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Published in:

01-02-2015

Navigated three-dimensional T1-weighted gradient-echo sequence for gadoxetic acid liver magnetic resonance imaging in patients with limited breath-holding capacity

Authors: Jeong Hee Yoon, Jeong Min Lee, Eun Sun Lee, Jeehyun Baek, Sangwoo Lee, Yuji Iwadate, Joon Koo Han, Byung Ihn Choi

Published in: Abdominal Radiology | Issue 2/2015

Abstract

Purpose

To determine whether a navigator-gated three-dimensional T1-weighted gradient-echo sequence (T1W-GRE, navigated LAVA) can improve diagnostic performance for the detection of focal liver lesions (FLLs) compared to standard breath-hold (BH) T1W-GRE breath-hold LAVA (BH-LAVA) during the hepatobiliary phase (HBP) of gadoxetic acid liver magnetic resonance imaging (MRI) in patients with limited breath-holding capacity.

Materials and methods

This retrospective study was approved by our institutional review board and the requirement for informed consent was waived. We included 372 patients who underwent liver MRI including both navigated LAVA and BH-LAVA sequences. Overall image quality of the two HBP image sets was compared. In patients with limited breath-holding capacity, diagnostic performances in detecting FLLs on the two HBP images were compared using jackknife-alternative free-response receiver-operating characteristic (JAFROC) analysis by two reviewers.

Results

There were 13 cases (13/372; 3.5%) of image acquisition failure using the navigated LAVA sequence due to severe irregular breathing, and 50 of 359 patients had limited breath-holding capacity. In these patients, overall image quality of navigated LAVA (2.78 ± 0.95) was significantly better than that of BH-LAVA (2.42 ± 0.81, P < 0.005), and both readers showed significantly higher JAFROC figure-of-merit values with navigated LAVA compared to BH-LAVA (0.94 and 0.86 in reviewer 1, respectively; 0.89 and 0.83 in reviewer 2, respectively, P < 0.005). Overall image quality of navigated LAVA was also better than that of BH-LAVA in patients with sufficient breath-holding capacity (n = 309, 3.96 ± 0.88, 3.81 ± 0.66, respectively, P < 0.001).

Conclusion

The navigated LAVA sequence could provide better image quality and diagnostic performance in detecting FLLs than BH-LAVA in patients with limited breath-holding capacity during HBP of gadoxetic acid MRI.

Ayuso C, Rimola J, García-Criado Á (2012) Imaging of HCC. Abdom Imaging 37:215–230PubMedCrossRef

Mainenti PP, Mancini M, Mainolfi C, et al. (2010) Detection of colo-rectal liver metastases: prospective comparison of contrast enhanced US, multidetector CT, PET/CT, and 1.5 Tesla MR with extracellular and reticulo-endothelial cell specific contrast agents. Abdom Imaging 35:511–521PubMedCrossRef

Gore R, Thakrar K, Wenzke D, et al. (2012) That liver lesion on MDCT in the oncology patient: is it important? Cancer Imaging 12:373–384PubMedCentralPubMedCrossRef

Becker-Weidman DJ, Kalb B, Sharma P, et al. (2011) Hepatocellular carcinoma lesion characterization: single-institution clinical performance review of multiphase gadolinium-enhanced MR imaging—comparison to prior same-center results after MR systems improvements. Radiology 261:824–833PubMedCrossRef

Lee JM, Zech CJ, Bolondi L, et al. (2011) Consensus report of the 4th International Forum for gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging. Korean J Radiol 12:403–415PubMedCentralPubMedCrossRef

Lee KH, Lee JM, Park JH, et al. (2013) MR imaging in patients with suspected liver metastases: value of liver-specific contrast agent gadoxetic acid. Korean J Radiol 14:894–904PubMedCentralPubMedCrossRef

Berger-Kulemann V, Schima W, Baroud S, et al. (2012) Gadoxetic acid-enhanced 3.0 T MR imaging versus multidetector-row CT in the detection of colorectal metastases in fatty liver using intraoperative ultrasound and histopathology as a standard of reference. Eur J Surg Oncol (EJSO) 38:670–676CrossRef

Martin DR, Semelka RC (2005) Magnetic resonance imaging of the liver: review of techniques and approach to common diseases Seminars in Ultrasound, CT, and MRI. Elsevier, Philadelphia, pp 116–131

Wile GE, Leyendecker JR (2010) Magnetic resonance imaging of the liver: sequence optimization and artifacts. Magn Reson Imaging Clin N Am 18:525–547PubMedCrossRef

10.

