scholarly journals Comparison of gadoxetic acid and gadopentetate dimeglumine-enhanced MRI for HCC detection: prospective crossover study at 3 T

2015 ◽  
Vol 4 (2) ◽  
pp. 204798161456128 ◽  
Author(s):  
Cecilia Besa ◽  
Suguru Kakite ◽  
Nancy Cooper ◽  
Marcelo Facciuto ◽  
Bachir Taouli
Keyword(s):  
Image Quality ◽  
Contrast Agents ◽  
Contrast Ratio ◽  
Gadopentetate Dimeglumine ◽  
Gadoxetic Acid ◽  
Arterial Phase ◽  
Hepatobiliary Phase ◽  
Significant Difference ◽  
Phase Images ◽  
Lesion Conspicuity

Background Gadoxetic acid and gadopentetate dimeglumine are gadolinium-based contrast agents (GBCAs) with an established role in HCC detection and characterization. Purpose To compare gadopentetate dimeglumine and gadoxetic acid-enhanced magnetic resonance imaging (MRI) for image quality and hepatocellular carcinoma (HCC) detection/conspicuity. Material and Methods In this IRB approved cross-over pilot prospective study, 12 patients (all men; mean age, 56 years) with chronic liver disease at risk of HCC underwent two repeat MRI examinations using gadopentetate dimeglumine and gadoxetic acid (mean interval between studies, 5 days). Two independent observers analyzed images for image quality and HCC detection/conspicuity. Per-lesion sensitivity, positive predictive value, quantitative enhancement, and lesion-to-liver contrast ratio were calculated for both contrast agents. Results There was no significant difference in image quality scores between both GBCAs ( P = 0.3). A total of 20 HCCs were identified with reference standard in 12 patients (mean size 2.6 cm, range, 1.0–5.0 cm). Higher sensitivity was seen for observer 1 for gadoxetic acid-set in comparison with gadopentetate dimeglumine-set (sensitivity increased from 85.7% to 92.8%), while no difference was noted for observer 2 (sensitivity of 78.5%). Lesion conspicuity was significantly higher on hepatobiliary phase (HBP) images compared to arterial phase images with both GBCAs for both observers ( P < 0.05). Lesion-to-liver contrast ratios were significantly higher for HBP compared to all dynamic phases for both agents ( P < 0.05). Conclusion Our initial experience suggests that gadoxetic acid-set was superior to gadopentetate dimeglumine-set in terms of HCC detection for one observer, with improved lesion conspicuity and liver-to-lesion contrast on HBP images.

Intra-individual comparison of hepatocellular carcinoma imaging features on contrast-enhanced computed tomography, gadopentetate dimeglumine-enhanced MRI, and gadoxetic acid-enhanced MRI

2017 ◽  
Vol 59 (6) ◽  
pp. 639-648 ◽  
Author(s):  
Yo Na Kim ◽  
Ji Soo Song ◽  
Woo Sung Moon ◽  
Hong Pil Hwang ◽  
Young Kon Kim
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Contrast Ratio ◽  
Gadopentetate Dimeglumine ◽  
Gadoxetic Acid ◽  
Arterial Phase ◽  
Hepatobiliary Phase ◽  
Imaging Features ◽  
Enhanced Mri ◽  
Individual Comparison

Background Gadoxetic acid is being widely used for detection and characterization of hepatic nodules. However, there are no data regarding intra-individual comparison of imaging features of hepatocellular carcinoma (HCC) on dynamic computed tomography (CT), gadopentetate dimeglumine-enhanced magnetic resonance imaging (Gd-DTPA-MRI), and gadoxetic acid-enhanced MRI (Gd-EOB-MRI). Purpose To evaluate typical imaging features of HCC and capsule appearance with dynamic CT, Gd-DTPA-MRI, and Gd-EOB-MRI. Material and Methods We retrospectively reviewed 56 HCCs in 49 patients. Lesion attenuation/signal intensity was graded using a five-point scale based on dynamic phase and hepatobiliary phase (HBP) imaging. Subjective washout and capsule appearance were evaluated on portal venous phase (PVP) or delayed/transitional phase (DP/TP) imaging. The tumor-to-liver contrast ratio (TLCR) was calculated. Results Gd-DTPA-MRI and Gd-EOB-MRI was graded higher than CT on arterial phase ( P < 0.001). Gd-EOB-MRI was graded lower than Gd-DTPA-MRI on PVP and DP/TP ( P < 0.05). The detection rate of subjective washout and capsule appearance did not differ among the three imaging studies on either PVP or DP/TP. TLCR of Gd-EOB-MRI was lower than CT on PVP ( P = 0.004) and was lower than Gd-DTPA-MRI on DP/TP ( P = 0.001). Conclusion Arterial phase hyperenhancement and washout appearance of HCC were well demonstrated in Gd-EOB-MRI. The detection of capsule appearance using Gd-EOB-MRI was not inferior to Gd-DTPA-MRI or CT.

