterial phase (type 1 PE); portal venous
phase (type 2 PE); and interstitial phase (type 3 PE). The relative and
absolute wash-out values were calculated. To test for mean differences
between adenomas and nonadenomas, Student's t-tests were
used. Receiver operating characteristic curve analysis was also
performed. Results The mean adrenal signal intensity index was significantly higher for the
adenomas than for the nonadenomas (p < 0.0001). Chemical
shift imaging showed a sensitivity and specificity of 94.4% and 100%,
respectively, for differentiating adenomas from nonadenomas. Of the
adenomas, 47.6%, 48.5%, and 3.9%, respectively, exhibited type 1, 2, and 3
PEs. For the mean wash-in proportions, significant differences were found
among the enhancement patterns. The wash-out calculations revealed a trend
toward better lesion differentiation for lesions exhibiting a type 1 PE,
showing a sensitivity and specificity of 71.4% and 80.0%, respectively, when
the absolute values were referenced, as well as for lesions exhibiting a
type 2 PE, showing a sensitivity and specificity of 68.0% and 100%,
respectively, when the relative values were referenced. The calculated
probability of a lipid-poor lesion that exhibited a type 3 PE being a
nonadenoma was > 99%. Conclusion Subgrouping dynamic enhancement patterns yields high diagnostic accuracy in
differentiating adenomas from nonadenomas.
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Affiliation(s)
- António P Matos
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, and Hospital Garcia de Orta, Almada, Portugal
| | - Richard C Semelka
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Vasco Herédia
- Department of Radiology, Hospital do Espírito Santo, Évora, Portugal
| | - Mamdoh AlObaidiy
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, and King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | - Miguel Ramalho
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, and Hospital Garcia de Orta, Almada, Portugal
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4
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AlObaidy M, Ramalho M, Busireddy KKR, Dale BM, Burke LM, Altun E, Liu B, Semelka RC. Surrogate arterial phase imaging using a long duration (≈1.5 min) radial acquisition T1-weighted sequence: an alternative in patients unable to breath-hold. Acta Radiol 2016; 57:955-63. [PMID: 26567963 DOI: 10.1177/0284185115616294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 10/17/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Pediatric and adult patients unable to suspend respiration generally undergo magnetic resonance (MR) examinations that lack arterial phase imaging, which is a phase that provides substantial information on disease processes. An MR strategy that provides this type of information may be of considerable value. PURPOSE To describe and assess the feasibility and enhancement quality of early-phase imaging utilizing long-duration radial 3D-GRE imaging by initiating the sequence prior to starting contrast injection. MATERIAL AND METHODS Thirty-three consecutive patients (10 men, 23 women; 50.7 ± 25.5 years) underwent free-breathing gadolinium-enhanced radial 3D-GRE, with sequence initiation 30 s prior to contrast injection. Late hepatic arterial (LHA) phase was chosen for comparison. Images were evaluated for enhancement and overall image quality. Organ enhancement was calculated. Sub-group analysis was performed. RESULTS Twenty-two examinations of radial 3D-GRE sequences were acquired during the LHA phase. Organ enhancement scores were of satisfactory to good quality (range, 3.32-3.82). There was a significant trend of superior overall enhancement quality scores in pediatrics and examinations performed at 3 T (P = 0.0225 and 0.0001, respectively). CONCLUSION Arterial phase abdominal MR imaging is feasible using conventional radial 3D-GRE by adopting this simplistic proposed approach, which may allow arterial-phase imaging in patients unable to breath-hold.
