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Kübler J, Krumm P, Martirosian P, Winkelmann MT, Gohla G, Nikolaou K, Hoffmann R. Improved visualization of hepatic tumors in magnetic resonance-guided thermoablation using T1-inversion-recovery imaging with variable inversion time. Eur Radiol 2023; 33:7015-7024. [PMID: 37133519 PMCID: PMC10511564 DOI: 10.1007/s00330-023-09696-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES In magnetic resonance (MR)-guided interventions, visualization of hepatic lesions may be difficult using standard unenhanced T1-weighted gradient-echo volume-interpolated breath-hold (VIBE) sequence due to low contrast. Inversion recovery (IR) imaging may have the potential to improve visualization without the necessity to apply contrast agent. METHODS Forty-four patients (mean age 64 years, female 33%) scheduled for MR-guided thermoablation due to liver malignancies (hepatocellular carcinoma or metastases) were prospectively included in this study between March 2020 and April 2022. Fifty-one liver lesions were intra-procedurally characterized before treatment. Unenhanced T1-VIBE was acquired as part of the standard imaging protocol. Additionally, T1-modified look-locker images were acquired with eight different inversion times (TI) between 148 and 1743 ms. Lesion-to-liver contrast (LLC) was compared between T1-VIBE and IR images for each TI. T1 relaxation times for liver lesions and liver parenchyma were calculated. RESULTS Mean LLC in T1-VIBE sequence was 0.3 ± 0.1. In IR images, LLC was highest at TI 228 ms (1.04 ± 1.1) and significantly higher compared to T1-VIBE (p < 0.001). In subgroup analysis, lesions of colorectal carcinoma showed the highest LLC at 228 ms (1.14 ± 1.4), and hepatocellular carcinoma showed the highest LLC at 548 ms (1.06 ± 1.16). T1-relaxation times in liver lesions were higher compared to the adjacent liver parenchyma (1184 ± 456 vs. 654 ± 96 ms, p < 0.001). CONCLUSIONS IR imaging is promising to provide improved visualization during unenhanced MR-guided liver interventions compared to standard T1-VIBE sequence when using specific TI. Low TI between 150 and 230 ms yields the highest contrast between liver parenchyma and malignant liver lesions. CLINICAL RELEVANCE STATEMENT Improved visualization of hepatic lesions during MR-guided percutaneous interventions using inversion recovery imaging without the necessity to apply contrast agent. KEY POINTS • Inversion recovery imaging is promising to provide improved visualization of liver lesions in unenhanced MRI. • Planning and guidance during MR-guided interventions in the liver can be performed with greater confidence without necessity to apply contrast agent. • Low TI between 150 and 230 ms yields the highest contrast between liver parenchyma and malignant liver lesions.
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Affiliation(s)
- J Kübler
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany.
| | - P Krumm
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany
| | - P Martirosian
- Section On Experimental Radiology, University Hospital of Tübingen, Tübingen, Germany
| | - M T Winkelmann
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany
| | - G Gohla
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany
| | - K Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany
| | - R Hoffmann
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany
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Kamali M, Clarke SE, Costa AF. Evaluation of liver MRI examinations with two dosages of gadobenate dimeglumine: a blinded intra-individual study. Abdom Radiol (NY) 2020; 45:36-44. [PMID: 31372778 DOI: 10.1007/s00261-019-02158-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE There is discrepancy in the literature regarding the optimal dose of gadobenate for liver MRI. We evaluated the quality of liver MRIs performed in the same individual using two dosages. METHODS With ethics approval, this retrospective study evaluated sixty patients who underwent liver MRIs between July 2015 and May 2017 (low dose, 0.06 mmol/kg) and May 2017 and September 2018 (standard dose, 0.10 mmol/kg). Regions of interest were drawn over the aorta, portal veins, and liver on unenhanced and post-contrast phases; relative enhancement values were compared (paired t-tests). Two blinded radiologists graded the arterial and portal venous sequences of each MRI from 1 to 4 (1 = suboptimal, 2 = adequate, 3 = good, 4 = excellent); grades were compared overall and in cirrhotic and non-cirrhotic subgroups (Wilcoxon signed-rank test). Radiologists graded each MRI pair from 1 to 5 (1 = substantially inferior, 2 = slightly inferior, 3 = equivalent, 4 = slightly improved, 5 = substantially improved). Inter-reader agreement was assessed (kappa statistic). RESULTS Relative enhancement increased significantly with the standard dose for all structures on all phases (p < 0.05). For both radiologists and both post-contrast phases, individual grades of the low- and standard-dose MRIs were similar, including the cirrhotic and non-cirrhotic subgroups (p > 0.05). Compared to the low-dose MRIs, the number of standard-dose MRIs graded 1-5 were 9, 31, 97, 88, and 11 for all patients, and 6, 13, 26, 45, and 6 in cirrhotics. Inter-observer agreement was fair-moderate (Κ range 0.23-0.45). CONCLUSIONS Although the standard dose of gadobenate yields greater relative enhancement, there is overall little improvement in subjective imaging quality. A trend towards better image quality is observed in cirrhotics.
