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Zhang K, Triphan SMF, Kurz FT, Ziener CH, Kauczor HU, Schlemmer HP, Sedlaczek O. Navigator-based slice tracking for prospective motion correction in kidney vessel architecture imaging. Magn Reson Imaging 2023; 98:26-35. [PMID: 36603781 DOI: 10.1016/j.mri.2023.01.001] [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: 10/14/2022] [Accepted: 01/01/2023] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To apply a navigator-based slice tracking method to prospectively compensate the respiratory motion for kidney vessel architecture imaging (VAI). MATERIALS AND METHODS A dual gradient echo spin echo 2D EPI sequence was developed for kidney VAI. A single gradient-echo slice selection and projection readout at the location of the diaphragm along the inferior-superior direction was applied as a navigator. Navigator acquisition and fat suppression were inserted before each transverse imaging slice. Motion information was calculated after exclusion of the signal saturation in the navigator signal caused by imaging slices. The motion information was then directly sent back to the sequence and slice positioning was adjusted in real-time. The whole sequence was applied during a contrast agent pass-through. RESULTS VAI parametric maps show the structural heterogeneity of the renal vasculature. The respiratory motion from the navigator signal was precisely calculated and slice positioning was changed in real-time based on the motion information. The vibration amplitude of the signal intensity of the liver tissue at the liver-lung interface in the case of prospective motion correction (PMC) on is about 28% of the PMC off case. Compared to the case of PMC off, the coefficient of variation was reduced 30% of the case of PMC on. CONCLUSIONS This study demonstrates the feasibility of the motion-compensating technique in kidney VAI. The sequence may improve the evaluation of microvasculature in kidney diseases.
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Affiliation(s)
- Ke Zhang
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Simon M F Triphan
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix T Kurz
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Christian H Ziener
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Oliver Sedlaczek
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
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Son JS, Park HS, Park S, Kim YJ, Yu MH, Jung SI, Paek M, Nickel MD. Motion-Corrected versus Conventional Diffusion-Weighted Magnetic Resonance Imaging of the Liver Using Non-Rigid Registration. Diagnostics (Basel) 2023; 13:diagnostics13061008. [PMID: 36980314 PMCID: PMC10047344 DOI: 10.3390/diagnostics13061008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/01/2023] [Accepted: 03/04/2023] [Indexed: 03/09/2023] Open
Abstract
It is challenging to overcome motion artifacts in diffusion-weighted imaging (DWI) of the abdomen. This study aimed to evaluate the image quality of motion-corrected DWI of the liver using non-rigid registration in comparison with conventional DWI (c-DWI) in patients with liver diseases. Eighty-nine patients who underwent 3-T magnetic resonance imaging (MRI) of the liver were retrospectively included. DWI was performed using c-DWI and non-rigid motion-corrected (moco) DWI was performed in addition to c-DWI. The image quality and conspicuity of hepatic focal lesions were scored using a five-point scale by two radiologists and compared between the two DWI image sets. The apparent diffusion coefficient (ADC) was measured in three regions of the liver parenchyma and in hepatic focal lesions, and compared between the two DWI image sets. Moco-DWI achieved higher scores in image quality compared to c-DWI in terms of liver edge sharpness and hepatic vessel margin delineation. The conspicuity scores of hepatic focal lesions were higher in moco-DWI. The standard deviation values of ADC of the liver parenchyma were lower in the moco-DWI than in the c-DWI. Moco-DWI using non-rigid registration showed improved overall image quality and provided more reliable ADC measurement, with an equivalent scan time, compared with c-DWI.
