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Jia X, Li X, Wei X, Sun J, Han Y, Guo M, Tong W, Qu Y, Zhu S, Guo J. Reducing transient severe motion artifacts of gadoxetate disodium-enhanced MRI by oxygen inhalation: effective for pleural effusion but not ascites. Abdom Radiol (NY) 2024:10.1007/s00261-024-04465-8. [PMID: 38995402 DOI: 10.1007/s00261-024-04465-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/12/2024] [Accepted: 06/15/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES To evaluate the efficacy of low-flow oxygen inhalation in mitigating transient severe motion (TSM) artifacts associated with gadoxetate disodium-enhanced hepatic magnetic resonance imaging (MRI). METHODS Patients undergoing gadoxetate disodium-enhanced MRI were included. During the examination, the experimental group received oxygen at 2 L/min via nasal cannula, while the control group did not. Images and TSM scores were evaluated and compared across precontrast, arterial, venous, and hepatobiliary phases. Subgroup analyses were conducted based on the presence of pleural effusion or ascites. RESULTS A total of 325 patients were included. The motion scores were highest in the arterial phase and lowest in the hepatobiliary phase in both groups, but were significantly lower in the experimental group (p < 0.05). The incidence of TSM was significantly lower in the experimental group (3.29%) compared to the control group (13.29%, p = 0.01). While pleural effusion was associated with reduced image quality in both groups (p < 0.05), the image quality in the pleural effusion category was higher in the experimental group than in the control group. Oxygen inhalation showed limited efficacy in mitigating TSM related to ascites. CONCLUSIONS Low-flow oxygen inhalation can effectively reduce the occurrence of gadoxetate disodium-related TSM. Pleural effusion may impair respiratory function and contribute to TSM, which can be alleviated by oxygen supplementation. However, Oxygen inhalation is less effective under the condition of ascites.
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Affiliation(s)
- Xiaoqian Jia
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China
| | - Xianjun Li
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China
| | - Xiaocheng Wei
- MR Research China, GE Healthcare, Beijing, 100176, China
| | - Jingtao Sun
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China
| | - Yangyang Han
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China
| | - Ming Guo
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China
| | - Wei Tong
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China
| | - Yuan Qu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China
| | - Shumeng Zhu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China
| | - Jianxin Guo
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China.
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Kim MY, Heo S, Choi S, Suh CH, Lee ES, Park HJ, Kim KW. Clinical impact and potential utility of non-enhanced computed tomography performed immediately after transarterial chemoembolization for hepatocellular carcinoma. J Gastrointest Oncol 2024; 15:1141-1152. [PMID: 38989419 PMCID: PMC11231851 DOI: 10.21037/jgo-24-134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 05/24/2024] [Indexed: 07/12/2024] Open
Abstract
Background Intratumoral lipiodol deposition following transarterial chemoembolization (TACE) is associated with the prognosis of hepatocellular carcinoma (HCC) patients. However, there is insufficient evidence regarding the actual clinical significance of the imaging tests conducted to evaluate the lipiodol uptake after TACE. This study evaluates the clinical impact and potential utility of performing immediate post-TACE non-enhanced computed tomography (NECT) on the treatment of HCC. Methods This retrospective study at a tertiary referral center included patients undergoing their first session of conventional TACE for initial treatment of HCC from November 2021 to December 2022 with available immediate post-TACE NECT. Patients were categorized based on lipiodol uptake into Cohorts A (incomplete uptake with additional treatment before the first follow-up 1 month after TACE), B incomplete uptake without additional treatment before first follow-up), and C (complete uptake). Survival curves for the time to progression (TTP) were estimated using the Kaplan-Meier method and were compared by using the log-rank test. Results Out of 189 patients, 58 (29.6%) showed incomplete lipiodol uptake; 2 in Cohort A and 56 in Cohort B. Cohort C included 131 patients (69.3%). Cohort B had the highest rate of residual viable tumor (48.2%) 1 month after TACE, compared to the other cohorts (0% in Cohort A and 32.1% in Cohort C). The median TTP of Cohort B was 7.9 months [95% confidence interval (CI): 4.6-15.7 months], significantly shorter than the 15.4 months (95% CI: 10.9-20.9 months) for Cohort C (P=0.03). During follow-up, no progression occurred in Cohort A. Conclusions Assessment of lipiodol uptake by performing immediate post-TACE NECT can stratify HCC patients and facilitate early prediction of therapeutic response. Identifying suboptimal lipiodol uptake immediately after TACE can aid future treatment adjustments and potentially improving oncologic outcomes.