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Affiliation(s)
- Mamdoh AlObaidy
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Miguel Ramalho
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kiran KR Busireddy
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian M Dale
- Siemens Medical Solutions, Inc., Morrisville, NC, USA
| | - Lauren M Burke
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ersan Altun
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Baodong Liu
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Richard C Semelka
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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5
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Enhancement of abdominal structures on MRI at 1.5 and 3 T: a retrospective intraindividual crossover comparison. Eur Radiol 2016; 27:1596-1604. [PMID: 27436014 DOI: 10.1007/s00330-016-4494-0] [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: 11/21/2015] [Revised: 05/24/2016] [Accepted: 06/27/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To quantitatively compare the extent of enhancement of abdominal structures on MRI in an intraindividual fashion at 1.5 and 3 T. METHODS HIPAA-compliant, retrospective, longitudinal, intraindividual, crossover study, with waived informed consent, of consecutive individuals scanned at both 1.5 and 3 T closed-bore magnets using gadobenate dimeglumine during different phases of enhancement at tightly controlled arterial phase timing. Quantitative ROI measurements and qualitative sub-phase arterial phase assignments were independently performed by two radiologists. Qualitative discrepancies were resolved by a senior radiologist. RESULTS Final population included 60 patients [41 female and 19 male; age, 49.35 ± 18.31 years (range 16-81); weight, 78.88 ± 20.3 kg (range 44.5-136)]. Similar enhancement peak patterns were noted at both field strengths. Interobserver agreement of quantitative evaluations was substantial. Significantly higher amplitudes of enhancement peaks were noted for all abdominal solid organs during all phases at 3 T, except for the pancreas (p = 0.17-0.30). Significantly higher amplitudes of enhancement peaks of the abdominal aorta at 1.5 T were noted. CONCLUSION Similar peak patterns of enhancement for abdominal structures were observed at 1.5 and 3 T, with solid abdominal organs showing a higher percentage enhancement at 3 T, while unexpectedly higher aortic higher percentage enhancement was observed at 1.5 T. KEY POINTS • Similar enhancement peak patterns at both field strengths for studied abdominal structures. • Significantly higher percentage enhancement of most abdominal organs at 3 T. • Non-statistically significant trend of higher pancreatic percentage enhancement at 3 T. • Significantly lower abdominal aortic percentage enhancement at 3 T.
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Rousseau C, Ronot M, Vilgrain V, Zins M. Optimal visualization of focal nodular hyperplasia: quantitative and qualitative evaluation of single and multiphasic arterial phase acquisition at 1.5 T MR imaging. Abdom Radiol (NY) 2016; 41:990-1000. [PMID: 27193796 DOI: 10.1007/s00261-015-0630-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate the qualitative and quantitative benefit of multiple arterial phase acquisitions for the depiction of hypervascularity in FNH explored MR imaging using an extracellular contrast agent. METHODS Between 2007 and 2014, all patients who underwent MR imaging for the exploration of FNH were included. The protocol included a single or a triple arterial phase ("single" and "triple" group, respectively). Arterial phases were visually divided into four types: (1) angiographic, (2) early, (3) late, and (4) portal. Signal intensity on arterial phase images was visually recorded as intense, moderate, or low for each lesion. Lesion-to-liver contrast (LLC) and relative lesion enhancement (RE) were calculated and compared between the two groups using the Mann-Whitney test. RESULTS Thirty-five women were included (mean 45-year old, range 20-66), with 50 FNH (mean size 30 mm). Single and triple groups included 20 patients (30 FNH) and 15 patients (20 FNH), respectively. Signal intensity was intense in all lesions in the triple group and in 22/30 (73%) in the single group (p = 0.041). Intense signals were more frequently found in the early arterial phase (p < 0.001). RE was not significantly different (1.78 ± 0.84 vs. 1.98 ± 1.81 p = 0.430, in the single and triple groups, respectively) but LLC was significantly higher in the triple group (0.32 ± 0.10 vs. 0.22 ± 0.10, p = 0.005). LLC was significantly higher in the first two arterial phases in the triple group (p < 0.001). CONCLUSION Acquisition of three arterial phases improves the visualization of hypervascularity of FNH, as lesions show high visual signal intensity and contrast. Optimal visualization is obtained in the early arterial phase.
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Affiliation(s)
- Caroline Rousseau
- Department of Radiology, Fondation Hôpital Saint-Joseph, 185 rue Raymond Losserand, 75674, Paris, France
| | - Maxime Ronot
- Department of Radiology, Hôpital Beaujon, HUPNVS, 100, Bd du Général Leclerc, Clichy, France.
- University Paris Diderot, Sorbonne Paris Cite, Paris, France.
- INSERM U1149, CRI, 75018, Paris, France.
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, HUPNVS, 100, Bd du Général Leclerc, Clichy, France
- University Paris Diderot, Sorbonne Paris Cite, Paris, France
- INSERM U1149, CRI, 75018, Paris, France
| | - Marc Zins
- Department of Radiology, Fondation Hôpital Saint-Joseph, 185 rue Raymond Losserand, 75674, Paris, France
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Lobulated margination of liver hemangiomas: Is this a definitive feature? Clin Imaging 2016; 40:801-5. [PMID: 27130984 DOI: 10.1016/j.clinimag.2016.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 02/25/2016] [Accepted: 03/04/2016] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate the occurrence rate of lobulated margination of hepatic hemangiomas. METHODS The study population included 585 hemangiomas in 261 patients (161 females; mean age: 51.9years). Two readers independently reviewed all cases. RESULTS Hemangiomas with lobulated margins accounted for 74.7% of all lesions. The incidence of lobulated margins was significantly higher (P<.001) in medium- and large-sized hemangiomas (77.6% and 99.5%, respectively). The majority of hemangiomas with type-3 enhancement showed lobulated margins (83.5%) (P<.001). CONCLUSION Virtually, all hemangiomas>18mm show lobulated margins. The majority of hemangiomas with type-3 enhancement show lobulated margins. Lack of lobulated margins in larger lesions lowers the likelihood ratio for being hemangiomas.
