Investig Magn Reson Imaging.  2017 Jun;21(2):71-81. 10.13104/imri.2017.21.2.71.

Comparison of Three, Motion-Resistant MR Sequences on Hepatobiliary Phase for Gadoxetic Acid (Gd-EOB-DTPA)-Enhanced MR Imaging of the Liver

• Kim DR
• Kim BS
• Lee JS
• Choi GM
• Kim SH
• Goh MJ
• Song BC
• Lee MS
• Lee KR
• Ko SY

• KMID: 2385603
• DOI: http://doi.org/10.13104/imri.2017.21.2.71

Abstract

PURPOSE
To compare three, motion-resistant, T1-weighted MR sequences on the hepatobiliary phase for gadoxetic acid-enhanced MR imaging of the liver.
MATERIALS AND METHODS
In this retrospective study, 79 patients underwent gadoxetic acid-enhanced, 3T liver MR imaging. Fifty-nine were examined using a standard protocol, and 20 were examined using a motion-resistant protocol. During the hepatocyte-specific phase, three MR sequences were acquired: 1) gradient recalled echo (GRE) with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA); 2) radial GRE with the interleaved angle-bisection scheme (ILAB); and 3) radial GRE with golden-angle scheme (GA). Two readers independently assessed images with motion artifacts, streaking artifacts, liver-edge sharpness, hepatic vessel clarity, lesion conspicuity, and overall image quality, using a 5-point scale. The images were assessed by measurement of liver signal-to-noise ratio (SNR), and tumor-to-liver contrast-to-noise ratio (CNR). The results were compared, using repeated post-hoc, paired t-tests with Bonferroni correction and the Wilcoxon signed rank test with Bonferroni correction.
RESULTS
In the qualitative analysis of cooperative patients, the results for CAIPIRINHA had significantly higher ratings for streak artifacts, liver-edge sharpness, hepatic vessel clarity, and overall image quality as compared to, radial GRE, (P < 0.016). In the imaging of uncooperative patients, higher scores were recorded for ILAB and GA with respect to all of the qualitative assessments, except for streak artifact, compared with CAIPIRINHA (P < 0.016). However, no significant differences were found between ILAB and GA. For quantitative analysis in uncooperative patients, the mean liver SNR and lesion-to-liver CNR with radial GRE were significantly higher than those of CAIPIRINHA (P < 0.016).
CONCLUSION
In uncooperative patients, the use of the radial GRE sequence can improve the image quality compared to GRE imaging with CAIPIRINHA, despite the data acquisition methods used. The GRE imaging with CAIPIRINHA is applicable for patients without breath-holding difficulties.

Keyword

Liver; Magnetic resonance imaging; Breath-holding; Gadolinium ethoxybenzyl DTPA

MeSH Terms

Acceleration
Artifacts
Humans
Liver*
Magnetic Resonance Imaging*
Retrospective Studies
Signal-To-Noise Ratio

Figure

• 

  Fig. 1 MR images of a 59-year-old man with hepatocellular carcinoma. He had one hepatocellular carcinoma in liver segment 6. A hepatocellular carcinoma (arrow) in the liver is clearly shown on the axial breath-hold, T1-weighted 3D GRE image with CAIPIRINHA (a) in this cooperative patient. The intrahepatic vessel (arrowhead) is well-visualized in the T1-weighted 3D GRE image with CAIPIRINHA (b). Axial free-breathing 3D radial GRE with GA (c, d) and 3D radial GRE with ILAB (e, f) show blurred resolution of the tumor (arrows) and margin of the intrahepatic vessel (arrowheads).

• 

  Fig. 2 MR images in a 75-year-old woman with intrahepatic, mass-forming cholangiocarcinoma. She had one intrahepatic, mass-forming cholangiocarcinoma in liver segments 4 and 8. Axial breath-hold, T1-weighted 3D GRE image with CAIPIRINHA (a) shows severe motion artifacts due to the patient's breathing. Axial free-breathing, 3D radial GRE with GA (b) and 3D radial GRE with ILAB (c) demonstrate substantially artifact reduction resistance to motion and high image quality in the patient who could not suspend respiration. The intrahepatic, mass-forming cholangiocarcinoma (arrows) and intrahepatic vessels (arrowheads) are better depicted in axial free-breathing, 3D radial GRE with GA and 3D radial GRE with ILAB.