Hepatobiliary phase images of gadoxetic acid-enhanced MRI may improve accuracy of predicting the size of hepatocellular carcinoma at pathology

2021 ◽  
pp. 028418512110141
Author(s):  
San-Yuan Dong ◽  
Yu-Tao Yang ◽  
Wen-Tao Wang ◽  
Shuo Zhu ◽  
Wei Sun ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Correlation Coefficient ◽  
Tumor Size ◽  
Pearson Correlation ◽  
Gadoxetic Acid ◽  
Arterial Phase ◽  
Hepatobiliary Phase ◽  
Enhanced Mri ◽  
Phase Images ◽  
Mri Sequences

Background Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has been widely used in clinical practice. However, scientific evidence is lacking for recommending a particular sequence for measuring tumor size. Purpose To retrospectively compare the size of hepatocellular carcinoma (HCC) measured on different gadoxetic acid-enhanced MRI sequences using pathology as a reference. Material and Methods A total of 217 patients with single HCC who underwent gadoxetic acid-enhanced MRI before surgery were included. The size of the HCC was measured by two abdominal radiologists independently on the following sequences: T1-weighted; T2-weighted; b-500 diffusion-weighted imaging (DWI); and arterial, portal venous, transitional, and hepatobiliary phases. Tumor size measured on MRI was compared with pathological size by using Pearson correlation coefficient, independent-sample t test, and Bland–Altman plot. Agreement between two readers was evaluated with intraclass correlation coefficient (ICC). Results Correlation between the MR images and pathology was high for both readers (0.899–0.955). Absolute error between MRI and pathologic assessment was lowest on hepatobiliary phase images for both readers (reader 1, 2.8±4.2 mm; reader 2, 3.2±3.4 mm) and highest on arterial phase images for reader 1 (4.9±4.4 mm) and DWI phase images for reader 2 (5.1±4.9 mm). Absolute errors were significantly different for hepatobiliary phase compared with other sequences for both readers (reader 1, P≤0.012; reader 2, P≤0.037). Inter-reader agreements for all sequence measurements were strong (0.971–0.997). Conclusion The performance of gadoxetic acid-enhanced MRI sequences varied with HCC size, and the hepatobiliary phase may be optimal among these sequences.

Detectability of Hypervascular Hepatocellular Carcinoma by Arterial Phase Images of MR and Spiral CT

1995 ◽  
Vol 36 (4-6) ◽  
pp. 372-376 ◽  
Author(s):  
Takamichi Murakami ◽  
Tonsok Kim ◽  
Hiromichi Oi ◽  
Hironobu Nakamura ◽  
Hideji Igarashi ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Spiral Ct ◽  
Arterial Phase ◽  
Breath Hold ◽  
Mr Images ◽  
Iodized Oil ◽  
Hepatocellular Carcinomas ◽  
Significant Difference ◽  
Phase Images ◽  
Arterial Chemoembolization

The ability of arterial phase images of breath-hold MR imaging and spiral CT to detect hypervascular hepatocellular carcinomas (HCCs) was evaluated. Prior to transcatheter arterial chemoembolization (TACE) with iodized oil, MR images and spiral CT during i.v. bolus injection of contrast medium (IV-MR imaging and IV-spiral CT) and spiral CT during intraarterial injection of contrast media through catheter (IA-spiral CT) of the entire liver were obtained in 24 consecutive patients with 93 HCCs. In the detection of HCCs less than 1 cm in diameter, IA-spiral CT (87.3%) was superior to IV-MR imaging (63.5%) and IV-spiral CT (54.0%) (p<0.001). There was no significant difference in detectability in any tumor size between IV-MR imaging and IV-spiral CT. IA-spiral CT was the best for detecting hypervascular HCCs, and there was no significant difference between IV-MR imaging and IV-spiral CT.

scholarly journals Quantitative Evaluation of Display Contrast of Gd-EOB-DTPA-Enhanced Magnetic Resonance Images: Effects of the Flip Angle and Grayscale Gamma Value

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Yusuke Inoue ◽  
Hirofumi Hata ◽  
Ai Nakajima ◽  
Keiji Matsunaga ◽  
Yusuke Ohzeki ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Liver Tumors ◽  
Contrast Ratio ◽  
Magnetic Resonance Images ◽  
Image Contrast ◽  
Focal Liver Lesions ◽  
Hepatobiliary Phase ◽  
Signal Ratio ◽  
Phase Images ◽  
Noise Ratio