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Affiliation(s)
- Mahsa Kamali
- Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Victoria General Building, 3rd Floor, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada
| | - Sharon E Clarke
- Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Victoria General Building, 3rd Floor, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada
| | - Andreu F Costa
- Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Victoria General Building, 3rd Floor, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada.
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Han X, Xu K, Taratula O, Farsad K. Applications of nanoparticles in biomedical imaging. NANOSCALE 2019; 11:799-819. [PMID: 30603750 PMCID: PMC8112886 DOI: 10.1039/c8nr07769j] [Citation(s) in RCA: 223] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
An urgent need for early detection and diagnosis of diseases continuously pushes the advancements of imaging modalities and contrast agents. Current challenges remain for fast and detailed imaging of tissue microstructures and lesion characterization that could be achieved via development of nontoxic contrast agents with longer circulation time. Nanoparticle technology offers this possibility. Here, we review nanoparticle-based contrast agents employed in most common biomedical imaging modalities, including fluorescence imaging, MRI, CT, US, PET and SPECT, addressing their structure related features, advantages and limitations. Furthermore, their applications in each imaging modality are also reviewed using commonly studied examples. Future research will investigate multifunctional nanoplatforms to address safety, efficacy and theranostic capabilities. Nanoparticles as imaging contrast agents have promise to greatly benefit clinical practice.
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Affiliation(s)
- Xiangjun Han
- Department of Radiology, First Hospital of China Medical University, Shenyang, Liaoning, 110001 P. R. China.
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Rogowska J, Olkowska E, Ratajczyk W, Wolska L. Gadolinium as a new emerging contaminant of aquatic environments. ENVIRONMENTAL TOXICOLOGY AND CHEMISTRY 2018; 37:1523-1534. [PMID: 29473658 DOI: 10.1002/etc.4116] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/13/2017] [Accepted: 02/21/2018] [Indexed: 05/22/2023]
Abstract
Since the 1980s, gadolinium (Gd)-based contrast agents (GBCAs) have been routinely used in magnetic resonance imaging as stable chelates of the Gd3+ ion, without toxic effects. Generally, GBCAs are considered some of the safest contrast agents. However, it has been observed that they can accumulate in patient tissue, bone, and probably brain (causing nephrogenic systemic fibrosis in patients with kidney failure or insufficiency and disturbance of calcium homeostasis in the organism). The GBCAs are predominantly removed renally without metabolization. Subsequently, they do not undergo degradation processes in wastewater-treatment plants and are emitted into the aquatic ecosystem. Their occurrence was confirmed in surface waters (up to 1100 ng/L), sediments (up to 90.5 μg/g), and living organisms. Based on a literature review, there is a need to investigate the contamination of different ecosystems and to ascertain the environmental fate of Gd. Long-term ecotoxicological data, degradation, metabolism, bioaccumulation processes, and biochemical effects of the Gd complexes should be explored. These data can be used to assess detailed environmental risks because currently only hotspots with high levels of Gd can be marked as dangerous for aquatic environments according to environmental risk assessments. Environ Toxicol Chem 2018;37:1523-1534. © 2018 SETAC.
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Affiliation(s)
- Justyna Rogowska
- Department of Environmental Toxicology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Ewa Olkowska
- Department of Environmental Toxicology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Wojciech Ratajczyk
- Department of Environmental Toxicology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Lidia Wolska
- Department of Environmental Toxicology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
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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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Sheybani A, Gaba RC, Lokken RP, Berggruen SM, Mar WA. Liver Masses: What Physicians Need to Know About Ordering and Interpreting Liver Imaging. Curr Gastroenterol Rep 2017; 19:58. [PMID: 29044439 DOI: 10.1007/s11894-017-0596-3] [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] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW This paper reviews diagnostic imaging techniques used to characterize liver masses and the imaging characteristics of the most common liver masses. RECENT FINDINGS The role of recently adopted ultrasound and magnetic resonance imaging contrast agents will be emphasized. Contrast-enhanced ultrasound is an inexpensive exam which can confirm benignity of certain liver masses without ionizing radiation. Magnetic resonance imaging using hepatocyte-specific gadolinium-based contrast agents can help confirm or narrow the differential diagnosis of liver masses.