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Affiliation(s)
- Mi Young Kim
- Department of Radiology, Asan Medical Institute of Convergence Science and Technology (AMIST), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Subin Heo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sejin Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Eun Seoung Lee
- Department of Radiology, Asan Medical Institute of Convergence Science and Technology (AMIST), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyo Jung Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Multiarterial Phase Acquisition in Gadoxetic Acid-Enhanced Liver MRI for the Detection of Hypervascular Hepatocellular Carcinoma in High-Risk Patients: Comparison of Compressed Sensing Versus View Sharing Techniques. Invest Radiol 2023; 58:139-147. [PMID: 35976759 DOI: 10.1097/rli.0000000000000910] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aim of this study was to compare compressed sensing (CS) and view sharing (VS) techniques for single breath-hold multiarterial phase imaging with respect to image quality and focal liver observation detectability during gadoxetic acid-enhanced magnetic resonance imaging in patients at high risk for hepatocellular carcinoma (HCC). MATERIALS AND METHODS A total of 385 patients who underwent gadoxetic acid-enhanced magnetic resonance imaging, including triple arterial phases using either CS (n = 224) or VS (n = 161) techniques, were retrospectively included. Among them, 117 patients had 171 focal liver observations (median diameter, 1.3 cm), which were classified according to Liver Imaging Reporting and Data System version 2018. The acquisition rate of optimally timed late arterial phase (LAP) was assessed, and image quality, including respiratory motion artifact and observation conspicuity, was rated on a 4-point scale by 3 radiologists. The Mann-Whitney U test and nonparametric test for repeated measures data were used for image quality and observation conspicuity analysis. The jackknife alternative free-response receiver operating characteristics method was used to compare the observation detectability between the 2 techniques. RESULTS The CS technique showed significantly higher acquisition rate of optimally timed LAP without transient severe motion (82.1% [184/224] vs 71.4% [115/161]; P = 0.013) than the VS technique. The CS technique also demonstrated significantly improved overall image quality (3.42 ± 0.70 vs 2.97 ± 0.61; P < 0.001) compared with the VS technique. Regarding the detection of hyperenhancing observations, there was no significant difference between the figure of merits of CS and VS techniques (0.660 vs 0.665; P = 0.890). However, the CS technique showed a higher detection rate in Liver Imaging Reporting and Data System M (LR-M, probably or definitely malignant but not HCC specific) observations than the VS technique (100.0% [9/9] vs 44.4% [8/18]; P = 0.009). CONCLUSION The CS technique tended to provide optimally timed LAP without transient severe motion and demonstrated greater detection rate of LR-M observations than the VS technique in patients at high risk of HCC.
