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Liu D, Qiao Z, Xu L, Fu F, Ye A, Hu C. Gd-EOB-DTPA Enhanced MRI Features of Liver Hemangiomatosis Coexistent with GCH. Curr Med Imaging 2022; 18:1390-1395. [PMID: 35657047 DOI: 10.2174/1573405618666220602113223] [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: 01/31/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES This study aimed to clarify features of giant cavernous hemangioma (GCH) and liver hemangiomatosis, existing simultaneously on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). METHOD A total of 17 patients with reported hepatic hemangiomatosis between 2015 and 2017 were identified retrospectively. All our patients underwent pre-contrast MRI, triphasic (atrial, portal, venous) Gd-EOB-DTPA dynamic enhancement and hepatobiliary phase (20 minutes delayed). The location, size, morphology and signal characteristics on T1-weighted (T1WI) and T2-weighted images (T2WI), and Gd-EOB-DTPA-enhanced MRI of liver hemangiomatosis were evaluated. RESULTS Hemangiomatosis involved the liver adjacent to the edge of the GCH with no normal liver tissue found in 13 cases; in the other 4 patients, a small area of normal liver tissue separated GCH from hemangiomatosis was seen. On non-contrast MRI images, hemangionmatosis presented as numerous microcystic lesions, with low signal intensity on T1WI and high signal intensity on T2WI, compared with unaffected liver. After administration of Gd-EOB-DTPA, heterogeneous enhancement was presented in the arterial phase, during portal and venous phase imaging, becoming more homogeneous. 11 cases showed hypointensity in the hepatobiliary phase (6 cases with intratumor necrosis), and 6 cases showed hyper-intensity in the hepatobiliary phase with a remaining unfilled portion. CONCLUSION Hemangiomatosis is extremely rare in the liver adjacent to a GCH. MRI is of great diagnostic and clinical value for this kind of tumor according to the configuration, size, signal, and style of enhancement, but the final diagnosis depends on pathology. Gd-EOB-DTPA-enhanced MRI may help in diagnosing hemangiomatosis coexistent with GCH.
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Affiliation(s)
- Dong Liu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhenguo Qiao
- Department of Gastroenterology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China
| | - Lihua Xu
- Department of Science and Education, Nantong No. 6 People's Hospital, Nantong, China
| | - Fangfang Fu
- Department of Radiology, Henan Provincial People\'s Hospital, Zhengzhou, China
| | - Aihua Ye
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chunhong Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Poetter-Lang S, Dovjak GO, Messner A, Ambros R, Polanec SH, Baltzer PAT, Kristic A, Herold A, Hodge JC, Weber M, Bastati N, Ba-Ssalamah A. Influence of dilution on arterial-phase artifacts and signal intensity on gadoxetic acid-enhanced liver MRI. Eur Radiol 2022; 33:523-534. [PMID: 35895119 DOI: 10.1007/s00330-022-08984-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/17/2022] [Accepted: 06/22/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the effect of saline-diluted gadoxetic acid, done for arterial-phase (AP) artifact reduction, on signal intensity (SI), and hence focal lesion conspicuity on MR imaging. METHODS We retrospectively examined 112 patients who each had at least two serial gadoxetic acid-enhanced liver MRIs performed at 1 ml/s, first with non-diluted (ND), then with 1:1 saline-diluted (D) contrast. Two blinded readers independently analyzed the artifacts and graded dynamic images using a 5-point scale. The absolute SI of liver parenchyma, focal liver lesions (if present), aorta, and portal vein at the level of the celiac trunk and the SI of the paraspinal muscle were measured in all phases. The signal-to-norm (SINorm) of the vascular structures, hepatic parenchyma and focal lesions, and the contrast-to-norm (CNorm) of focal liver lesions were calculated. RESULTS AP artifacts were significantly reduced with dilution. Mean absolute contrast-enhanced liver SI was significantly higher on the D exams compared to the ND exams. Likewise, SINorm of liver parenchyma was significantly higher in all contrast-enhanced phases except transitional phase on the D exams. SINorm values in the AP for the aorta and in the PVP for portal vein were significantly higher on the diluted exams. The CNorm was not significantly different between ND and D exams for lesions in any imaging phase. The interclass correlation coefficient was excellent (0.89). CONCLUSION Gadoxetic acid dilution injected at 1ml/s produces images with significantly fewer AP artifacts but no significant loss in SINorm or CNorm compared to standard non-diluted images. KEY POINTS • Diluted gadoxetic acid at slow injection (1 ml/s) yielded images with higher SINorm of the liver parenchyma and preserved CNorm for focal liver lesions. • Gadoxetic acid-enhanced MRI injected at 1 ml/s is associated with arterial-phase (AP) artifacts in 31% of exams, which may degrade image quality and limits focal liver lesion detection. • Saline dilution of gadoxetic acid 1:1 combined with a slow injection rate of 1 ml/s significantly reduced AP artifacts from 31 to 9% and non-diagnostic AP artifacts from 16 to 1%.
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Affiliation(s)
- Sarah Poetter-Lang
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Gregor O Dovjak
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Alina Messner
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Raphael Ambros
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Stephan H Polanec
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Pascal A T Baltzer
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Antonia Kristic
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Alexander Herold
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Jacqueline C Hodge
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Michael Weber
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Nina Bastati
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Ahmed Ba-Ssalamah
- Department of Biomedical Imaging and Image-Guided Therapy, General Hospital of Vienna (AKH), Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Hemachandran N, Gamanagatti S, Sharma R, Kumar A, Gupta A, Kumar S. Unidentified bright objects of spleen on arterial phase CT: mimicker of splenic vascular injury in blunt abdominal trauma. Diagn Interv Radiol 2021; 27:497-503. [PMID: 34313234 DOI: 10.5152/dir.2021.20278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We have described unidentified bright objects of spleen (UBOS), a hitherto undescribed entity, as hyperdense areas on arterial phase (AP) computed tomography (CT) seen in relation to splenic lacerations and are isodense to the normal parenchyma on portal venous phase with no correlate on digital subtraction angiography (DSA). UBOS mimic splenic vascular injuries like active contrast extravasation and pseudoaneurysm and need to be differentiated from them as it would have implications on patient management. We undertook this study to identify CT features of UBOS that can differentiate them from splenic vascular injuries and to calculate their diagnostic accuracy. METHODS This retrospective study was approved by the institutional ethical committee and the need for informed consent was waived. Patients with splenic injury who had undergone dual-phase CT and DSA were included. All the lesions that were hyperdense on AP were evaluated for their outline, their relation to the adjacent/parallel margins of a laceration (margin sign), string of beads appearance, and the presence of adjacent normal parenchyma (adjacent parenchyma sign). The Hounsfield unit (HU) of the lesion and the aorta on the AP were also noted. The diagnostic accuracy of various signs for distinguishing UBOS from splenic vascular injuries was calculated using DSA as the reference standard. RESULTS Of 48 patients, 5 were excluded due to suboptimal quality of the examination or a time difference of more than 6 hours between the CT and DSA. A total of 54 hyperdense lesions were detected on AP in 43 patients. These were classified as vascular injuries (pseudoaneurysm, n=11; active contrast extravasation, n=11) and UBOS (n=32) based on DSA. The margin sign, string of beads appearance, and ill-defined outline had high specificity (95%, 86%, and 82%, respectively) but low sensitivity (50%, 65%, and 63%, respectively). The adjacent parenchyma sign had a moderate sensitivity and specificity of 84% and 77%, respectively. ROC analysis showed that a difference of 50 HU between the aorta and the lesion had a high sensitivity and specificity of 88.9% and 90.6%, respectively, with an area under the curve of 0.90. CONCLUSION An attenuation difference of over 50 HU between the aorta and the lesion and the presence of normal adjacent parenchyma had the highest diagnostic accuracy, while an ill-defined outline, string of beads appearance, and margin sign had high specificity but low sensitivity for differentiating UBOS from splenic vascular injuries.
