Respiratory motion artifacts during arterial phase imaging with gadoxetic acid: Can the injection protocol minimize this drawback?

Purpose To assess the interrater agreement and reliability of experienced abdominal radiologists in the characterization and grading of arterial phase gadoxetate disodium-related respiratory motion artifact on liver MRI. Materials and Methods This prospective multicenter study was initiated by the working group for abdominal imaging within the German Roentgen Society (DRG), and approved by the local IRB of each participating center. 11 board-certified radiologists independently reviewed 40 gadoxetate disodium-enhanced liver MRI datasets. Motion artifacts in the arterial phase were assessed on a 5-point scale. Interrater agreement and reliability were calculated using the intraclass correlation coefficient (ICC) and Kendall coefficient of concordance (W), with p < 0.05 deemed significant. Results The ICC for interrater agreement and reliability were 0.983 (CI 0.973 – 0.990) and 0.985 (CI 0.978 – 0.991), respectively (both p < 0.0001), indicating excellent agreement and reliability. Kendall’s W for interrater agreement was 0.865. A severe motion artifact, defined as a mean motion score ≥ 4 in the arterial phase was observed in 12 patients. In these specific cases, a motion score ≥ 4 was assigned by all readers in 75 % (n = 9/12 cases). Conclusion Differentiation and grading of arterial phase respiratory motion artifact is possible with a high level of inter-/intrarater agreement and interrater reliability, which is crucial for assessing the incidence of this phenomenon in larger multicenter studies. Key Points Citation Format

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Respiratory Motion Artifact Affecting Hepatic Arterial Phase Imaging with Gadoxetate Disodium: Examination Recovery with a Multiple Arterial Phase Acquisition

Radiology ◽

10.1148/radiol.13131988 ◽

2014 ◽

Vol 271 (2) ◽

pp. 426-434 ◽

Cited By ~ 119

Author(s):

Jason A. Pietryga ◽

Lauren M. B. Burke ◽

Daniele Marin ◽

Tracy A. Jaffe ◽

Mustafa R. Bashir

Keyword(s):

Respiratory Motion ◽

Motion Artifact ◽

Arterial Phase ◽

Phase Imaging ◽

Gadoxetate Disodium ◽

Respiratory Motion Artifact ◽

Hepatic Arterial Phase

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Ring-Like Enhancement of Hepatocellular Carcinoma in Gadoxetic Acid–Enhanced Multiphasic Hepatic Arterial Phase Imaging With Differential Subsampling With Cartesian Ordering

Investigative Radiology ◽

10.1097/rli.0000000000000428 ◽

2018 ◽

Vol 53 (4) ◽

pp. 191-199 ◽

Cited By ~ 9

Author(s):

Shintaro Ichikawa ◽

Utaroh Motosugi ◽

Naoki Oishi ◽

Tatsuya Shimizu ◽

Tetsuya Wakayama ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Gadoxetic Acid ◽

Arterial Phase ◽

Phase Imaging ◽

Hepatic Arterial Phase

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Experimental studies on artifacts and tumor enhancement on gadoxetic acid-enhanced arterial phase liver MRI in a rabbit VX2 tumor model

Acta Radiologica ◽

10.1177/0284185117747134 ◽

2017 ◽

Vol 59 (9) ◽

pp. 1029-1037 ◽

Cited By ~ 1

Author(s):

Takahiro Tsuboyama ◽

Gregor Jost ◽

Tonsok Kim ◽

Masatoshi Hori ◽

Hiromitsu Onishi ◽

...

Keyword(s):

Experimental Studies ◽

Gadoxetic Acid ◽

Arterial Phase ◽

Phase Imaging ◽

Injection Time ◽

Liver Mri ◽

Arterial Blood ◽

Rapid Injection ◽

Vascular Enhancement ◽

Slow Injection

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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Does transient arterial-phase respiratory-motion-related artifact impact on diagnostic performance? An intra-patient comparison of extracellular gadolinium versus gadoxetic acid

European Radiology ◽

10.1007/s00330-020-07039-6 ◽

2020 ◽

Vol 30 (12) ◽

pp. 6694-6701

Author(s):

Jordi Rimola ◽

Anna Darnell ◽

Ernest Belmonte ◽

Victor Sapena ◽

Carla Caparroz ◽

...

Keyword(s):

Diagnostic Performance ◽

Respiratory Motion ◽

Gadoxetic Acid ◽

Arterial Phase

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Transient Severe Motion Artifact Related to Gadoxetate Disodium-Enhanced Liver MRI: Frequency and Risk Evaluation at a German Institution

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/s-0043-102940 ◽

2017 ◽

Vol 189 (07) ◽

pp. 651-660 ◽

Cited By ~ 7

Author(s):

Lennart Well ◽

Vanessa Rausch ◽

Gerhard Adam ◽

Frank Henes ◽

Peter Bannas

Keyword(s):

United States ◽

Risk Factors ◽

Respiratory Motion ◽

The United States ◽

Gadobenate Dimeglumine ◽

Motion Artifacts ◽

Arterial Phase ◽

Gadoxetate Disodium ◽

Liver Mri ◽

Potential Risk Factors

Purpose Varying frequencies (5 – 18 %) of contrast-related transient severe motion (TSM) imaging artifacts during gadoxetate disodium-enhanced arterial phase liver MRI have been reported. Since previous reports originated from the United States and Japan, we aimed to determine the frequency of TSM at a German institution and to correlate it with potential risk factors and previously published results. Materials and Methods Two age- and sex-matched groups were retrospectively selected (gadoxetate disodium n = 89; gadobenate dimeglumine n = 89) from dynamic contrast-enhanced MRI examinations in a single center. Respiratory motion-related artifacts in non-enhanced and dynamic phases were assessed independently by two readers blinded to contrast agents on a 4-point scale. Scores of ≥ 3 were considered as severe motion artifacts. Severe motion artifacts in arterial phases were considered as TSM if scores in all other phases were < 3. Potential risk factors for TSM were evaluated via logistic regression analysis. Results For gadoxetate disodium, the mean score for respiratory motion artifacts was significantly higher in the arterial phase (2.2 ± 0.9) compared to all other phases (1.6 ± 0.7) (p < 0.05). The frequency of TSM was significantly higher with gadoxetate disodium (n = 19; 21.1 %) than with gadobenate dimeglumine (n = 1; 1.1 %) (p < 0.001). The frequency of TSM at our institution is similar to some, but not all previously published findings. Logistic regression analysis did not show any significant correlation between TSM and risk factors (all p > 0.05). Conclusion We revealed a high frequency of TSM after injection of gadoxetate disodium at a German institution, substantiating the importance of a diagnosis-limiting phenomenon that so far has only been reported from the United States and Japan. In accordance with previous studies, we did not identify associated risk factors for TSM. Key Points: Citation Format

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