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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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Tsuboyama T, Jost G, Pietsch H, Tomiyama N. Effect of Gadoxetic Acid Injection Duration on Tumor Enhancement in Arterial Phase Liver MRI. Acad Radiol 2020; 27:e216-e223. [PMID: 31787566 DOI: 10.1016/j.acra.2019.10.018] [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] [Received: 08/25/2019] [Revised: 10/14/2019] [Accepted: 10/17/2019] [Indexed: 12/12/2022]
Abstract
RATIONALE AND OBJECTIVES Rapid injection of gadoxetic acid has been shown not to increase tumor enhancement in arterial phase liver MRI for unknown reasons. This study aimed to investigate the effect of injection durations on peak contrast concentration in tumors and to correlate it with signal enhancement in gadoxetic acid-enhanced arterial phase MRI. MATERIALS AND METHODS Gadoxetic acid-enhanced arterial phase MRI was obtained using a bolus-tracking technique with injection durations of 1, 3, and 6s in six rabbits with VX2 liver tumors. The peak concentration of gadoxetic acid in the aorta and tumor was estimated by iopromide-enhanced time-resolved CT using the same injection volume and durations with those for MRI. Signal enhancement on MRI and peak enhancement on CT were compared and correlated. RESULTS There was no significant difference in MR signal enhancement of tumors among the 3 injection durations (p = 0.87). In CT, shorter injection durations significantly increased peak contrast concentration in the aorta (p < 0.01) but produced equivalent peak contrast concentration in tumors (p = 0.24). The longer injections resulted in the stronger correlation between peak contrast concentration in CT and MR signal enhancement in tumors (r = 0.31, 0.43, and 0.86 with 1s-, 3s-, and 6s-injection, respectively) with a statistical significance only found with 6s-injection (p = 0.03). CONCLUSION Estimation of contrast concentration by CT demonstrated that shorter injections did not increase peak contrast concentration in tumors despite increased peak concentration in the aorta. Furthermore, tumor signal enhancement in gadoxetic acid-enhanced arterial phase MRI was less correlated with the peak contrast concentration with shorter injections.
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Huang H, Zhang Y, Zhang H, Chen J, Zheng Q, Cao D, Zhang Z. Qualitative and quantitative assessment of sacroiliitis in axial spondyloarthropathy: can a single T2-weighted dixon sequence replace the standard protocol? Clin Radiol 2020; 75:321.e13-321.e20. [DOI: 10.1016/j.crad.2019.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/13/2019] [Indexed: 12/17/2022]
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Compressed Sensing and Parallel Imaging for Double Hepatic Arterial Phase Acquisition in Gadoxetate-Enhanced Dynamic Liver Magnetic Resonance Imaging. Invest Radiol 2019; 54:374-382. [DOI: 10.1097/rli.0000000000000548] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Kim YC, Min JH, Kim YK, Lee SJ, Ahn S, Kim E, Peeters H. Intra-individual comparison of gadolinium-enhanced MRI using pseudo-golden-angle radial acquisition with gadoxetic acid-enhanced MRI for diagnosis of HCCs using LI-RADS. Eur Radiol 2018; 29:2058-2068. [PMID: 30324388 DOI: 10.1007/s00330-018-5771-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/23/2018] [Accepted: 09/17/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To determine the usefulness of extracellular contrast agent (ECA)-enhanced multiphasic liver magnetic resonance imaging (MRI) using a pseudo-golden-angle radial acquisition scheme by intra-individual comparison with gadoxetic acid-MRI (EOB-MRI) with regard to image quality and the diagnosis of hepatocellular carcinoma (HCC). MATERIALS AND METHODS This prospective study enrolled 15 patients with 18 HCCs who underwent EOB-MRI using a Cartesian approach and ECA-MRI using the pseudo-golden-angle radial acquisition scheme (free-breathing continuous data acquisition for 64 s following ECA injection, generating six images). Two reviewers evaluated the arterial and portal phases of each MRI for artifacts, organ sharpness, and conspicuity of intrahepatic vessels and the hepatic tumors. A Liver Imaging Reporting and Data System category was also assigned to each lesion. RESULTS There were no differences in the subjective image quality analysis between the arterial phases of two MRIs (p > 0.05). However, ghosting artifact was seen only in EOB-MRI (N = 3). Six HCCs showed different signal intensities in the arterial phase or portal phase between the two MRIs; five HCCs showed arterial hyperenhancement on ECA-MRI, but not on EOB-MRI. The capsule was observed in 15 HCCs on ECA-MRI and 6 HCCs on EOB-MRI. Five and one HCC were assigned as LR-5 and LR-4 with ECA-MRI and LR-4 and LR-3 with EOB-MRI, respectively. CONCLUSION Free-breathing ECA-enhanced multiphasic liver MRI using a pseudo-golden-angle radial acquisition was more sensitive in detecting arterial hyperenhancement of HCC than conventional EOB-MRI, and the image quality was acceptable. KEY POINTS • The pseudo-golden-angle radial acquisition scheme can be applied to perform free-breathing multiphasic dynamic liver MRI. • Adopting the pseudo-golden-angle radial acquisition scheme can improve the detection of arterial enhancement of HCC. • The pseudo-golden-angle radial acquisition scheme enables motion-free liver MRI.
