Feasibility of 15-Minute Delayed Hepatobiliary Phase Imaging Using a 30 Degree Flip Angle in Gadoxetic Acid-Enhanced MRI in the Detection of the Focal Liver Lesion in Cirrhotic Liver
Keywords:
Gadoxetic acid-enhanced MRI, Hepatobiliary phase imaging, Liver-to-lesion contrast-to-noise ratio, Liver-to-lesion contrast ratioAbstract
Introduction: Added hepatobiliary phase images (HBI) of gadoxetic acid-enhanced MRI improve sensitivity for detection of focal liver lesions (FLLs) due to good liver-to-lesion contrast-to-noise ratios (CNRs). The 20-minute delay time is a standard recommendation to obtain appropriate HBI which producing the best liver-to-lesion CNRs.
Objectives: To compare the liver-to-lesion CNR, contrast ratio (CR), and the sensitivity of FLL detection of a 15-minute delayed HBI using a 30º flip angle (15min-FA30) in gadoxetic acid-enhanced MRI with those of a standard 20-minute delayed HBI using 25º FA (20min-FA25) in patient with cirrhotic liver.
Methods: Seventy FLLs from 62 patients who underwent gadoxetic acid-enhanced MRI with 15minFA30 and 20min-FA25 HBI were enrolled. Liver-to-lesion CNRs and CRs were compared between the two groups. Two radiologists independently reviewed the presence of FLLs using a four-point scale and detection sensitivity was calculated.
Results: There was no significant difference in the median CNR of all FLLs on the 15min-FA30 (77.6: IQR; 47.4 - 133.2) and that of the 20min-FA25 (81.5: IQR; 48.2 - 140.0). The mean CR of all FLLs on the 15min-FA30 (0.47 ± 0.16) and 20min-FA25 (0.47 ± 0.17) was no significant difference. There was no significant difference in FLLs detection sensitivity for two readers between 15min-FA30 (91.4% and 97.1%) and 20min-FA25 (92.9% and 97.1%)
Conclusions: The CNRs, CRs and lesion detection sensitivity of shorten delayed HBI with high FA in gadoxetic acid-enhanced MRI are comparable with the standard delayed HBI in patient with cirrhotic liver. This result indicates that 15min-FA30 can replace 20min-FA25 that help to reduce the total examination time.
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References
Teerasamit W, Tongdee R, Yodying J. Diagnostic performance of gadoxetic acid-enhanced MR imaging in the diagnosis of hepatocellular carcinoma in cirrhotic Liver. J Med Assoc Thai. 2017;100(8):918-926.
Hwang J, Kim SH, Lee MW, Lee JY. Small (≤2 cm) hepatocellular carcinoma in patients with chronic liver disease: comparison of
gadoxetic acid-enhanced 3.0 T MRI and multiphasic 64-multirow detector CT. Br J Radiol. 2012;85(1015):314-322.
Onishi H, Kim T, Imai Y, et al. Hypervascular hepatocellular carcinomas: detection with gadoxetate disodium-enhanced MR imaging
and multiphasic multidetector CT. Eur Radiol. 2012;22(4):845-854.
Cruite I, Schroeder M, Merkle EM, Sirlin CB. Gadoxetate disodium-enhanced MRI of the liver: part 2, protocol optimization and lesion
appearance in the cirrhotic liver. AJR Am J Roentgenol 2010;195(1):29-41.
Ahn SS, Kim MJ, Lim JS, Hong HS, Chung YE, Choi JY. Added value of gadoxetic acidenhanced hepatobiliary phase MR imaging in the diagnosis of hepatocellular carcinoma. Radiology. 2010;255(2):459-466.
Frericks BB, Loddenkemper C, Huppertz A, et al. Qualitative and quantitative evaluation of hepatocellular carcinoma and cirrhotic liver enhancement using Gd-EOB-DTPA. AJR Am J Roentgenol. 2009;193(4):1053-1060.
Jeon I, Cho ES, Kim JH, Kim DJ, Yu JS, Chung JJ. Feasibility of 10-minute delayed hepatocyte phase imaging using a 30° flip angle in Gd-EOB-DTPA-enhanced liver MRI for the detection of hepatocellular carcinoma in patients with chronic hepatitis or cirrhosis.
PLOS ONE. 2016;11(12):0167701.
Lee D, Cho ES, Kim DJ, Kim JH, Yu JS, Chung JJ. Validation of 10-minute delayed hepatocyte phase imaging with 30° flip angle in gadoxetic acid-enhanced MRI for the detection of liver metastasis. PLOS ONE. 2015;10(10):0139863
Motosugi U, Ichikawa T, Tominaga L, et al. Delay before the hepatocyte phase of Gd-EOBDTPA-enhanced MR imaging: Is it possible
to shorten the examination time? Eur Radiol. 2009;19(11):2623-2629
van Kessel CS, Veldhuis WB, van den Bosch MA, van Leeuwen MS. MR liver imaging with Gd-EOB-DTPA: a delay time of 10 minutes
is sufficient for lesion characterization. Eur Radiol. 2012;22(10):2153-2160.
Sofue K, Tsurusaki M, Tokue H, Arai Y, Sugimura K. Gd-EOB-DTPA-enhanced 3.0 T MR imaging: quantitative and qualitative
comparison of hepatocyte-phase images obtained 10 min and 20 min after injection for the detection of liver metastases from colorectal carcinoma. Eur Radiol. 2011;21(11): 2336-2343.
Verloh N, Haimerl M, Rennert J, et al. Impact of liver cirrhosis on liver enhancement at Gd-EOB-DTPA enhanced MRI at 3 Tesla. Eur J Radiol. 2013;82(10):1710-1715.
Bashir MR, Merkle EM. Improved liver lesion conspicuity by increasing the flip angle during hepatocyte phase MR imaging. Eur Radiol. 2011;21(2):291-294.
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