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Affiliation(s)
- Je Seung Son
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Hee Sun Park
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
- Department of Radiology, Konkuk University School of Medicine, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
- Correspondence: ; Tel.: +82-2-2030-5497; Fax: +82-2-2030-7748
| | - Sungeun Park
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Young Jun Kim
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
- Department of Radiology, Konkuk University School of Medicine, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Mi Hye Yu
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
- Department of Radiology, Konkuk University School of Medicine, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Sung Il Jung
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
- Department of Radiology, Konkuk University School of Medicine, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Munyoung Paek
- Department of Diagnostic Imaging, Siemens Healthineers Ltd., The Asset Bldg. 10F, 14 Seocho-Daero 74-gil, Seocho-gu, Seoul 06620, Republic of Korea
| | - Marcel Dominik Nickel
- MR Application Predevelopment, Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052 Erlangen, Germany
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Loh M, Führes T, Stuprich C, Uder M, Saake M, Laun FB. Influence of saturation effects on biexponential liver intravoxel incoherent motion. Magn Reson Med 2023; 90:270-279. [PMID: 36861449 DOI: 10.1002/mrm.29622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/20/2023] [Accepted: 02/07/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE Studies on intravoxel incoherent motion (IVIM) imaging in the liver have been carried out with different acquisition protocols. The number of acquired slices and the distances between slices can influence IVIM measurements due to saturation effects, but these effects have often been disregarded. This study investigated differences in biexponential IVIM parameters between two slice settings. METHODS Fifteen healthy volunteers (21-30 years) were examined at a field strength of 3 T. Diffusion-weighted images of the abdomen were acquired with 16 b values (0-800 s/mm2 ), with four slices for the few slices setting and 24-27 slices for the many slices setting. Regions of interest were manually drawn in the liver. The data were fitted with a monoexponential signal curve and a biexponential IVIM curve, and biexponential IVIM parameters were determined. The dependence on the slice setting was assessed with Student's t test for paired samples (normally distributed IVIM parameters) and the Wilcoxon signed-rank test (non-normally distributed parameters). RESULTS None of the parameters were significantly different between the settings. For few slices and many slices, respectively, the mean values (SDs) for D $$ D $$ were 1.21 μm 2 / ms $$ 1.21{\upmu \mathrm{m}}^2/\mathrm{ms} $$ ( 0.19 μm 2 / ms $$ 0.19\kern0.3em {\upmu \mathrm{m}}^2/\mathrm{ms} $$ ) and 1.20 μm 2 / ms $$ 1.20{\upmu \mathrm{m}}^2/\mathrm{ms} $$ ( 0.11 μm 2 / ms $$ 0.11\kern0.3em {\upmu \mathrm{m}}^2/\mathrm{ms} $$ ); for f $$ f $$ they were 29.7% (6.2%) and 27.7% (3.6%); and for D * $$ {D}^{\ast } $$ they were 8.76 ⋅ 10 - 2 mm 2 / s $$ 8.76\cdot {10}^{-2}{\mathrm{mm}}^2/\mathrm{s} $$ ( 4.54 ⋅ 10 - 2 mm 2 / s $$ 4.54\cdot {10}^{-2}\kern0.3em {\mathrm{mm}}^2/\mathrm{s} $$ ) and 8.71 ⋅ 10 - 2 mm 2 / s $$ 8.71\cdot {10}^{-2}{\mathrm{mm}}^2/\mathrm{s} $$ ( 4.06 ⋅ 10 - 2 mm 2 / s $$ 4.06\cdot {10}^{-2}\kern0.3em {\mathrm{mm}}^2/\mathrm{s} $$ ). CONCLUSION Biexponential IVIM parameters in the liver are comparable among IVIM studies that use different slice settings, with mostly negligible saturation effects. However, this may not hold for studies that use much shorter TR.
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Affiliation(s)
- Martin Loh
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tobit Führes
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Stuprich
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Marc Saake
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Frederik Bernd Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Kamal O, Sy E, Chernyak V, Gupta A, Yaghmai V, Fowler K, Karampinos D, Shanbhogue K, Miller FH, Kambadakone A, Fung A. Optional MRI sequences for LI-RADS: why, what, and how? Abdom Radiol (NY) 2023; 48:519-531. [PMID: 36348024 DOI: 10.1007/s00261-022-03726-8] [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: 08/03/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 11/09/2022]
Abstract
Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver worldwide. Noninvasive diagnosis of HCC is possible based on imaging features, without the need for tissue diagnosis. Liver Imaging Reporting and Data System (LI-RADS) CT/MRI diagnostic algorithm allows for standardized radiological interpretation and reporting of imaging studies for patients at high risk for HCC. Diagnostic categories of LR-1 to LR-5 designate each liver observation to reflect the probability of overall malignancy, HCC, or benignity based on imaging features, where LR-5 category has > 95% probability of HCC. Optimal imaging protocol and scanning technique as described by the technical recommendations for LI-RADS are essential for the depiction of features to accurately characterize liver observations. The LI-RADS MRI technical guidelines recommend the minimum required sequences of T1-weighted out-of-phase and in-phase Imaging, T2-weighted Imaging, and multiphase T1-weighted Imaging. Additional sequences, including diffusion-weighted imaging, subtraction imaging, and the hepatobiliary phase when using gadobenate dimeglumine as contrast, improve diagnostic confidence, but are not required by the guidelines. These optional sequences can help differentiate true lesions from pseudolesions, detect additional observations, identify parenchymal observations when other sequences are suboptimal, and improve observations conspicuity. This manuscript reviews the optional sequences, the advantages they offer, and discusses technical optimization of these sequences to obtain the highest image quality and to avoid common artifacts.