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8
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Sousa MSC, Ramalho M, Herédia V, Matos AP, Palas J, Jeon YH, Afonso D, Semelka RC. Perilesional enhancement of liver cavernous hemangiomas in magnetic resonance imaging. ACTA ACUST UNITED AC 2016; 39:722-30. [PMID: 24531350 DOI: 10.1007/s00261-014-0100-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate on magnetic resonance imaging (MRI) the occurrence rate of temporal perilesional parenchymal enhancement (PPE) associated with hepatic hemangiomas in a large consecutive series and to determine which aspects are associated with this observation. MATERIALS AND METHODS Institutional review board approved this retrospective study. A computerized search of the MRI database was performed for consecutive patients between January 2008 and January 2012. The study population included 513 liver hemangiomas in 224 patients (104 males and 120 females; mean age of 55.2 ± 13.5 years; age range 24-89 years). Two readers independently reviewed the frequency of PPE, size, speed of enhancement and location of each hemangioma. Marginal models with generalized estimating equation were used. Wald test was applied to verify if the model coefficients were significant. RESULTS 80/513 (15.6%) hemangiomas showed PPE. The incidence of PPE was significantly higher (p < 0.05) in hemangiomas with Type1 speed of enhancement (51/80, 63.8%) than in those with Type2 or Type3. 66/80 (82.5%) hemangiomas with PPE were subcapsular (p < 0.05). Conversely, the majority (280/433, 64.7%) of hemangiomas without PPE were deep in location (p < 0.001). Lesser proportion of hemangiomas with PPE was located in segment IVa (p < 0.05). CONCLUSION PPE is not uncommonly seen along with hepatic hemangiomas. This appearance is most frequently observed in rapidly enhancing small lesions with a subcapsular location.
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Affiliation(s)
- Marta S C Sousa
- Department of Radiology, Hospital Garcia de Orta, 2801-951, Almada, Portugal
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9
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Matos AP, Velloni F, Ramalho M, AlObaidy M, Rajapaksha A, Semelka RC. Focal liver lesions: Practical magnetic resonance imaging approach. World J Hepatol 2015; 7:1987-2008. [PMID: 26261689 PMCID: PMC4528273 DOI: 10.4254/wjh.v7.i16.1987] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 06/24/2015] [Accepted: 07/23/2015] [Indexed: 02/06/2023] Open
Abstract
With the widespread of cross-sectional imaging, a growth of incidentally detected focal liver lesions (FLL) has been observed. A reliable detection and characterization of FLL is critical for optimal patient management. Maximizing accuracy of imaging in the context of FLL is paramount in avoiding unnecessary biopsies, which may result in post-procedural complications. A tremendous development of new imaging techniques has taken place during these last years. Nowadays, Magnetic resonance imaging (MRI) plays a key role in management of liver lesions, using a radiation-free technique and a safe contrast agent profile. MRI plays a key role in the non-invasive correct characterization of FLL. MRI is capable of providing comprehensive and highly accurate diagnostic information, with the additional advantage of lack of harmful ionizing radiation. These properties make MRI the mainstay for the noninvasive evaluation of focal liver lesions. In this paper we review the state-of-the-art MRI liver protocol, briefly discussing different sequence types, the unique characteristics of imaging non-cooperative patients and discuss the role of hepatocyte-specific contrast agents. A review of the imaging features of the most common benign and malignant FLL is presented, supplemented by a schematic representation of a simplistic practical approach on MRI.