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Affiliation(s)
- Naren Hemachandran
- JPN Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, India
| | - Shivanand Gamanagatti
- JPN Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, India
| | - Raju Sharma
- JPN Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, India
| | - Atin Kumar
- JPN Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, India
| | - Amit Gupta
- JPN Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, India
| | - Subodh Kumar
- JPN Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, India
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Gadoxetic acid-enhanced MRI for diagnosis of hepatocellular carcinoma in patients with chronic liver disease: can hypointensity on the late portal venous phase be used as an alternative to washout? Abdom Radiol (NY) 2020; 45:2705-2716. [PMID: 32382820 DOI: 10.1007/s00261-020-02553-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To investigate the added value of considering hypointensity on late portal venous phase (LPVP) images as washout for diagnosis of hepatocellular carcinoma (HCC) using gadoxetic acid-enhanced MRI (Gd-EOB-MRI) in patients with chronic liver disease (CLD). METHODS This retrospective study comprised 97 patients at high risk for HCC who underwent Gd-EOB-MRI including unenhanced, multi-arterial phase, conventional portal venous phase (CPVP, 60 s), and LPVP (mean, 99.9 ± 9.1 s; range, 90-119 s) images. A total of 115 hepatic lesions were identified by histopathological or clinical diagnosis. Three independent radiologists assessed the MRI images by consensus. Diagnosis of HCC was made using criteria of arterial hyperenhancement and hypointensity relative to the surrounding liver parenchyma (1) on CPVP or (2) on CPVP and/or LPVP images. The generalized estimating equation was used to compare diagnostic performance for HCC between Criterion 1 and 2. RESULTS In 82 HCCs, the frequency of hypointensity differed significantly between the CPVP and LPVP images (64.6% [53/82] vs. 84.1% [69/82], P < 0.001). Among 33 non-HCCs, two cHCC-CCs showed additional hypointensity on LPVP than CPVP images (33.3% [11/33] vs. 39.4% [13/33], P = 0.500). Criterion 2 provided significantly greater sensitivity for diagnosing HCC than Criterion 1 (54.9% [45/82] vs. 74.4% [61/82], P < 0.001), with relatively little reduction in specificity (90.9% [30/33] vs. 84.8% [28/33], P = 0.145). CONCLUSION Additional use of LPVP hypointensity as washout could significantly improve sensitivity for HCC diagnosis when utilizing Gd-EOB-MRI in patients with CLD, without a significant decrease in specificity.
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Liu X, Zhang W, Li Z, Fu Y, Ren J, Shen W, Wang J, Xu Y, Song B. Improved display of abdominal contrast-enhanced MRA using gadobutrol: comparison with Gd-DTPA. Clin Radiol 2019; 74:978.e1-978.e7. [PMID: 31551147 DOI: 10.1016/j.crad.2019.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 08/20/2019] [Indexed: 02/05/2023]
Abstract
AIM To qualitatively and quantitatively compare gadobutrol with gadopentetate dimeglumine (Gd-DTPA) in abdominal contrast-enhanced magnetic resonance angiography (CE-MRA) and contrast-enhanced magnetic resonance imaging (CE-MRI) during one-stop imaging. MATERIALS AND METHODS This prospective, blinded, multicentre, intra-individual comparison study was approved by the institutional review board. All patients underwent gadobutrol- and Gd-DTPA-enhanced MRA and MRI. Qualitative analysis for vessels was performed using a three-point scale while quantity analysis was performed by signal-to-noise ratio (SNR). Visceral organs enhancements were also analysed. A Wilcoxon matched-pair signed-rank test was used to evaluate the quality and quantity results. RESULTS One hundred and twelve patients were enrolled. Quality analyses results for large vessels and small vessels of gadobutrol and Gd-DTPA were 18.38±1.51 and 6.76±1.58 and 17.87±1.84 and 6.09±1.55, respectively. Wilcoxon signed-rank tests revealed gadobutrol was significantly superior to Gd-DTPA (p=0.036) for small vessels. For large vessel quantity analysis, gadobutrol demonstrated significantly higher signal-to-noise ratios (SNR; p=0.041) than Gd-DTPA, with mean values of 948.156±349.731 and 838.925±248.197. There was no statistically significant in enhancement of liver, spleen, and renal tissue during gadobutrol- and Gd-DTPA-enhanced imaging (p>0.05). One patient reported an adverse event. Dizziness and vomiting occurred after injection of Gd-DTPA. CONCLUSIONS The present study demonstrates gadobutrol-enhanced MRA was superior to that of Gd-DTPA without statistical significance in visceral organ enhancement. It indicates gadobutrol may be more suitable for abdominal one-stop imaging for CE-MRA and CE-MRI by improving depiction of vessels in MRA images.
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Affiliation(s)
- X Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - W Zhang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Z Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Y Fu
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - J Ren
- Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China
| | - W Shen
- Department of Radiology, Tianjin First Central Hospital, Tianjin, Tianjin Province, China
| | - J Wang
- Department of Radiology, The Third Affiliated Hospital of Zhongshan University, Guangzhou, Guangdong Province, China
| | - Y Xu
- Department of Radiology, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong Province, China
| | - B Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Fehrenbach U, Kahn J, Fahlenkamp U, Baur A, Pavel M, Geisel D, Denecke T. Optimized imaging of the lower abdomen and pelvic region in hepatocyte-specific MRI: evaluation of a whole-abdomen first-pass shuttle protocol in patients with neuroendocrine neoplasms. Acta Radiol 2019; 60:1074-1083. [PMID: 30541328 DOI: 10.1177/0284185118817936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Uli Fehrenbach
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Johannes Kahn
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Ute Fahlenkamp
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander Baur
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Bereich klinische Nuklearmedizin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Marianne Pavel
- Medizinische Klinik m.S. Hepatologie und Gastroenterologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Medizinische Klinik, Endokrinologie, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Dominik Geisel
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Timm Denecke
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Bereich klinische Nuklearmedizin, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Liu X, Li Z, Zhang W, Yang C, Diao Y, Duan T, Fu Y, Ren J, Bin S. Gadobutrol Precedes Gd-DTPA in Abdominal Contrast-Enhanced MRA and MRI: A Prospective, Multicenter, Intraindividual Study. CONTRAST MEDIA & MOLECULAR IMAGING 2019; 2019:9738464. [PMID: 31866800 PMCID: PMC6914877 DOI: 10.1155/2019/9738464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/22/2019] [Accepted: 10/26/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To qualitatively and quantitatively compare the contrast-enhanced magnetic resonance angiography (MRA) and magnetic resonance imaging (MRI) in one-stop shop of abdominal imaging with Gadobutrol and Gd-DTPA at equimolar doses of gadolinium. MATERIALS AND METHODS This was a prospective designed, multiple center, intraindividual comparison study. All volunteers underwent Gadobutrol- and Gd-DTPA-enhanced MRA and MRI in one-stop shop. Qualitative analysis for large vessels and small vessels was performed by a three-point scale, while for minute small vessels, by a five-point scale. Quantitative analysis was performed for large vessels by signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Visceral organ enhancements on the equilibrium phase were also analyzed. Wilcoxon matched-pair signed-rank tests were used to evaluate the qualitative and quantitative results. RESULTS 40 volunteers were enrolled. Qualitative analyses results for large vessels, small vessels, and minute small vessels of Gadobutrol and Gd-DTPA were 20.98 ± 2.11, 6.03 ± 1.03, and 3.41 ± 1.18 and 20.01 ± 2.18, 5.28 ± 1.67, and 2.61 ± 1.40, respectively. Wilcoxon signed-rank tests revealed Gadobutrol-enhanced MRA was superior to that of Gd-DTPA significantly for small vessels (p=0.028) and minute small vessels (p=0.007). For quantitative analysis of large vessels, no statistic difference was found. Gadobutrol-enhanced MRI had higher CNR of the liver (p=0.003), spleen (p=0.001), and pancreas (p=0.001) and higher SNR of spleen (p=0.009) than those of Gd-DTPA statistically. CONCLUSION Our study proved Gadobutrol was superior to Gd-DTPA in qualitative analysis of CE-MRA and quantitative analysis of visceral organ enhancement on CE-MRI in abdomen of healthy volunteers. Gadobutrol may be more suitable for abdominal one-stop examination for CE-MRA and CE-MRI.