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Affiliation(s)
- Omar Kamal
- Oregon Health & Science University, Portland, OR, USA. .,Department of Diagnostic Radiology, Oregon Health & Science University, L340, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
| | - Ethan Sy
- A.T. Still University School of Osteopathic Medicine in Arizona, Mesa, AZ, USA
| | | | - Ayushi Gupta
- Emory University School of Medicine, Atlanta, Georgia
| | | | | | | | | | - Frank H Miller
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Alice Fung
- Oregon Health & Science University, Portland, OR, USA
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State-of-the-art magnetic resonance imaging sequences for pediatric body imaging. Pediatr Radiol 2022:10.1007/s00247-022-05528-y. [PMID: 36255456 DOI: 10.1007/s00247-022-05528-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/17/2022] [Accepted: 10/03/2022] [Indexed: 10/24/2022]
Abstract
Longer examination time, need for anesthesia in smaller children and the inability of most children to hold their breath are major limitations of MRI in pediatric body imaging. Fortunately, with technical advances, many new and upcoming MRI sequences are overcoming these limitations. Advances in data acquisition and k-space sampling methods have enabled sequences with improved temporal and spatial resolution, and minimal artifacts. Sequences to minimize movement artifacts mainly utilize radial k-space filling, and examples include the stack-of-stars method for T1-weighted imaging and the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER)/BLADE method for T2-weighted imaging. Similarly, the sequences with improved temporal resolution and the ability to obtain multiple phases in a single breath-hold in dynamic imaging mainly use some form of partial k-space filling method. New sequences use a variable combination of data sampling methods like compressed sensing, golden-angle radial k-space filling, parallel imaging and partial k-space filling to achieve free-breathing, faster sequences that could be useful for pediatric abdominal and thoracic imaging. Simultaneous multi-slice method has improved diffusion-weighted imaging (DWI) with reduction in scan time and artifacts. In this review, we provide an overview of data sampling methods like parallel imaging, compressed sensing, radial k-space sampling, partial k-space sampling and simultaneous multi-slice. This is followed by newer available and upcoming sequences for T1-, T2- and DWI based on these other advances. We also discuss the Dixon method and newer approaches to reducing metal artifacts.
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Bae SH, Hwang J, Hong SS, Lee EJ, Jeong J, Benkert T, Sung J, Arberet S. Clinical feasibility of accelerated diffusion weighted imaging of the abdomen with deep learning reconstruction: Comparison with conventional diffusion weighted imaging. Eur J Radiol 2022; 154:110428. [DOI: 10.1016/j.ejrad.2022.110428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 01/03/2023]
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Li W. Non-Gaussian Diffusion MRI for Evaluating Hepatic Fibrosis. Acad Radiol 2022; 29:964-966. [PMID: 35597754 DOI: 10.1016/j.acra.2022.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 11/01/2022]
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Hernando D, Zhang Y, Pirasteh A. Quantitative diffusion MRI of the abdomen and pelvis. Med Phys 2021; 49:2774-2793. [PMID: 34554579 DOI: 10.1002/mp.15246] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/05/2021] [Accepted: 09/15/2021] [Indexed: 12/14/2022] Open
Abstract
Diffusion MRI has enormous potential and utility in the evaluation of various abdominal and pelvic disease processes including cancer and noncancer imaging of the liver, prostate, and other organs. Quantitative diffusion MRI is based on acquisitions with multiple diffusion encodings followed by quantitative mapping of diffusion parameters that are sensitive to tissue microstructure. Compared to qualitative diffusion-weighted MRI, quantitative diffusion MRI can improve standardization of tissue characterization as needed for disease detection, staging, and treatment monitoring. However, similar to many other quantitative MRI methods, diffusion MRI faces multiple challenges including acquisition artifacts, signal modeling limitations, and biological variability. In abdominal and pelvic diffusion MRI, technical acquisition challenges include physiologic motion (respiratory, peristaltic, and pulsatile), image distortions, and low signal-to-noise ratio. If unaddressed, these challenges lead to poor technical performance (bias and precision) and clinical outcomes of quantitative diffusion MRI. Emerging and novel technical developments seek to address these challenges and may enable reliable quantitative diffusion MRI of the abdomen and pelvis. Through systematic validation in phantoms, volunteers, and patients, including multicenter studies to assess reproducibility, these emerging techniques may finally demonstrate the potential of quantitative diffusion MRI for abdominal and pelvic imaging applications.