Ringe KI, Husarik DB, Gupta RT, Boll DT, Merkle EM (2011) Hepatobiliary transit times of gadoxetate disodium for protocol optimization of comprehensive MR imaging of the biliary system—what is normal? Eur J Radiol 79:201–205PubMedCrossRef

11.

Yu MH, Lee JM, Yoon JH, et al. (2013) Clinical application of controlled aliasing in parallel imaging results in a higher acceleration (CAIPIRINHA)-volumetric interpolated breathhold (VIBE) sequence for gadoxetic acid-enhanced liver MR imaging. J Magn Reson Imaging 38:1020–1026PubMedCrossRef

12.

Yoon JH, Lee JM, Yu MH, et al. (2014) High-resolution T1-weighted gradient echo imaging for liver MRI using parallel imaging at high-acceleration factors. Abdom Imaging 39:711–721PubMedCrossRef

13.

Nagle SK, Busse RF, Brau AC, et al. (2012) High resolution navigated three-dimensional T1-weighted hepatobiliary MRI using gadoxetic acid optimized for 1.5 tesla. J Magn Reson Imaging 36:890–899PubMedCentralPubMedCrossRef

14.

Tran PV, Jhaveri KS (2013) Comparison of high spatial resolution respiratory triggered inversion recovery-prepared spoiled gradient echo sequence with standard breathhold T1 sequence MRI of the liver using gadoxetic acid. J Magn Reson Imaging 37:700–706PubMedCrossRef

15.

Young PM, Brau AC, Iwadate Y, et al. (2010) Respiratory navigated free breathing 3D spoiled gradient-recalled echo sequence for contrast-enhanced examination of the liver: diagnostic utility and comparison with free breathing and breath-hold conventional examinations. Am J Roentgenol 195:687–691CrossRef

16.

Asbach P, Warmuth C, Stemmer A, et al. (2008) High spatial resolution T1-weighted MR imaging of liver and biliary tract during uptake phase of a hepatocyte-specific contrast medium. Invest Radiol 43:809–815PubMedCrossRef

17.

Motosugi U, Ichikawa T, Morisaka H, et al. (2011) Detection of pancreatic carcinoma and liver metastases with gadoxetic acid–enhanced MR imaging: comparison with contrast-enhanced multi-detector row ct. Radiology 260:446–453PubMedCrossRef

18.

Bruix J, Sherman M (2011) Management of hepatocellular carcinoma: an update. Hepatology 53:1020–1022PubMedCentralPubMedCrossRef

19.

Ahn SJ, Kim MJ, Hong HS, Kim KA, Song HT (2011) Distinguishing hemangiomas from malignant solid hepatic lesions: a comparison of heavily T2-weighted images obtained before and after administration of gadoxetic acid. J Magn Reson Imaging 34:310–317PubMedCrossRef

20.

Ba-Ssalamah A, Uffmann M, Saini S, et al. (2009) Clinical value of MRI liver-specific contrast agents: a tailored examination for a confident non-invasive diagnosis of focal liver lesions. Eur Radiol 19:342–357PubMedCrossRef

21.

Yun E, Choi B, Han J, et al. (1999) Hepatic hemangioma: contrast-enhancement pattern during the arterial and portal venous phases of spiral CT. Abdom Imaging 24:262–266PubMedCrossRef

22.

Horton KM, Bluemke DA, Hruban RH, Soyer P, Fishman EK (1999) CT and MR imaging of benign hepatic and biliary tumors. Radiographics 19:431–451PubMedCrossRef

23.

Hyodo T, Murakami T, Imai Y, et al. (2013) Hypovascular nodules in patients with chronic liver disease: risk factors for development of hypervascular hepatocellular carcinoma. Radiology 266:480–490PubMedCrossRef

24.

Golfieri R, Grazioli L, Orlando E, et al. (2012) Which is the best MRI marker of malignancy for atypical cirrhotic nodules: hypointensity in hepatobiliary phase alone or combined with other features? Classification after Gd-EOB-DTPA administration. J Magn Reson Imaging 36:648–657PubMedCrossRef

25.