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Affiliation(s)
- Yoon-Chul Kim
- Clinical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Hye Min
- Department of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Young Kon Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - Soon Jin Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Soohyun Ahn
- Department of Mathematics, Ajou University, Suwon, Republic of Korea
| | - Eunju Kim
- MR Clinical Scientist Philips Korea, Sowol-ro 2-gil, Joong-gu, Seoul, Republic of Korea
| | - Hans Peeters
- MR Clinical Scientist Philips Netherlands: Veenpluis 4-6, Building QR-0.113, 5684 PC , Best, Netherlands
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Tsuboyama T, Jost G, Kim T, Hori M, Onishi H, Pietsch H, Tomiyama N. Experimental studies on artifacts and tumor enhancement on gadoxetic acid-enhanced arterial phase liver MRI in a rabbit VX2 tumor model. Acta Radiol 2018; 59:1029-1037. [PMID: 29235879 DOI: 10.1177/0284185117747134] [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: 12/18/2022]
Abstract
Background Rapid injection of gadoxetic acid is reported to produce more frequent artifacts and lower vascular enhancement on arterial phase liver magnetic resonance imaging (MRI). However, its effect on tumor enhancement and the mechanism of the artifacts remain unclear. Purpose To evaluate the effect of rapid injection of gadoxetic acid on artifacts and tumor enhancement during arterial phase liver MRI, and on arterial blood gases (ABGs) which may explain the cause of the artifacts. Material and Methods ABG analysis was performed in 13 free-breathing rabbits after rapid injection (1 mL/s; injection time = 0.6-0.8 s) of gadoxetic acid (0.025 mmol/kg). Dynamic liver MRI was performed in six anesthetized rabbits with VX2 tumors under a ventilation stoppage after rapid and slow injection (0.25 mL/s; injection time = 2.4-3.2 s) of gadoxetic acid. Artifacts and signal enhancement on arterial phase imaging were compared with those obtained after rapid injection of gadopentetic acid (Gd-DTPA, 0.1 mmol/kg) using a Friedman test or Kruskal-Wallis test. Results ABG analysis did not find any significant changes. Artifacts were not related to injection protocols ( P = 0.95). Aortic enhancement with slow injection of gadoxetic acid was significantly higher than that with rapid injection ( P < 0.05), and was comparable to that with Gd-DTPA injection. Tumor enhancement obtained with gadoxetic acid was not significantly different between rapid and slow injection, and was significantly lower than that with Gd-DTPA injection ( P < 0.05). Conclusion Rapid injection of gadoxetic acid did not affect ABGs and may not be the cause of the artifacts. It lowered vascular enhancement but not arterial tumor enhancement.