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Affiliation(s)
- Xijiao Liu
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Zhengyan Li
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Weiwei Zhang
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Caiwei Yang
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yike Diao
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ting Duan
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yu Fu
- 2Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jing Ren
- 3Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China
| | - Song Bin
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Kurozumi M, Fujinaga Y, Kitou Y, Yamada A, Ohya A, Adachi Y, Tsukahara Y, Nickel MD, Maruyama K, Uehara T, Miyagawa SI, Kadoya M. Evaluation of hemodynamic imaging findings of hypervascular hepatocellular carcinoma: comparison between dynamic contrast-enhanced magnetic resonance imaging using radial volumetric imaging breath-hold examination with k-space-weighted image contrast reconstruction and dynamic computed tomography during hepatic arteriography. Jpn J Radiol 2018; 36:295-302. [PMID: 29327116 DOI: 10.1007/s11604-018-0720-9] [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: 09/08/2017] [Accepted: 01/03/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE To compare the visualization of hemodynamic imaging findings of hypervascular hepatocellular carcinoma (HCC) on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using radial volumetric imaging breath-hold examination with k-space-weighted image contrast reconstruction (r-VIBE-KWIC) versus dynamic computed tomography during hepatic arteriography (dyn-CTHA). MATERIALS AND METHODS We retrospectively reviewed the databases of preoperative DCE-MRI using r-VIBE-KWIC, dyn-CTHA, and postoperative pathology of resected specimens. Fourteen patients with 14 hypervascular HCCs underwent both DCE-MRI and dyn-CTHA. The imaging findings of the tumor and adjacent liver parenchyma were assessed on both modalities by two readers. The tumor enhancement time was also compared between the two modalities. RESULTS On DCE-MRI/dyn-CTHA, early staining, peritumoral low-intensity or low-density bands, corona enhancement, and washout of HCC were observed in 14/14 (100%), 10/12 (83%), 11/14 (78%), and 4/14 (29%) patients, respectively. Pathologically, four HCCs with low-density bands on dyn-CTHA had no fibrous capsules. The median tumor enhancement time on DCE-MRI and dyn-CTHA was 24 (9-24) and 23 (8-35) s, respectively. The correlation coefficient between the two groups was 0.762 (P < 0.002). CONCLUSIONS DCE-MRI using r-VIBE-KWIC has diagnostic potential comparable with that of dyn-CTHA in the hemodynamic evaluation of hypervascular HCC except for the washout phenomenon.
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Affiliation(s)
- Masahiro Kurozumi
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
| | - Yasunari Fujinaga
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
| | - Yoshihiro Kitou
- Radiology Division of Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
| | - Akira Yamada
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
| | - Ayumi Ohya
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
| | - Yasuo Adachi
- Radiology Division of Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
| | - Yoshinori Tsukahara
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
| | | | - Katsuya Maruyama
- DI Research and Collaboration Department, Siemens Healthcare K.K., Shinagawa, Tokyo, Japan
| | - Takeshi Uehara
- Department of Laboratory Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
| | - Shin-Ichi Miyagawa
- First Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
| | - Masumi Kadoya
- Radiology Division of Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
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Hwang JA, Jang KM, Kim SH, Kang TW, Song KD, Cha DI, Ahn S. Integration of different criteria for borderline resectable pancreatic cancer using classification tree analysis: the use of radiological tumour-vascular interface in correlation with surgical and pathological outcomes. Clin Radiol 2017; 73:321.e1-321.e10. [PMID: 29221719 DOI: 10.1016/j.crad.2017.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/02/2017] [Indexed: 02/07/2023]
Abstract
AIM To integrate various criteria for borderline resectable pancreatic cancer (BRPC) based on radiological parameters using classification tree analysis. MATERIALS AND METHODS The institutional review board approved this retrospective study and waived the requirement for informed consent. Two hundred and thirty-five tumour-vein interfaces and 67 tumour-artery interfaces in 245 patients with surgically confirmed pancreatic ductal adenocarcinoma who underwent both preoperative computed tomography (CT) and magnetic resonance imaging (MRI) were assessed by two independent readers. Radiological parameters for evaluation of the tumour-vascular interface were boundary, length of interface, degree of circumferential interface, and contour deformity of affected vessels. Classification tree analysis was performed to determine parameters associated with vascular invasion using pathological and surgical results as the reference standard. RESULTS In the classification tree analysis for the tumour-vein interface, contour deformity and degree of circumferential interface were the first and second determining factors, respectively, for both surgical and pathological vascular invasion. For the tumour-artery interface, boundary and degree of circumferential interface were the first and second determining factors for surgical invasion, while contour deformity and length of interface were the first and second determining factors for pathological invasion. The BRPC group of modified criteria arbitrarily formed based on the results had similar surgical (74.1-81.6%) and pathological (54.3-63.3%) venous invasion compared to that of the National Comprehensive Cancer Network (NCCN) criteria, and the lowest surgical (33.3%) and pathological (6.7%) arterial invasion compared with those in previously established criteria for BRPC (43.3-55.6% and 22.2-26.1%, respectively). CONCLUSION Various criteria for BRPCs were integrated using classification tree analysis, and a modified criterion for BRPC, which provides satisfactory results, was established.