Reference

1. Bamrungchart S, Tantaway EM, Midia EC, et al. Free breathing three-dimensional gradient echo-sequence with radial data sampling (radial 3D-GRE) examination of the pancreas: Comparison with standard 3D-GRE volumetric interpolated breathhold examination (VIBE). J Magn Reson Imaging. 2013; 38:1572–1577.

2. Birchard KR, Semelka RC, Hyslop WB, et al. Suspected pancreatic cancer: evaluation by dynamic gadolinium-enhanced 3D gradient-echo MRI. AJR Am J Roentgenol. 2005; 185:700–703.

3. Kim BS, Angthong W, Jeon YH, Semelka RC. Body MR imaging: fast, efficient, and comprehensive. Radiol Clin North Am. 2014; 52:623–636.

4. Rofsky NM, Lee VS, Laub G, et al. Abdominal MR imaging with a volumetric interpolated breath-hold examination. Radiology. 1999; 212:876–884.

5. Semelka RC, Helmberger TK. Contrast agents for MR imaging of the liver. Radiology. 2001; 218:27–38.

6. Semelka RC, Martin DR, Balci NC. Magnetic resonance imaging of the liver: how I do it. J Gastroenterol Hepatol. 2006; 21:632–637.

7. Kim BS, Lee KR, Goh MJ. New imaging strategies using a motion-resistant liver sequence in uncooperative patients. Biomed Res Int. 2014; 2014:142658.

8. Park YS, Lee CH, Kim IS, et al. Usefulness of controlled aliasing in parallel imaging results in higher acceleration in gadoxetic acid-enhanced liver magnetic resonance imaging to clarify the hepatic arterial phase. Invest Radiol. 2014; 49:183–188.

9. Wright KL, Harrell MW, Jesberger JA, et al. Clinical evaluation of CAIPIRINHA: comparison against a GRAPPA standard. J Magn Reson Imaging. 2014; 39:189–194.

10. Yu MH, Lee JM, Yoon JH, Kiefer B, Han JK, Choi BI. 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. 2013; 38:1020–1026.

11. Azevedo RM, de Campos RO, Ramalho M, Heredia V, Dale BM, Semelka RC. Free-breathing 3D T1-weighted gradient-echo sequence with radial data sampling in abdominal MRI: preliminary observations. AJR Am J Roentgenol. 2011; 197:650–657.

12. Chandarana H, Block TK, Rosenkrantz AB, et al. Free-breathing radial 3D fat-suppressed T1-weighted gradient echo sequence: a viable alternative for contrast-enhanced liver imaging in patients unable to suspend respiration. Invest Radiol. 2011; 46:648–653.

13. Chandarana H, Feng L, Block TK, et al. Free-breathing contrast-enhanced multiphase MRI of the liver using a combination of compressed sensing, parallel imaging, and golden-angle radial sampling. Invest Radiol. 2013; 48:10–16.

14. Kim KW, Lee JM, Jeon YS, et al. Free-breathing dynamic contrast-enhanced MRI of the abdomen and chest using a radial gradient echo sequence with K-space weighted image contrast (KWIC). Eur Radiol. 2013; 23:1352–1360.

15. Song HK, Dougherty L. Dynamic MRI with projection reconstruction and KWIC processing for simultaneous high spatial and temporal resolution. Magn Reson Med. 2004; 52:815–824.

16. Runge VM, Richter JK, Heverhagen JT. Speed in clinical magnetic resonance. Invest Radiol. 2017; 52:1–17.

17. Chandarana H, Block KT, Winfeld MJ, et al. Free-breathing contrast-enhanced T1-weighted gradient-echo imaging with radial k-space sampling for paediatric abdominopelvic MRI. Eur Radiol. 2014; 24:320–326.

18. Shin HJ, Kim MJ, Lee MJ, Kim HG. Comparison of image quality between conventional VIBE and radial VIBE in free-breathing paediatric abdominal MRI. Clin Radiol. 2016; 71:1044–1049.

19. Pruessmann KP, Weiger M, Scheidegger MB, Boesiger P. SENSE: sensitivity encoding for fast MRI. Magn Reson Med. 1999; 42:952–962.

20. Mitchell DG, Vinitski S, Saponaro S, Tasciyan T, Burk DL Jr, Rifkin MD. Liver and pancreas: improved spin-echo T1 contrast by shorter echo time and fat suppression at 1.5 T. Radiology. 1991; 178:67–67.