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Affiliation(s)
- António P Matos
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
| | - Fernanda Velloni
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
| | - Miguel Ramalho
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
| | - Mamdoh AlObaidy
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
| | - Aruna Rajapaksha
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
| | - Richard C Semelka
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
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10
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Song KD, Kim SH, Lee J, Kang KA, Kim J, Yoo H. Half-dose gadoxetic acid-enhanced liver magnetic resonance imaging in patients at risk for nephrogenic systemic fibrosis. Eur J Radiol 2015; 84:378-383. [DOI: 10.1016/j.ejrad.2014.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 11/30/2014] [Accepted: 12/09/2014] [Indexed: 12/17/2022]
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Veloso Gomes F, Matos AP, Palas J, Mascarenhas V, Herédia V, Duarte S, Ramalho M. Renal cell carcinoma subtype differentiation using single-phase corticomedullary contrast-enhanced CT. Clin Imaging 2014; 39:273-7. [PMID: 25457534 DOI: 10.1016/j.clinimag.2014.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 08/23/2014] [Accepted: 09/11/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To compare multiphase and single-phase corticomedullary contrast-enhanced computed tomographic (CT) imaging in the differentiation of renal cell carcinoma (RCC) subtype. MATERIAL AND METHODS Pathology records were reviewed from January 2008 to March 2013. The final cohort consisted of 79 patients (57 men, 22 women; mean age: 64±13). Quantitative tumor percentage enhancement (TE), cortical enhancement, and tumor-to-cortex enhancement (TCI) indexes were calculated. RESULTS Single-phase evaluations showed significantly lower mean TE and TCI for papillary tumors when compared with clear cell and cromophobe tumors (P<.01). Comparison of receiver operating characteristic curve analyses did not show significant differences between both evaluation methods. CONCLUSION Accuracy of RCC subtype differentiation with single-phase corticomedullary contrast-enhanced CT is comparable to multiphasic imaging.
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Affiliation(s)
- Filipe Veloso Gomes
- Department of Radiology, Hospital Garcia de Orta, Almada, Portugal; Department of Radiology, Hospital de Faro, Faro, Portugal
| | - António P Matos
- Department of Radiology, Hospital Garcia de Orta, Almada, Portugal
| | - João Palas
- Department of Radiology, Hospital Garcia de Orta, Almada, Portugal
| | | | - Vasco Herédia
- Department of Radiology, Hospital Espírito Santo, Évora, Portugal
| | - Sérgio Duarte
- Department of Radiology, Hospital da Luz, Lisbon, Portugal
| | - Miguel Ramalho
- Department of Radiology, Hospital Garcia de Orta, Almada, Portugal.
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Inter- and intra-individual comparative study of two gadolinium-based agents: A pilot study. ACTA ACUST UNITED AC 2014; 40:865-74. [DOI: 10.1007/s00261-014-0248-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Kim MJ, Kim SH, Kim HJ, Kim BS, Hernandes M, Semelka RC. Enhancement of liver and pancreas on late hepatic arterial phase Imaging: Quantitative comparison among multiple gadolinium-based contrast agents at 1.5 tesla MRI. J Magn Reson Imaging 2013; 38:102-8. [DOI: 10.1002/jmri.23934] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 10/01/2012] [Indexed: 12/22/2022] Open
Affiliation(s)
| | | | | | | | - Mateus Hernandes
- Department of Radiology; University of North Carolina at Chapel Hill; Chapel Hill; North Carolina; USA
| | - Richard C. Semelka
- Department of Radiology; University of North Carolina at Chapel Hill; Chapel Hill; North Carolina; USA
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14
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Kim HJ, Kim BS, Kim MJ, Kim SH, de Campos ROP, Hernandes M, Semelka RC. Enhancement of the liver and pancreas in the hepatic arterial dominant phase: comparison of hepatocyte-specific MRI contrast agents, gadoxetic acid and gadobenate dimeglumine, on 3 and 1.5 Tesla MRI in the same patient. J Magn Reson Imaging 2012; 37:903-8. [PMID: 23065959 DOI: 10.1002/jmri.23874] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 09/11/2012] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To evaluate the relative enhancement of liver, pancreas, focal nodular hyperplasia (FNH), pancreas-to-liver index, and FNH-to-liver index in the hepatic arterial dominant phase (HADP) after injection of hepatocyte-specific MRI contrast agents, gadoxetic acid and gadobenate dimeglumine, on 3 and 1.5 Tesla (T) MRI in the same patient. MATERIALS AND METHODS The MRI database was retrospectively searched to identify consecutive patients who underwent abdominal MRI at 3T and 1.5T systems, using both 0.025 mmol/kg gadoxetic acid-enhanced and 0.05 mmol/kg gadobenate dimeglumine-enhanced MRI at the same magnetic strength field system. 22 patients were identified, 10 were scanned at 3T system and 12 at 1.5T system. The enhancement of liver, pancreas, and FNH was evaluated quantitatively on MR images. RESULTS The relative enhancement of liver in HADP in the gadobenate dimeglumine-enhanced group in all subjects was significantly higher than that in gadoxetic acid-enhanced group (P = 0.023). The gadobenate dimeglumine-enhanced group in HADP had better relative enhancement of pancreas and FNH, pancreas-to-liver index, and FNH-to-liver index than gadoxetic acid-enhanced group, but the difference was not statistically significant. CONCLUSION The 0.05 mmol/kg gadobenate dimeglumine-enhanced abdominal MRI studies at 3T and 1.5T MR systems are superior in relative enhancement of the liver in HADP to 0.025 mmol/kg gadoxetic acid-enhanced MRI. This type of assessment may provide comparative effectiveness data.