Golfieri R, Renzulli M, Lucidi V, et al. (2011) Contribution of the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI to dynamic MRI in the detection of hypovascular small (≤2 cm) HCC in cirrhosis. Eur Radiol 21:1233–1242PubMedCrossRef

26.

Kitao A, Matsui O, Yoneda N, et al. (2011) The uptake transporter OATP8 expression decreases during multistep hepatocarcinogenesis: correlation with gadoxetic acid enhanced MR imaging. Eur Radiol 21:2056–2066PubMedCrossRef

27.

Yoon MA, Kim SH, Park HS, et al. (2009) Value of dual contrast liver MRI at 3.0 T in differentiating well-differentiated hepatocellular carcinomas from dysplastic nodules: preliminary results of multivariate analysis. Invest Radiol 44:641–649PubMedCrossRef

28.

Vasanawala SS, Iwadate Y, Church DG, Herfkens RJ, Brau AC (2010) Navigated abdominal T1-W MRI permits free-breathing image acquisition with less motion artifact. Pediatr Radiol 40:340–344PubMedCentralPubMedCrossRef

29.

Chakraborty DP (2006) Analysis of location specific observer performance data: validated extensions of the jackknife free-response (JAFROC) method. Acad Radiol 13:1187–1193PubMedCrossRef

30.

Chakraborty DP, Berbaum KS (2004) Observer studies involving detection and localization: modeling, analysis, and validation. Med Phys 31:2313–2330PubMedCrossRef

31.

Zheng B, Chakraborty DP, Rockette HE, Maitz GS, Gur D (2005) A comparison of two data analyses from two observer performance studies using jackknife ROC and JAFROC. Med Phys 32:1031–1034PubMedCrossRef

32.

Sun HY, Lee JM, Shin CI, et al. (2010) Gadoxetic acid-enhanced magnetic resonance imaging for differentiating small hepatocellular carcinomas (≤2 cm in diameter) from arterial enhancing pseudolesions: special emphasis on hepatobiliary phase imaging. Invest Radiol 45:96–103PubMedCrossRef

33.

Knowles B, Welsh FK, Chandrakumaran K, John TG, Rees M (2012) Detailed liver-specific imaging prior to pre-operative chemotherapy for colorectal liver metastases reduces intra-hepatic recurrence and the need for a repeat hepatectomy. HPB 14:298–309PubMedCentralPubMedCrossRef

34.

Maniam S, Szklaruk J (2010) Magnetic resonance imaging: review of imaging techniques and overview of liver imaging. World J Radiol 2:309–322PubMedCentralPubMedCrossRef

35.

Reiner C, Neville A, Nazeer H, et al. (2013) Contrast-enhanced free-breathing 3D T1-weighted gradient-echo sequence for hepatobiliary MRI in patients with breath-holding difficulties. Eur Radiol 23:3087–3093PubMedCrossRef

36.

Iwadate Y, Brau A, Vasanawala SS, Kabasawa H (2013) Enhancement of respiratory navigator-gated three-dimensional spoiled gradient-recalled echo sequence with variable flip angle scheme. Magn Reson Med 72:172–177PubMedCrossRef

37.

Bashir MR, Merkle EM (2011) Improved liver lesion conspicuity by increasing the flip angle during hepatocyte phase MR imaging. Eur Radiol 21:291–294PubMedCrossRef

38.

Bashir MR, Husarik DB, Ziemlewicz TJ, et al. (2012) Liver MRI in the hepatocyte phase with gadolinium-EOB-DTPA: does increasing the flip angle improve conspicuity and detection rate of hypointense lesions? J Magn Reson Imaging 35:611–616PubMedCrossRef

Title: Navigated three-dimensional T1-weighted gradient-echo sequence for gadoxetic acid liver magnetic resonance imaging in patients with limited breath-holding capacity
Authors: Jeong Hee Yoon
Jeong Min Lee
Eun Sun Lee
Jeehyun Baek
Sangwoo Lee
Yuji Iwadate
Joon Koo Han
Byung Ihn Choi
Publication date: 01-02-2015
Publisher: Springer US
Published in: Abdominal Radiology / Issue 2/2015
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-014-0214-x

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