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Affiliation(s)
- Diego Hernando
- Departments of Radiology and Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Yuxin Zhang
- Departments of Radiology and Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ali Pirasteh
- Departments of Radiology and Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Larsen SKA, Sivesgaard K, Pedersen EM. Multi-band whole-body diffusion-weighted imaging with inversion recovery fat saturation: Effects of respiratory compensation. Eur J Radiol Open 2021; 8:100374. [PMID: 34485628 PMCID: PMC8403743 DOI: 10.1016/j.ejro.2021.100374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 10/25/2022] Open
Abstract
Purpose To prospectively compare artefacts and image quality in testicular stage I cancer patients using different combinations of breathing schemes and Multi-band (MB) in whole-body DWIBS at 1.5 T.Diffusion-Weighted whole-body Imaging with Background body signal Suppression (DWIBS) using inversion recovery (IR) fat saturation is a cornerstone in oncologic whole-body MRI, but implementation is restrained by long acquisition times. The new Multi-Band (MB) technique reduces scan time which can be reinvested in respiratory compensation. Methods Thirty testicular cancer stage I patients were included. Three variations of whole-body DWIBS were tested: Standard free Breathing (FB)-DWIBS, FB-MB-DWIBS and Respiratory triggered (RT)-MB-DWIBS. Artefacts and image quality of b = 800 s/mm2 images were evaluated using a Likert scale. No pathology was revealed. SNR was calculated in a healthy volunteer. Results RT-MB-DWIBS was rated significantly better than FB-DWIBS in the thorax (p < 0.001) and abdomen (p < 0.001), but not in the pelvis (p = 0.569). FB-MB-DWIBS was ranked significantly lower than both FB-DWIBS (p < 0.001) and RT-MB-DWIBS (p < 0.001) at all locations. However, FB-MB-DWIBS was scanned in half the time without being less than "satisfactory". Few artefacts were encountered. SNR was similar for low-intensity tissues, but the SNR in high-intensity and respiratory-prone tissue (spleen) was slightly lower for FB-DWIBS than the other sequences. Conclusion Images produced by the sequences were similar. MB enables the use of respiratory trigger or can be used to produce very fast free-breathing DWI with acceptable image quality.