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Affiliation(s)
- Takahiro Tsuboyama
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Gregor Jost
- MR and CT Contrast Media Research, Bayer Pharma AG, Berlin, Germany
| | - Tonsok Kim
- Department of Radiology, Naniwa Ikuno Hospital, Osaka, Japan
| | - Masatoshi Hori
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiromitsu Onishi
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hubertus Pietsch
- MR and CT Contrast Media Research, Bayer Pharma AG, Berlin, Germany
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
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Min JH, Kim YK, Kang TW, Jeong WK, Lee WJ, Ahn S, Hwang NY. Artifacts during the arterial phase of gadoxetate disodium-enhanced MRI: Multiple arterial phases using view-sharing from two different vendors versus single arterial phase imaging. Eur Radiol 2018; 28:3335-3346. [DOI: 10.1007/s00330-018-5307-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 11/27/2017] [Accepted: 01/02/2018] [Indexed: 12/15/2022]
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Lee GM, Kim YR, Ryu JH, Kim TH, Cho EY, Lee YH, Yoon KH. Quantitative Measurement of Hepatic Fibrosis with Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Patients with Chronic Hepatitis B Infection: A Comparative Study on Aspartate Aminotransferase to Platelet Ratio Index and Fibrosis-4 Index. Korean J Radiol 2017; 18:444-451. [PMID: 28458596 PMCID: PMC5390613 DOI: 10.3348/kjr.2017.18.3.444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/19/2016] [Indexed: 12/21/2022] Open
Abstract
Objective To quantitatively measure hepatic fibrosis on gadoxetic acid-enhanced magnetic resonance (MR) in chronic hepatitis B (CHB) patients and identify the correlations with aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) values. Materials and Methods This study on gadoxetic acid-enhanced 3T MR imaging included 81 patients with CHB infection. To quantitatively measure hepatic fibrosis, MR images were analyzed with an aim to identify inhomogeneous signal intensities calculated from a coefficient of variation (CV) map in the liver parenchyma. We also carried out a comparative analysis between APRI and FIB-4 based on metaregression results. The diagnostic performance of the CV map was evaluated using a receiver-operating characteristic (ROC) curve. Results In the MR images, the mean CV values in control, groups I, II, and III based on APRI were 4.08 ± 0.92, 4.24 ± 0.80, 5.64 ± 1.11, and 5.73 ± 1.28, respectively (p < 0.001). In CHB patients grouped by FIB-4, the mean CV values of groups A, B, and C were 4.22 ± 0.95, 5.40 ± 1.19, and 5.71 ± 1.17, respectively (p < 0.001). The mean CV values correlated well with APRI (r = 0.392, p < 0.001) and FIB-4 (r = 0.294, p < 0.001). In significant fibrosis group, ROC curve analysis yielded an area under the curve of 0.875 using APRI and 0.831 using FIB-4 in HB, respectively. Conclusion Gadoxetic acid-enhanced MR imaging for calculating a CV map showed moderate correlation with APRI and FIB-4 values and could be employed to quantitatively measure hepatic fibrosis in patients with CHB.
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Affiliation(s)
- Guy Mok Lee
- Department of Radiology, Wonkwang University School of Medicine, Iksan 54538, Korea
| | - Youe Ree Kim
- Department of Radiology, Wonkwang University School of Medicine, Iksan 54538, Korea
| | - Jong Hyun Ryu
- Imaging Science Research Center, Wonkwang University, Iksan 54538, Korea
| | - Tae-Hoon Kim
- Imaging Science Research Center, Wonkwang University, Iksan 54538, Korea
| | - Eun Young Cho
- Department of Internal Medicine, Wonkwang University School of Medicine, Iksan 54538, Korea
| | - Young Hwan Lee
- Department of Radiology, Wonkwang University School of Medicine, Iksan 54538, Korea
| | - Kwon-Ha Yoon
- Department of Radiology, Wonkwang University School of Medicine, Iksan 54538, Korea.,Imaging Science Research Center, Wonkwang University, Iksan 54538, Korea
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Respiratory motion artifacts during arterial phase imaging with gadoxetic acid: Can the injection protocol minimize this drawback? J Magn Reson Imaging 2017; 46:1107-1114. [DOI: 10.1002/jmri.25657] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 02/06/2023] Open
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Yoon JH, Lee JM, Yu MH, Kim EJ, Han JK. Triple Arterial Phase MR Imaging with Gadoxetic Acid Using a Combination of Contrast Enhanced Time Robust Angiography, Keyhole, and Viewsharing Techniques and Two-Dimensional Parallel Imaging in Comparison with Conventional Single Arterial Phase. Korean J Radiol 2016; 17:522-32. [PMID: 27390543 PMCID: PMC4936174 DOI: 10.3348/kjr.2016.17.4.522] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 04/07/2016] [Indexed: 01/25/2023] Open