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Affiliation(s)
- J A Hwang
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea
| | - K M Jang
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - S H Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - T W Kang
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - K D Song
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D I Cha
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S Ahn
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
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11
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Schelhorn J, Best J, Dechêne A, Göbel T, Bertram S, Lauenstein T, Kinner S. Evaluation of combined Gd-EOB-DTPA and gadobutrol magnetic resonance imaging for the prediction of hepatocellular carcinoma grading. Acta Radiol 2016; 57:932-8. [PMID: 26586852 DOI: 10.1177/0284185115616293] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 10/15/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND Tumor biopsy is not essential for the diagnosis of hepatocellular carcinoma (HCC); however, grading remains important for the prognosis. PURPOSE To investigate whether combined Gd-EOB-DTPA and gadobutrol liver magnetic resonance imaging (MRI) can predict HCC grading. MATERIAL AND METHODS Thirty patients (66.6 ± 7.3 years) with histologically confirmed HCC (grade 1, n = 5; grade 1-2, n = 6; grade 2, n = 13; grade 2-3, n = 2; grade 3, n = 4) underwent two liver MRIs, one with gadobutrol and one with Gd-EOB-DTPA, on consecutive days. Blinded to grading, two radiologists reviewed the gadobutrol and Gd-EOB-DTPA images in consensus with respect to: (i) HCC hyper-/iso-/hypointensity in the arterial, portal-venous/delayed, and Gd-EOB-DTPA hepatocellular phase; and (ii) morphologic tumor features (encapsulated growth, vessel invasion, heterogeneity, liver capsule infiltration, satellite metastases). RESULTS A significant correlation with grading was not found for either the combined dynamic information of all gadobutrol phases (r = -0.187, P = 0.331) or all the Gd-EOB-DTPA phases (r = 0.052, P = 0.802). No correlation with grading was found for a combination of arterial and hepatocellular phase in Gd-EOB-DTPA MRI (r = 0.209, P = 0.305), a combination of both arterial phases (gadobutrol and Gd-EOB-DTPA) with the Gd-EOB-DTPA hepatocellular phase (r = 0.240, P = 0.248), or a combination of all available gadobutrol and Gd-EOB-DTPA phases (r = 0.086, P = 0.691). For all gadobutrol information (dynamic phases and morphology; r = 0.049, P = 0.801) and for all Gd-EOB-DTPA information (r = 0.040, P = 0.845), no correlation with grading was found. Hepatocellular Gd-EOB-DTPA phase iso-/hyperintensity never occurred in grade 3 HCCs. CONCLUSION Histological HCC grading cannot be predicted by combined Gd-EOB-DTPA/gadobutrol MRI. However, Gd-EOB-DTPA hepatocellular phase iso-/hyperintensity was never detected in grade 3 HCCs.
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Affiliation(s)
- Juliane Schelhorn
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Jan Best
- Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
| | - Alexander Dechêne
- Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
| | - Thomas Göbel
- Department of Gastroenterology and Hepatology, Petrus Hospital, Wuppertal, Germany
| | - Stefanie Bertram
- Department of Pathology, University Hospital Essen, Essen, Germany
| | - Thomas Lauenstein
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Sonja Kinner
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
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12
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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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13
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Choi SY, Kim SH, Jang KM, Kang TW, Song KD, Moon JY, Choi YH, Lee BR. The value of contrast-enhanced dynamic and diffusion-weighted MR imaging for distinguishing benign and malignant splenic masses. Br J Radiol 2016; 89:20160054. [PMID: 27164031 DOI: 10.1259/bjr.20160054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To assess the value of contrast-enhanced dynamic and diffusion-weighted (DW) MR imaging for differentiating malignant from benign splenic lesions. METHODS This retrospective study included 51 patients with 35 benign and 16 malignant focal splenic lesions. All patients underwent contrast-enhanced dynamic and DW MR imaging. Two radiologists evaluated the MR images in consensus. Significant imaging findings on univariate and multivariate analyses were identified and their diagnostic performance for predicting the malignant splenic lesion was analyzed. Using receiver-operating characteristic analysis, the optimal cut-off of the apparent diffusion coefficient (ADC) value corresponding to the maximal Youden's index (J) for differentiating the two groups was determined. RESULTS In univariate analysis, low signal intensity (SI) on the arterial, portal and 3-min delayed-phase images, high or iso SI on the DW image, iso or low SI on the ADC map, the presence of diffusion restriction and arterial hypovascularity with a progressive enhancement pattern were more frequently observed (p < 0.05) in malignant splenic lesions. The ADC value was significantly lower for malignancy than for benignancy (0.78 ± 0.24 vs 1.16 ± 0.53 × 10(-3) mm(2) s(-1); p < 0.001). The optimal cut-off ADC value for differentiating the two groups was 0.995 × 10(-3) mm(2) s(-1). In multivariate analysis, findings that differentiated malignant from benign splenic lesions were low SI on the 3-min delayed-phase image [odds ratio (OR), 27.68; p = 0.006] and the presence of diffusion restriction (OR, 48.01; p = 0.002). When two of these criteria were combined, 12 (75.0%) of 16 malignant splenic masses were identified with a specificity of 100%. CONCLUSION Contrast-enhanced dynamic and DW MR imaging may be helpful for differentiating malignant from benign splenic lesions. A low SI on the 3-min delayed phase and diffusion restriction are the most reliable findings for the differentiation of malignant from benign splenic lesions. ADVANCES IN KNOWLEDGE Dynamic and DW MR imaging help in distinguishing malignant from benign splenic lesions. A low SI on the 3-min delayed phase and diffusion restriction are the most reliable findings for the differentiation of malignant from benign splenic lesions.
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Affiliation(s)
- Seo-Youn Choi
- 1 Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea
| | - Seong Hyun Kim
- 2 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung Mi Jang
- 2 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Wook Kang
- 2 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyoung Doo Song
- 2 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Yoon Moon
- 3 Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Yoon-Hyeong Choi
- 4 Department of Preventive Medicine, Gachon University Graduate School of Medicine, Incheon, Republic of Korea
| | - Bo Ra Lee
- 5 Department of Biomedical Statistics, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
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TATEYAMA A, FUKUKURA Y, TAKUMI K, SHINDO T, KUMAGAE Y, NAKAMURA F. Hepatic Hemangiomas: Factors Associated with Pseudo Washout Sign on Gd-EOB-DTPA-enhanced MR Imaging. Magn Reson Med Sci 2016; 15:73-82. [DOI: 10.2463/mrms.2014-0125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Akihiro TATEYAMA
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Yoshihiko FUKUKURA
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Koji TAKUMI
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Toshikazu SHINDO
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Yuichi KUMAGAE
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Fumihiko NAKAMURA
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences
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15
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Kupczyk PA, Willinek WA, Hadizadeh DR, Traeber F, Gieseke J, Meyer C, Schild HH, Kukuk GM. Abdominal vasculature in dynamic contrast-enhanced liver MRI at 3.0T: an intraindividual comparative study using gadoxetate disodium and gadofosveset trisodium. Magn Reson Imaging 2015; 33:1258-1266. [PMID: 26271178 DOI: 10.1016/j.mri.2015.08.001] [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: 01/12/2015] [Accepted: 08/05/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To intraindividually compare gadoxetate disodium and gadofosveset trisodium regarding vessel contrast, image quality and vessel delineation in dynamic contrast-enhanced liver MRI at 3.0T. METHODS Twelve patients underwent 3.0T MRI twice (24 examinations) with a single dose of gadoxetate disodium and gadofosveset trisodium, respectively. Signal intensity in abdominal vessels and tissue was determined. Vessel-to-background ratio (VBR) was calculated for each vessel and dynamic phase. All images were evaluated by two radiologists regarding image quality, vessel delineation and anatomic variants or pathologies with digital subtraction angiography as the standard of reference. RESULTS Gadofosveset trisodium demonstrated a significantly higher VBR compared to gadoxetate disodium (arterial phase: 0.57±0.12 [SD] vs. 0.46±0.19; portal venous phase: 0.51±0.11 vs. 0.37±0.14; equilibrium phase: 0.48±0.10 vs. 0.31±0.13; p≤0.01). Image quality and vessel delineation were rated equal or better for gadofosveset trisodium in all cases. These differences were not significant for most vessel segments. All anatomic variants were correctly identified by both readers for both contrast agents. CONCLUSIONS Although gadofosveset trisodium provides a significantly higher vessel contrast at 3.0T, gadoxetate disodium is equivalent by qualitative measurements. Thus, gadoxetate-enhanced liver MRI at 3.0T enables reliable assessment of the upper abdominal vasculature with the additional benefit of hepatobiliary imaging.