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Key Words
- ADC, apparent diffusion coefficient
- CT, computed tomography
- DWI, diffusion-weighted imaging
- DWIBS, diffusion-weighted whole-body imaging with background body signal suppression
- Diffusion magnetic resonance imaging
- EPI, echo planar imaging
- FB, free-breathing
- IR, inversion recovery
- MB, multi-band
- MRI, magnetic resonance imaging
- Multi-band
- NSA, number of signal averages
- Pet, positron emission tomography
- RF, radio frequency
- ROI, region of interest
- RT, respiratory triggered
- Respiratory compensation
- SAR, specific absorption rate
- SMS, simultaneous multislice
- SNR, signal-to-noise ratio
- SPAIR, spectral attenuated inversion recovery
- T, tesla
- TE, echo time
- TR, repetition time
- Testicular neoplasm
- WB, whole-body
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Affiliation(s)
| | - Kim Sivesgaard
- Department of Radiology, Aarhus University Hospital, Denmark
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Respiratory triggered diffusion-weighted imaging with a single diffusion sensitising gradient to reduce image acquisition time - A feasibility study in the workup of hepatocellular carcinoma. Eur J Radiol 2021; 141:109807. [PMID: 34146912 DOI: 10.1016/j.ejrad.2021.109807] [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: 07/02/2020] [Revised: 04/15/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE We evaluated respiratory triggered unidirectional single-shot echo-planar imaging (u-SSEPI) as a time-saving measure in diffusion imaging of the upper abdomen. Specifically, we compared the ADC values obtained from unidirectional DWI (u-SSEPI) and routine DWI (4t-SSEPI) and also the diagnostic accuracies of unidirectional and routine DWI sequences in the identification of focal liver lesions in the setting of chronic liver disease (CLD). MATERIALS AND METHODS This prospective, IRB approved study, included 48 patients of CLD who underwent-DCE-MRI on a 1.5 T scanner for hepatocellular carcinoma (HCC) workup. In addition to 4t-SSEPI, u-SSEPI was acquired with the diffusion sensitising gradient being applied in only one direction; keeping all other parameters same as 4t-SSEPI. Two blinded radiologists evaluated the DWI studies for image quality and detection of liver lesions. A composite gold standard was established using DCE-MRI, follow-up imaging and patient clinical details. The apparent diffusion coefficients (ADCs) of the liver, spleen and the lesions were compared between the two sequences. ROC analysis evaluated the diagnostic accuracy of ADC from both the sequences in identifying HCC. RESULTS Eighty-eight lesions were identified using the composite gold standard. u-SSEPI resulted in 3 times faster image acquisition. No statistically significant differences were demonstrated between the unidirectional and routine DWI sequences for image quality parameters and lesion detection rates. Lesion wise comparison of the ADC values from both the sequences was not statistically different (p = 0.8) with a coefficient of variation = 12-14 %. The Bland- Altman plots and the Passing-Bablock regression analysis demonstrated a systematic and proportional bias between the ADC values obtained. The AUC of the ROC curve, however, was 0.63-observer1; 0.62-oobserver2 for routine DWI and 0.65; 0.62 for unidirectional DWI when ADC was used to identify HCC (the AUCs were not statistically different (p = 0.6-0.8)). CONCLUSION No significant differences were demonstrated in the diagnostic accuracies of unidirectional and routine DWI in the diagnosis of HCC. Unidirectional diffusion may be further evaluated in other organs where diffusion is isotropic, especially in respiratory triggered sequences where the imaging time dividend is significant.
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Brunsing RL, Fowler KJ, Yokoo T, Cunha GM, Sirlin CB, Marks RM. Alternative approach of hepatocellular carcinoma surveillance: abbreviated MRI. HEPATOMA RESEARCH 2020; 6:59. [PMID: 33381651 PMCID: PMC7771881 DOI: 10.20517/2394-5079.2020.50] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This review focuses on emerging abbreviated magnetic resonance imaging (AMRI) surveillance of patients with chronic liver disease for hepatocellular carcinoma (HCC). This surveillance strategy has been proposed as a high-sensitivity alternative to ultrasound for identification of patients with early-stage HCC, particularly in patients with cirrhosis or obesity, in whom sonographic visualization of small tumors may be compromised. Three general AMRI approaches have been developed and studied in the literature - non-contrast AMRI, dynamic contrast-enhanced AMRI, and hepatobiliary phase contrast-enhanced AMRI - each comprising a small number of selected sequences specifically tailored for HCC detection. The rationale, general technique, advantages and disadvantages, and diagnostic performance of each AMRI approach is explained. Additionally, current gaps in knowledge and future directions are discussed. Based on emerging evidence, we cautiously recommend the use of AMRI for HCC surveillance in situations where ultrasound is compromised.
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Affiliation(s)
- Ryan L. Brunsing
- Department of Radiology, Stanford University, Stanford, CA 94305, USA
| | - Kathryn J. Fowler
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA 92093, USA
| | - Takeshi Yokoo
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Guilherme Moura Cunha
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA 92093, USA
| | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA 92093, USA
| | - Robert M. Marks
- Department of Radiology, Naval Medical Center San Diego, San Diego, CA 92134, USA
- Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, MD 20892, USA
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