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Affiliation(s)
- Hee Jin Kim
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7510, USA
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15
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Objective evaluation of acute adverse events and image quality of gadolinium-based contrast agents (gadobutrol and gadobenate dimeglumine) by blinded evaluation. Pilot study. Magn Reson Imaging 2012; 31:96-101. [PMID: 22898688 DOI: 10.1016/j.mri.2012.06.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 05/16/2012] [Accepted: 06/21/2012] [Indexed: 01/19/2023]
Abstract
PURPOSE The purpose was to objectively evaluate a recently FDA-approved gadolinium-based contrast agent (GBCA) in comparison to our standard GBCA for acute adverse events and image quality by blinded evaluation. METHODS Evaluation was made of a recently FDA-approved GBCA, gadobutrol (Gadavist; Bayer), in comparison to our standard GBCA, gadobenate dimeglumine (MultiHance; Bracco), in an IRB- and HIPAA-compliant study. Both the imaging technologist and patient were not aware of the brand of the GBCA used. A total of 59 magnetic resonance studies were evaluated (59 patients, 31 men, 28 women, age range of 5-85 years, mean age of 52 years). Twenty-nine studies were performed with gadobutrol (22 abdominal and 7 brain studies), and 30 studies were performed with gadobenate dimeglumine (22 abdominal and 8 brain studies). Assessment was made of acute adverse events focusing on objective observations of vomiting, hives, and moderate and severe reactions. Adequacy of enhancement was rated as poor, fair and good by one of two experienced radiologists who were blinded to the type of agent evaluated. RESULTS No patient experienced acute adverse events with either agent. The target minor adverse events of vomiting or hives, and moderate and severe reactions were not observed in any patient. Adequacy of enhancement was rated as good for both agents in all patients. CONCLUSIONS Objective, blinded evaluation is feasible and readily performable for the evaluation of GBCAs. This proof-of-concept study showed that both GBCAs evaluated exhibited consistent good image quality and no noteworthy adverse events.
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16
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Xu B, Spincemaille P, Chen G, Agrawal M, Nguyen TD, Prince MR, Wang Y. Fast 3D contrast enhanced MRI of the liver using temporal resolution acceleration with constrained evolution reconstruction. Magn Reson Med 2012; 69:370-81. [PMID: 22442108 DOI: 10.1002/mrm.24253] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 02/01/2012] [Accepted: 02/24/2012] [Indexed: 01/26/2023]
Abstract
Time-resolved imaging is crucial for the accurate diagnosis of liver lesions. Current contrast enhanced liver magnetic resonance imaging acquires a few phases in sequential breath-holds. The image quality is susceptible to bolus timing errors, which could result in missing the critical arterial phase. This impairs the detection of malignant tumors that are supplied primarily by the hepatic artery. In addition, the temporal resolution may be too low to reliably separate the arterial phase from the portal venous phase. In this study, a method called temporal resolution acceleration with constrained evolution reconstruction was developed with three-dimensional volume coverage and high-temporal frame rate. Data is acquired using a stack of spirals sampling trajectory combined with a golden ratio view order using an eight-channel coil array. Temporal frames are reconstructed from vastly undersampled data sets using a nonlinear inverse algorithm assuming that the temporal changes are small at short time intervals. Numerical and phantom experimental validation is presented. Preliminary in vivo results demonstrated high spatial resolution dynamic three-dimensional images of the whole liver with high frame rates, from which numerous subarterial phases could be easily identified retrospectively.
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Affiliation(s)
- Bo Xu
- Department of Radiology, Weill Cornell Medical College, New York, NY, USA
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Goncalves Neto JA, Altun E, Elazzazi M, Vaidean GD, Chaney M, Semelka RC. Enhancement of abdominal organs on hepatic arterial phase: quantitative comparison between 1.5- and 3.0-T magnetic resonance imaging. Magn Reson Imaging 2010; 28:47-55. [DOI: 10.1016/j.mri.2009.05.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2008] [Revised: 03/19/2009] [Accepted: 05/10/2009] [Indexed: 10/20/2022]
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