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Affiliation(s)
- Patrick A Kupczyk
- Department of Radiology - University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Winfried A Willinek
- Department of Radiology - University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Dariusch R Hadizadeh
- Department of Radiology - University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Frank Traeber
- Department of Radiology - University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Juergen Gieseke
- Department of Radiology - University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Carsten Meyer
- Department of Radiology - University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Hans H Schild
- Department of Radiology - University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Guido M Kukuk
- Department of Radiology - University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
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16
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Besa C, Kakite S, Cooper N, Facciuto M, Taouli B. Comparison of gadoxetic acid and gadopentetate dimeglumine-enhanced MRI for HCC detection: prospective crossover study at 3 T. Acta Radiol Open 2015; 4:2047981614561285. [PMID: 25793110 PMCID: PMC4364400 DOI: 10.1177/2047981614561285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 10/31/2014] [Indexed: 12/29/2022] Open
Abstract
Background Gadoxetic acid and gadopentetate dimeglumine are gadolinium-based contrast agents (GBCAs) with an established role in HCC detection and characterization. Purpose To compare gadopentetate dimeglumine and gadoxetic acid-enhanced magnetic resonance imaging (MRI) for image quality and hepatocellular carcinoma (HCC) detection/conspicuity. Material and Methods In this IRB approved cross-over pilot prospective study, 12 patients (all men; mean age, 56 years) with chronic liver disease at risk of HCC underwent two repeat MRI examinations using gadopentetate dimeglumine and gadoxetic acid (mean interval between studies, 5 days). Two independent observers analyzed images for image quality and HCC detection/conspicuity. Per-lesion sensitivity, positive predictive value, quantitative enhancement, and lesion-to-liver contrast ratio were calculated for both contrast agents. Results There was no significant difference in image quality scores between both GBCAs (P = 0.3). A total of 20 HCCs were identified with reference standard in 12 patients (mean size 2.6 cm, range, 1.0–5.0 cm). Higher sensitivity was seen for observer 1 for gadoxetic acid-set in comparison with gadopentetate dimeglumine-set (sensitivity increased from 85.7% to 92.8%), while no difference was noted for observer 2 (sensitivity of 78.5%). Lesion conspicuity was significantly higher on hepatobiliary phase (HBP) images compared to arterial phase images with both GBCAs for both observers (P < 0.05). Lesion-to-liver contrast ratios were significantly higher for HBP compared to all dynamic phases for both agents (P < 0.05). Conclusion Our initial experience suggests that gadoxetic acid-set was superior to gadopentetate dimeglumine-set in terms of HCC detection for one observer, with improved lesion conspicuity and liver-to-lesion contrast on HBP images.
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Affiliation(s)
- Cecilia Besa
- Department of Radiology, Body MRI, Icahn School of Medicine at Mount Sinai, New York, NY, USA ; Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Suguru Kakite
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nancy Cooper
- Department of Radiology, Body MRI, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marcelo Facciuto
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bachir Taouli
- Department of Radiology, Body MRI, Icahn School of Medicine at Mount Sinai, New York, NY, USA ; Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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17
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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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18
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Choi JY, Lee JM, Sirlin CB. CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part I. Development, growth, and spread: key pathologic and imaging aspects. Radiology 2014; 272:635-54. [PMID: 25153274 PMCID: PMC4263631 DOI: 10.1148/radiol.14132361] [Citation(s) in RCA: 322] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Computed tomography (CT) and magnetic resonance (MR) imaging play critical roles in the diagnosis and staging of hepatocellular carcinoma (HCC). The first article of this two-part review discusses key concepts of HCC development, growth, and spread, emphasizing those features with imaging correlates and hence most relevant to radiologists; state-of-the-art CT and MR imaging technique with extracellular and hepatobiliary contrast agents; and the imaging appearance of precursor nodules that eventually may transform into overt HCC.
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Affiliation(s)
- Jin-Young Choi
- From the Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Seoul, Korea (J.Y.C.); Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea (J.M.L.); and Liver Imaging Group, Department of Radiology, University of California, San Diego Medical Center, 408 Dickinson St, San Diego, CA 92103-8226 (C.B.S.)
| | - Jeong-Min Lee
- From the Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Seoul, Korea (J.Y.C.); Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea (J.M.L.); and Liver Imaging Group, Department of Radiology, University of California, San Diego Medical Center, 408 Dickinson St, San Diego, CA 92103-8226 (C.B.S.)
| | - Claude B. Sirlin
- From the Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Seoul, Korea (J.Y.C.); Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea (J.M.L.); and Liver Imaging Group, Department of Radiology, University of California, San Diego Medical Center, 408 Dickinson St, San Diego, CA 92103-8226 (C.B.S.)
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19
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Schalkx HJ, van Stralen M, Coenegrachts K, van den Bosch MAAJ, van Kessel CS, van Hillegersberg R, van Erpecum KJ, Verkooijen HM, Pluim JPW, Veldhuis WB, van Leeuwen MS. Liver perfusion in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI): comparison of enhancement in Gd-BT-DO3A and Gd-EOB-DTPA in normal liver parenchyma. Eur Radiol 2014; 24:2146-56. [DOI: 10.1007/s00330-014-3275-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 05/26/2014] [Accepted: 06/03/2014] [Indexed: 01/01/2023]
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20
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Kühn JP, Spoerl M, Nassif A, Mester M, Weitschies W, Siegmund W, Hosten N, Mensel B. Feasibility of gadoxetate disodium-enhanced MR cholangiography in chronic cholestatic biliary disease. Clin Radiol 2014; 69:1027-33. [PMID: 24957855 DOI: 10.1016/j.crad.2014.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 05/05/2014] [Accepted: 05/08/2014] [Indexed: 12/22/2022]
Abstract
AIM To investigate the feasibility of gadoxetate disodium-enhanced magnetic resonance (MR) cholangiography in chronic obstructive cholestatic biliary disease in the clinical setting. MATERIALS AND METHODS Twenty-three patients with dilated bile duct trees and ten volunteers underwent gadoxetate disodium-enhanced liver MR cholangiography and were enrolled in the present retrospective study. Gadoxetate disodium was given in a standardized manner as a bolus injection at a dose of 0.25 mmol/kg of body weight (0.1 ml/kg). Region of interest-based measurement of mean enhancement of the dilated bile ducts was performed in series before gadoxetate disodium administration and during hepatobiliary phases. RESULTS Direct comparison of mean bile duct enhancement during hepatobiliary phases in the clinical imaging window between healthy volunteers [4.7 ± 2.2 arbitrary units (au)] and patients with dilated bile ducts (0.1 ± 0.3 au) revealed significantly lower or absent enhancement in dilated bile ducts (p = 0.001). CONCLUSION Standard clinical gadoxetate disodium-enhanced MR cholangiography is not a reliable technique for the evaluation of the biliary trees, because of altered biliary gadoxetate disodium elimination in patients with chronic obstructive biliary diseases.