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Affiliation(s)
- Arman Sheybani
- Department of Radiology, University of Illinois at Chicago, 1740 W Taylor St Rm 2483, MC 931, Chicago, IL, 60612, USA
| | - Ron C Gaba
- Department of Radiology, University of Illinois at Chicago, 1740 W Taylor St Rm 2483, MC 931, Chicago, IL, 60612, USA
| | - R Peter Lokken
- Department of Radiology, University of Illinois at Chicago, 1740 W Taylor St Rm 2483, MC 931, Chicago, IL, 60612, USA
| | - Senta M Berggruen
- Department of Radiology, Northwestern University, NMH/Arkes Family Pavilion Suite 800, 676 N Saint Clair, Chicago, IL, 60611, USA
| | - Winnie A Mar
- Department of Radiology, University of Illinois at Chicago, 1740 W Taylor St Rm 2483, MC 931, Chicago, IL, 60612, USA.
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Donato H, França M, Candelária I, Caseiro-Alves F. Liver MRI: From basic protocol to advanced techniques. Eur J Radiol 2017; 93:30-39. [PMID: 28668428 DOI: 10.1016/j.ejrad.2017.05.028] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/18/2017] [Accepted: 05/22/2017] [Indexed: 02/07/2023]
Abstract
Liver MR is a well-established modality with multiparametric capabilities. However, to take advantage of its full capacity, it is mandatory to master the technique and optimize imaging protocols, apply advanced imaging concepts and understand the use of different contrast media. Physiologic artefacts although inherent to upper abdominal studies can be minimized using triggering techniques and new strategies for motion control. For standardization, the liver MR protocol should include motion-resistant T2-w sequences, in-op phase GRE T1 and T2-w fast spin echo sequences with fat suppression. Diffusion-weighted imaging (DWI) is mandatory, especially for detection of sub-centimetre metastases. Contrast-enhanced MR is the cornerstone of liver MR, especially for lesion characterization. Although extracellular agents are the most extensively used contrast agents, hepatobiliary contrast media can provide an extra-layer of functional diagnostic information adding to the diagnostic value of liver MR. The use of high field strength (3T) increases SNR but is more challenging especially concerning artefact control. Quantitative MR belongs to the new and evolving field of radiomics where the use of emerging biomarkers such as perfusion or DWI can derive new information regarding disease detection, prognostication and evaluation of tumour response. This information can overcome some of the limitations of current tests, especially when using vascular disruptive agents for oncologic treatment assessment. MR is, today, a robust, mature, multiparametric imaging modality where clinical applications have greatly expanded from morphology to advanced imaging. This new concept should be acknowledged by all those involved in producing high quality, high-end liver MR studies.
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Affiliation(s)
- Henrique Donato
- Imaging Department, Faculty of Medicine of Coimbra, University Centre Hospitals of Coimbra (CHUC), Portugal.
| | - Manuela França
- Imaging Department, Centro Hospitalar do Porto, Portugal.
| | - Isabel Candelária
- Imaging Department, Faculty of Medicine of Coimbra, University Centre Hospitals of Coimbra (CHUC), Portugal.
| | - Filipe Caseiro-Alves
- Imaging Department, Faculty of Medicine of Coimbra, University Centre Hospitals of Coimbra (CHUC), Portugal.
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Agostini A, Kircher MF, Do RKG, Borgheresi A, Monti S, Giovagnoni A, Mannelli L. Magnetic Resonanance Imaging of the Liver (Including Biliary Contrast Agents)-Part 2: Protocols for Liver Magnetic Resonanance Imaging and Characterization of Common Focal Liver Lesions. Semin Roentgenol 2016; 51:317-333. [PMID: 27743568 DOI: 10.1053/j.ro.2016.05.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Andrea Agostini
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Radiology, School of Radiology, Università Politecnica delle Marche, Ancona, Italy
| | - Moritz F Kircher
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Richard K G Do
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Alessandra Borgheresi
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Radiology, School of Radiology, Università degli Studi di Firenze, Firenze, Italy
| | | | - Andrea Giovagnoni
- Department of Radiology, School of Radiology, Università Politecnica delle Marche, Ancona, Italy
| | - Lorenzo Mannelli
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY.
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Agostini A, Kircher MF, Do R, Borgheresi A, Monti S, Giovagnoni A, Mannelli L. Magnetic Resonance Imaging of the Liver (Including Biliary Contrast Agents) Part 1: Technical Considerations and Contrast Materials. Semin Roentgenol 2016; 51:308-316. [PMID: 27743567 DOI: 10.1053/j.ro.2016.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- A Agostini
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Radiology, School of Radiology, Universita' Politecnica delle Marche Ancona, Italy
| | - M F Kircher
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - R Do
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - A Borgheresi
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Radiology, School of Radiology, Universita' degli Studi di Firenze Firenze, Italy
| | | | - A Giovagnoni
- Department of Radiology, School of Radiology, Universita' Politecnica delle Marche Ancona, Italy
| | - L Mannelli
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY.
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