Abstract
Objective To determine whether triple arterial phase acquisition via a combination of Contrast Enhanced Time Robust Angiography, keyhole, temporal viewsharing and parallel imaging can improve arterial phase acquisition with higher spatial resolution than single arterial phase gadoxetic-acid enhanced magnetic resonance imaging (MRI). Materials and Methods Informed consent was waived for this retrospective study by our Institutional Review Board. In 752 consecutive patients who underwent gadoxetic acid-enhanced liver MRI, either single (n = 587) or triple (n = 165) arterial phases was obtained in a single breath-hold under MR fluoroscopy guidance. Arterial phase timing was assessed, and the degree of motion was rated on a four-point scale. The percentage of patients achieving the late arterial phase without significant motion was compared between the two methods using the χ2 test. Results The late arterial phase was captured at least once in 96.4% (159/165) of the triple arterial phase group and in 84.2% (494/587) of the single arterial phase group (p < 0.001). Significant motion artifacts (score ≤ 2) were observed in 13.3% (22/165), 1.2% (2/165), 4.8% (8/165) on 1st, 2nd, and 3rd scans of triple arterial phase acquisitions and 6.0% (35/587) of single phase acquisitions. Thus, the late arterial phase without significant motion artifacts was captured in 96.4% (159/165) of the triple arterial phase group and in 79.9% (469/587) of the single arterial phase group (p < 0.001). Conclusion Triple arterial phase imaging may reliably provide adequate arterial phase imaging for gadoxetic acid-enhanced liver MRI.
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Affiliation(s)
- Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul 03087, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul 03087, Korea.; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 03087, Korea
| | - Mi Hye Yu
- Department of Radiology, Konkuk University Medical Center, Seoul 05030, Korea
| | - Eun Ju Kim
- Philips Healthcare Korea, Seoul 04342, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul 03087, Korea.; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 03087, Korea
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Huh J, Kim SY, Yeh BM, Lee SS, Kim KW, Wu EH, Wang ZJ, Zhao LQ, Chang WC. Troubleshooting Arterial-Phase MR Images of Gadoxetate Disodium-Enhanced Liver. Korean J Radiol 2015; 16:1207-15. [PMID: 26576109 PMCID: PMC4644741 DOI: 10.3348/kjr.2015.16.6.1207] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/28/2015] [Indexed: 12/22/2022] Open
Abstract
Gadoxetate disodium is a widely used magnetic resonance (MR) contrast agent for liver MR imaging, and it provides both dynamic and hepatobiliary phase images. However, acquiring optimal arterial phase images at liver MR using gadoxetate disodium is more challenging than using conventional extracellular MR contrast agent because of the small volume administered, the gadolinium content of the agent, and the common occurrence of transient severe motion. In this article, we identify the challenges in obtaining high-quality arterial-phase images of gadoxetate disodium-enhanced liver MR imaging and present strategies for optimizing arterial-phase imaging based on the thorough review of recent research in this field.
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Affiliation(s)
- Jimi Huh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul 05505, Korea. ; Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - So Yeon Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul 05505, Korea. ; Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Benjamin M Yeh
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143-0628, USA
| | - Seung Soo Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul 05505, Korea. ; Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul 05505, Korea. ; Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - En-Haw Wu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University College of Medicine, Taoyuan County 333, Taiwan
| | - Z Jane Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143-0628, USA
| | - Li-qin Zhao
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Wei Chou Chang
- Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan
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