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Affiliation(s)
- J-P Kühn
- Department of Radiology and Neuroradiology, Ernst Moritz Arndt University Greifswald, Ferdinand-Sauerbruch-Straße NK, Greifswald, D-17475, Germany.
| | - M Spoerl
- Department of Radiology and Neuroradiology, Ernst Moritz Arndt University Greifswald, Ferdinand-Sauerbruch-Straße NK, Greifswald, D-17475, Germany
| | - A Nassif
- Department of Clinical Pharmacology, Ernst Moritz Arndt University Greifswald, Felix Hausdorff-Strasse 3, Greifswald, D-17475, Germany
| | - M Mester
- Department of Radiology and Neuroradiology, Ernst Moritz Arndt University Greifswald, Ferdinand-Sauerbruch-Straße NK, Greifswald, D-17475, Germany
| | - W Weitschies
- Department of Biopharmacy and Pharmaceutical Technology, Ernst Moritz Arndt University Greifswald, Felix Hausdorff-Strasse 3, Greifswald, D-17475, Germany
| | - W Siegmund
- Department of Clinical Pharmacology, Ernst Moritz Arndt University Greifswald, Felix Hausdorff-Strasse 3, Greifswald, D-17475, Germany
| | - N Hosten
- Department of Radiology and Neuroradiology, Ernst Moritz Arndt University Greifswald, Ferdinand-Sauerbruch-Straße NK, Greifswald, D-17475, Germany
| | - B Mensel
- Department of Radiology and Neuroradiology, Ernst Moritz Arndt University Greifswald, Ferdinand-Sauerbruch-Straße NK, Greifswald, D-17475, Germany
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21
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Radial volumetric imaging breath-hold examination (VIBE) with k-space weighted image contrast (KWIC) for dynamic gadoxetic acid (Gd-EOB-DTPA)-enhanced MRI of the liver: advantages over Cartesian VIBE in the arterial phase. Eur Radiol 2014; 24:1290-9. [PMID: 24633374 DOI: 10.1007/s00330-014-3122-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 01/30/2014] [Accepted: 02/11/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To compare radial volumetric imaging breath-hold examination with k-space weighted image contrast reconstruction (r-VIBE-KWIC) to Cartesian VIBE (c-VIBE) in arterial phase dynamic gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (DCE-MRI) of the liver. METHODS We reviewed 53 consecutive DCE-MRI studies performed on a 3-T unit using c-VIBE and 53 consecutive cases performed using r-VIBE-KWIC with full-frame image subset (r-VIBEfull) and sub-frame image subsets (r-VIBEsub; temporal resolution, 2.5-3 s). All arterial phase images were scored by two readers on: (1) contrast-enhancement ratio (CER) in the abdominal aorta; (2) scan timing; (3) artefacts; (4) visualisation of the common, right, and left hepatic arteries. RESULTS Mean abdominal aortic CERs for c-VIBE, r-VIBEfull, and r-VIBEsub were 3.2, 4.3 and 6.5, respectively. There were significant differences between each group (P < 0.0001). The mean score for c-VIBE was significantly lower than that for r-VIBEfull and r-VIBEsub in all factors except for visualisation of the common hepatic artery (P < 0.05). The mean score of all factors except for scan timing for r-VIBEsub was not significantly different from that for r-VIBEfull. CONCLUSIONS Radial VIBE-KWIC provides higher image quality than c-VIBE, and r-VIBEsub features high temporal resolution without image degradation in arterial phase DCE-MRI. KEY POINTS Radial VIBE-KWIC minimised artefact and produced high-quality and high-temporal-resolution images. Maximum abdominal aortic enhancement was observed on sub-frame images of r-VIBE-KWIC. Using r-VIBE-KWIC, optimal arterial phase images were obtained in over 90 %. Using r-VIBE-KWIC, visualisation of the hepatic arteries was improved. A two-reader study revealed r-VIBE-KWIC's advantages over Cartesian VIBE.
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Detection of recurrent hepatocellular carcinoma on post-operative surveillance: comparison of MDCT and gadoxetic acid-enhanced MRI. ACTA ACUST UNITED AC 2014; 39:291-9. [DOI: 10.1007/s00261-013-0064-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Kühn JP, Holmes JH, Brau AC, Iwadate Y, Hernando D, Reeder SB. Navigator flip angle optimization for free-breathing T1-weighted hepatobiliary phase imaging with gadoxetic acid. J Magn Reson Imaging 2013; 40:1129-36. [DOI: 10.1002/jmri.24480] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 09/17/2013] [Indexed: 02/02/2023] Open
Affiliation(s)
- Jens-P. Kühn
- Department of Radiology and Neuroradiology; Ernst Moritz Arndt University Greifswald; Greifswald Germany
- Department of Radiology; University of Wisconsin; Madison Wisconsin USA
| | - James H. Holmes
- Global Applied Science Laboratory GE Healthcare; Madison Wisconsin USA
| | - Anja C.S. Brau
- MR Applications and Workflow GE Healthcare; Munich Germany
| | - Yuji Iwadate
- Global Applied Science Laboratory GE Healthcare; Hino Japan
| | - Diego Hernando
- Department of Radiology and Neuroradiology; Ernst Moritz Arndt University Greifswald; Greifswald Germany
- Department of Radiology; University of Wisconsin; Madison Wisconsin USA
| | - Scott B. Reeder
- Global Applied Science Laboratory GE Healthcare; Hino Japan
- Department of Medical Physics, Biomedical Engineering and Medicine; University of Wisconsin; Madison Wisconsin USA
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Feeney D, Sharkey L, Steward S, Bahr K, Henson M, Ito D, O'Brien T, Jessen C, Husbands B, Borgatti A, Modiano J. Applicability of 3T Body MRI in Assessment of Nonfocal Bone Marrow Involvement of Hematopoietic Neoplasia in Dogs. J Vet Intern Med 2013; 27:1165-71. [DOI: 10.1111/jvim.12151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 04/22/2013] [Accepted: 06/06/2013] [Indexed: 02/06/2023] Open
Affiliation(s)
- D.A. Feeney
- Department of Veterinary Clinical Sciences; University of Minnesota; St. Paul MN
| | - L.C. Sharkey
- Masonic Cancer Center; University of Minnesota; St. Paul MN
| | - S.M. Steward
- Veterinary Medical Center; University of Minnesota; St. Paul MN
| | - K.L. Bahr
- Metropolitan Veterinary Hospital; Akron OH
| | - M.S. Henson
- Masonic Cancer Center; University of Minnesota; St. Paul MN
| | - D. Ito
- Masonic Cancer Center; University of Minnesota; St. Paul MN
| | - T.D. O'Brien
- Department of Veterinary Population Medicine; University of Minnesota; St. Paul MN
| | - C.R. Jessen
- Department of Veterinary Clinical Sciences; University of Minnesota; St. Paul MN
| | | | - A. Borgatti
- Masonic Cancer Center; University of Minnesota; St. Paul MN
| | - J. Modiano
- Masonic Cancer Center; University of Minnesota; St. Paul MN
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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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Ringe KI, Boll DT, Husarik DB, Bashir MR, Gupta RT, Merkle EM. Lesion detection and assessment of extrahepatic findings in abdominal MRI using hepatocyte specific contrast agents--comparison of Gd-EOB-DTPA and Gd-BOPTA. BMC Med Imaging 2013; 13:10. [PMID: 23506523 PMCID: PMC3610274 DOI: 10.1186/1471-2342-13-10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 02/19/2013] [Indexed: 12/22/2022] Open
Abstract
Background To evaluate the contrast agent performance of Gd-EOB-DTPA and Gd-BOPTA for detection and assessment of extrahepatic findings, semi-quantitatively and qualitatively. Methods 13 patients with 19 extrahepatic lesions underwent liver MRI with Gd-EOB-DTPA and Gd-BOPTA. Quantitative and relative SNR measurements were performed in each dataset in the arterial and portalvenous phase within the extrahepatic lesion, aorta, inferior vena cava, portal vein, spleen, pancreas and renal cortex. Further, relative CNR measurements were performed. Three readers assessed contrast quality using a five-point scale and choosing the preferred image dataset. Statistical analysis consisted of a Student’s t-test with p < 0.05 deemed significant, a weighted kappa statistic for assessment of interobserver variability and an ROC analysis. Results Mean SNR after injection of Gd-BOPTA was significantly higher compared with Gd-EOB-DTPA for all measurements (p < 0.05). Mean relative SNR was also higher for Gd-BOPTA, but without being statistically significant. There was no significant difference in relative CNR. Interobserver agreement for selection of image preference was moderate (mean weighted kappa 0.485). The area under the curve for the ROC-analysis regarding contrast agent performance was 0.464. Conclusion Even though mean SNR is significantly higher after injection of Gd-BOPTA compared with Gd-EOB-DTPA, there is no significant difference in relative CNR with extrahepatic lesions being assessed equally well. Visual impression may differ after injection of Gd-EOB-DTPA, but does not influence image interpretation. Extrahepatic findings can be assessed similarly to MRI after injection of Gd-BOPTA.
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Affiliation(s)
- Kristina I Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany.
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MOTOSUGI U, ICHIKAWA T, ARAKI T. Rules, Roles, and Room for Discussion in Gadoxetic Acid-enhanced Magnetic Resonance Liver Imaging: Current Knowledge and Future Challenges. Magn Reson Med Sci 2013; 12:161-75. [DOI: 10.2463/mrms.2012-0085] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Tateyama A, Fukukura Y, Takumi K, Shindo T, Kumagae Y, Kamimura K, Nakajo M. Gd-EOB-DTPA-enhanced magnetic resonance imaging features of hepatic hemangioma compared with enhanced computed tomography. World J Gastroenterol 2012; 18:6269-6276. [PMID: 23180948 PMCID: PMC3501776 DOI: 10.3748/wjg.v18.i43.6269] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To clarify features of hepatic hemangiomas on gadolinium-ethoxybenzyl-diethylenetriaminpentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) compared with enhanced computed tomography (CT).
METHODS: Twenty-six patients with 61 hepatic hemangiomas who underwent both Gd-EOB-DTPA-enhanced MRI and enhanced CT were retrospectively reviewed. Hemangioma appearances (presence of peripheral nodular enhancement, central nodular enhancement, diffuse homogenous enhancement, and arterioportal shunt during the arterial phase, fill-in enhancement during the portal venous phase, and prolonged enhancement during the equilibrium phase) on Gd-EOB-DTPA-enhanced MRI and enhanced CT were evaluated. The degree of contrast enhancement at the enhancing portion within the hemangioma was visually assessed using a five-point scale during each phase. For quantitative analysis, the tumor-muscle signal intensity ratio (SIR), the liver-muscle SIR, and the attenuation value of the tumor and liver parenchyma were calculated. The McNemar test and the Wilcoxon’s signed rank test were used to assess the significance of differences in the appearances of hemangiomas and in the visual grade of tumor contrast enhancement between Gd-EOB-DTPA-enhanced MRI and enhanced CT.
RESULTS: There was no significant difference between Gd-EOB-DTPA-enhanced MRI and enhanced CT in the presence of peripheral nodular enhancement (85% vs 82%), central nodular enhancement (3% vs 3%), diffuse enhancement (11% vs 16%), or arterioportal shunt (23% vs 34%) during arterial phase, or fill-in enhancement (79% vs 80%) during portal venous phase. Prolonged enhancement during equilibrium phase was observed less frequently on Gd-EOB-DTPA-enhanced MRI than on enhanced CT (52% vs 100%, P < 0.001). On visual inspection, there was significantly less contrast enhancement of the enhancing portion on Gd-EOB-DTPA-enhanced MRI than on enhanced CT during the arterial (3.94 ± 0.98 vs 4.57 ± 0.64, respectively, P < 0.001), portal venous (3.72 ± 0.82 vs 4.36 ± 0.53, respectively, P < 0.001), and equilibrium phases (2.01 ± 0.95 vs 4.04 ± 0.51, respectively, P < 0.001). In the quantitative analysis, the tumor-muscle SIR and the liver-muscle SIR observed with Gd-EOB-DTPA-enhanced MRI were 0.80 ± 0.24 and 1.28 ± 0.33 precontrast, 1.92 ± 0.58 and 1.57 ± 0.55 during the arterial phase, 1.87 ± 0.44 and 1.73 ± 0.39 during the portal venous phase, 1.63 ± 0.41 and 1.78 ± 0.39 during the equilibrium phase, and 1.10 ± 0.43 and 1.92 ± 0.50 during the hepatobiliary phase, respectively. The attenuation values in the tumor and liver parenchyma observed with enhanced CT were 40.60 ± 8.78 and 53.78 ± 7.37 precontrast, 172.66 ± 73.89 and 92.76 ± 17.92 during the arterial phase, 152.76 ± 35.73 and 120.12 ± 18.02 during the portal venous phase, and 108.74 ± 18.70 and 89.04 ± 7.25 during the equilibrium phase, respectively. Hemangiomas demonstrated peak enhancement during the arterial phase, and both the SIR with Gd-EOB-DTPA-enhanced MRI and the attenuation value with enhanced CT decreased with time. The SIR of hemangiomas was lower than that of liver parenchyma during the equilibrium and hepatobiliary phases on Gd-EOB-DTPA-enhanced MRI. However, the attenuation of hemangiomas after contrast injection was higher than that of liver parenchyma during all phases of enhanced CT.
CONCLUSION: Prolonged enhancement during the equilibrium phase was observed less frequently on Gd-EOB-DTPA-enhanced MRI than enhanced CT, which may exacerbate differentiating between hemangiomas and malignant tumors.
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Fujinaga Y, Ueda H, Kitou Y, Tsukahara Y, Sugiyama Y, Kadoya M. Time-intensity curve in the abdominal aorta on dynamic contrast-enhanced MRI with high temporal and spatial resolution: Gd-EOB-DTPA versus Gd-DTPA in vivo. Jpn J Radiol 2012. [PMID: 23179788 DOI: 10.1007/s11604-012-0162-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate the difference in the time-intensity curves (TICs) of the abdominal aorta on dynamic contrast-enhanced MRI (DCE-MRI) between Gd-DTPA and Gd-EOB-DTPA. MATERIALS AND METHODS Ten healthy volunteers underwent DCE-MRI three times with the following protocol: group A, Gd-DTPA at an injection rate of 3 ml/s; group B, Gd-EOB-DTPA, 3 ml/s; group C, Gd-EOB-DTPA, 1.5 ml/s. Signal intensities (SIs) of the abdominal aorta were measured, and the contrast enhancement ratio (CER) was calculated. Time-to-CER curves were compared among the three groups. The differences in maximum CER (CERmax) and time-to-peak of CER were analyzed. RESULTS The time-to-CER curve showed a double peak pattern in group A and single-peak pattern in groups B and C. The mean time between the first and the second peak was 6.2 s. The mean CERmax of each group was 4.50, 4.52 and 4.27, respectively. In group A, B and C, the mean time-to-peak was 14.6, 10.6 and 12.6 s, respectively. There was a significant difference between group A and B (P < 0.01). CONCLUSION To set up the optimal protocol for abdominal DCE-MRI, it should be noted that TIC in the Gd-DTPA and Gd-EOB-DTPA group showed different patterns, and a slower injection rate showed a less abrupt SI change in the Gd-EOB-DTPA group than in the Gd-DTPA group.
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Affiliation(s)
- Yasunari Fujinaga
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
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Imaging features of small (≤3 cm) pancreatic solid tumors on gadoxetic-acid-enhanced MR imaging and diffusion-weighted imaging: an initial experience. Magn Reson Imaging 2012; 30:916-25. [DOI: 10.1016/j.mri.2012.02.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 02/06/2012] [Accepted: 02/17/2012] [Indexed: 11/23/2022]
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Jaw TS, Chen SH, Wang YM, Hsu JS, Kuo YT, Chiu YY, Tsai KB, Hsieh TJ, Liu GC. Comparison of Gd-Bz-TTDA, Gd-EOB-DTPA, and Gd-BOPTA for dynamic MR imaging of the liver in rat models. Kaohsiung J Med Sci 2012; 28:130-7. [PMID: 22385605 DOI: 10.1016/j.kjms.2011.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 06/10/2011] [Indexed: 10/14/2022] Open
Abstract
To evaluate the competitive potential of a new lipophilic paramagnetic complex, Gd-Bz-TTDA [4-benzyl-3,6,10-tri (carboxymethyl)-3,6,10-triazado-decanedioic acid] compared with two other commercially available MR hepatobiliary contrast agents, gadobenate dimeglumine (Gd-BOPTA) and gadoxetic acid (Gd-EOB-DTPA), dynamic MR imaging studies were performed on normal and hepatocellular carcinoma (HCC) rat models using a 1.5-Tesla MR scanner. The results indicate that normal rats that were injected with 0.1 mmol/kg Gd-Bz-TTDA showed significantly more intense and persistent liver enhancement than those that were injected with the same dose of Gd-EOB-DTPA or Gd-BOPTA. All of these agents showed similar enhancement patterns in the implanted HCC. The liver-lesion contrast-to-noise ratios were higher and more persistent in rats that were injected with Gd-Bz-TTDA. These results indicate that Gd-Bz-TTDA is comparable with the commercially available hepatobiliary agents, Gd-EOB-DTPA and Gd-BOPTA, and can result in more intense and prolonged liver enhancement while still providing better liver-lesion discrimination. These results warrant further large-scale studies.
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Affiliation(s)
- Twei-Shiun Jaw
- Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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32
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Fujinaga Y, Ohya A, Matsushita T, Kurozumi M, Ueda K, Kitou Y, Ueda H, Kadoya M. Effect of hepatobiliary uptake of Gd-EOB-DTPA on the hepatic venous phase of dynamic magnetic resonance imaging on a 3.0-T apparatus: comparison between Gd-EOB-DTPA and Gd-DTPA. Jpn J Radiol 2011; 29:695-700. [DOI: 10.1007/s11604-011-0615-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 05/26/2011] [Indexed: 11/24/2022]
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Hyodoh K, Hyodoh H, Kasahara M, Washio Y, Asai M, Hareyama M. Dynamic MR imaging of kidneys perfused with EOB-Gd-DTPA. ACTA ACUST UNITED AC 2011; 58:29-32. [PMID: 21630549 DOI: 10.2298/aci1101029h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Gandolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) is a hepatobiliary contrast agent for MRI. It was reported that Gd-EOB-DTPA is useful to detect liver tumors and differentially diagnose benign and malignant pathologies in the liver. Since Gd-EOB-DTPA partially accumulates in the hepatocytes and bile via various transporters after intravenous injection, signal intensity in the liver increases on T1-weighted images. The signal intensity of the liver after Gd-EOB-DTPA injection depends on the Gd-EOB-DTPA uptake by hepatocytes and bile excretion. It is known tha the Gd-EOB-DTPA accumulating in the kidney is excreted to the urine through glomerular filtration. Because Gd-DTPA is concentrated in the renal tubules after being filtered at the Bowman's capsule, and since it is neither secreted nor reabsorbed the concentrating and diluting function of the renal tubules can be studied by imaging techniques. since renal function can be evaluated with Gd-EOB-DTPA can also be used to evaluate renal function. Eith the development of MRI equipment and rapid imaging techniques, temporal resolution had improved greatly. However, no previous study has been carried out on renal function using Gd-EOB-DTPA dynamic MR study that was correlated with estimated glomerular filtration rate (eGFR) and stage of chronic kidney disease (CKD) in the Japan Association of chronic kidney disease initiative.
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Affiliation(s)
- Kazusa Hyodoh
- Department of Radiology, Sapporo Medical University, Sapporo, Japan
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Wile GE, Leyendecker JR. Magnetic resonance imaging of the liver: sequence optimization and artifacts. Magn Reson Imaging Clin N Am 2011; 18:525-47, xi. [PMID: 21094454 DOI: 10.1016/j.mric.2010.07.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The liver is one of the most challenging organs of the body to image with magnetic resonance because it is large and mobile, receives a dual blood supply, and is surrounded by organs and structures that contribute to artifacts from flow and susceptibility. Recent advances in imaging hardware, in addition to improvements in temporal resolution and development of hepatocyte-specific contrast agents, make imaging of the liver more approachable than in the past; however, it remains a complex process that requires compromise. In this article the authors discuss development and optimization of a liver imaging protocol at 1.5 T, with common variations in each element of the protocol, as well as the strengths and weaknesses associated with the relevant sequences.
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Affiliation(s)
- Geoffrey E Wile
- Body Imaging Section, Department of Radiology, Vanderbilt University Medical Center, 1161 21st Avenue South, Nashville, TN 37232, USA.
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Reimer P, Vosshenrich R. Detection and characterization of liver lesions using gadoxetic acid as a tissue-specific contrast agent. Biologics 2010; 4:199-212. [PMID: 20714357 PMCID: PMC2921257 DOI: 10.2147/btt.s6479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Indexed: 12/22/2022]
Abstract
The value of cross-sectional liver imaging is evaluated by the accuracy, sensitivity, and specificity of the specific imaging technique. Magnetic resonance imaging (MRI) has become a key technique for the characterization and detection of focal and diffuse liver disease. More recently, gadoxetic acid, the hepatocyte-specific MR contrast agent, was clinically approved and introduced in many countries. Gadoxetic acid may be considered a "molecular imaging" probe because the compound is actively taken into hepatocytes via the ATP-dependent organic anion transport system in the plasma membrane for the hepatic uptake. The transport of gadoxetic acid from the cytoplasm to the bile is mainly determined by the capacity of the transport protein glutathione-S-transferase. Gadoxetic acid enhances hepatocyte-containing lesions and improves detection of lesions devoid of normal hepatocytes, such as metastases. Innovative rapid MR acquisition techniques with near isotropic 3D pulse sequences with fat saturation parallel the technical progress made by multidetector computed tomography combined with an impressive improvement in tumor-liver contrast when used for gadoxetic acid-enhanced MRI. The purpose of this review is to provide an overview of the development, clinical testing, and applications of this novel MR contrast agent.
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Affiliation(s)
- Peter Reimer
- Department of Radiology, Klinikum Karlsruhe, Karlsruhe, Germany
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