Introduction. Display contrast can be changed nonlinearly by manipulating the gamma value of the grayscale. We investigated the contrast of the hepatobiliary-phase images acquired with different flip angles (FAs) and displayed with different gamma values in Gd-EOB-DTPA-enhanced magnetic resonance imaging. Material and Methods. Twenty patients with liver tumors were studied. Hepatobiliary-phase images were acquired at low (12°) and high (30°) FAs. Low-FA images were converted to simulate images displayed with different gamma values, using ImageJ software. To assess image contrast, the liver-to-muscle signal ratio (LMR), liver-to-spleen signal ratio (LSR), contrast ratio (CR), liver signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated. Results. The LMR, LSR, and CR were higher in the high-FA images than in the low-FA original images. Although the SNR was lower in the high-FA images, indicating an increase in noise, the CNR was higher. Raising the gamma value increased the LMR, LSR, and CR, notably decreased the SNR, and slightly decreased the CNR. Conclusion. Increasing the FA enhanced image contrast, supporting its usefulness for improving the delineation of focal liver lesions. Although the associated increase in noise may be problematic, raising the grayscale gamma value enhances the display contrast of low-FA images.

scholarly journals Magnetic resonance cholangiopancreatography with compressed sensing at 1.5 T: clinical application for the evaluation of branch duct IPMN of the pancreas

2020 ◽  
Vol 30 (11) ◽  
pp. 6014-6021
Author(s):  
Benjamin Henninger ◽  
Michael Steurer ◽  
Michaela Plaikner ◽  
Elisabeth Weiland ◽  
Werner Jaschke ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Image Quality ◽  
Compressed Sensing ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Rank Test ◽  
Breath Hold ◽  
Branch Duct ◽  
Significant Difference ◽  
Lesion Conspicuity ◽  
Short Breath

Abstract Objectives To evaluate magnetic resonance cholangiopancreatography (MRCP) with compressed sensing (CS) for the assessment of branch duct intraductal papillary mucinous neoplasm (BD-IPMN) of the pancreas. For this purpose, conventional navigator-triggered (NT) sampling perfection with application-optimized contrast using different flip angle evolutions (SPACE) MRCP was compared with various CS-SPACE-MRCP sequences in a clinical setting. Methods A total of 41 patients (14 male, 27 female, mean age 68 years) underwent 1.5-T MRCP for the evaluation of BD-IPMN. The MRCP protocol consisted of the following sequences: conventional NT-SPACE-MRCP, CS-SPACE-MRCP with long (BHL, 17 s) and short single breath-hold (BHS, 8 s), and NT-CS-SPACE-MRCP. Two board-certified radiologists evaluated image quality, duct sharpness, duct visualization, lesion conspicuity, confidence, and communication with the main pancreatic duct in consensus using a 5-point scale (1–5), with higher scores indicating better quality/delineation/confidence. Maximum intensity projection reconstructions and originally acquired data were used for evaluation. Wilcoxon signed-rank test was used to compare the intra-individual difference between sequences. Results BHS-CS-SPACE-MRCP had the highest scores for image quality (3.85 ± 0.79), duct sharpness (3.81 ± 1.05), and duct visualization (3.81 ± 1.01). There was a significant difference compared with NT-CS-SPACE-MRCP (p < 0.05) but no significant difference to the standard NT-SPACE-MRCP (p > 0.05). Concerning diagnostic quality, BHS-CS-SPACE-MRCP had the highest scores in lesion conspicuity (3.95 ± 0.92), confidence (4.12 ± 1.08), and communication (3.8 ± 1.06), significantly higher compared with NT-SPACE-MRCP, BHL-SPACE-MRCP, and NT-CS-SPACE-MRCP (p = <0.05). Conclusions MRCP with CS 3D SPACE for the evaluation of BD-IPMN at 1.5 T provides the best results using a short breath-hold sequence. This approach is feasible and an excellent alternative to standard NT 3D MRCP sequences. Key Points • 1.5-T MRCP with compressed sensing for the evaluation of branch duct IPMN is a feasible method. • Short breath-hold sequences provide the best results for this purpose.

scholarly journals Comparison of normal facial nerve enhancement at 3T MRI using gadobutrol and gadopentetate dimeglumine

2017 ◽  
Vol 30 (6) ◽  
pp. 554-560 ◽  
Author(s):  
Rupa Radhakrishnan ◽  
Shamima Ahmed ◽  
Joshua Cole Tilden ◽  
Humberto Morales
Keyword(s):  
Facial Nerve ◽  
Contrast Agents ◽  
Spin Echo ◽  
Cranial Nerves ◽  
Gadopentetate Dimeglumine ◽  
Gradient Echo ◽  
3D Inversion ◽  
Post Contrast ◽  
Significant Difference ◽  
Facial Nerves

Background and purpose The facial nerve is unique among cranial nerves in demonstrating normal enhancement of particular segments. The effect of varying T1 relaxivities of gadolinium-based contrast agents on facial nerve enhancement is unclear. In this study, we assess differences in normal facial nerve enhancement with two different gadolinium-based contrast agents, gadobutrol and gadopentetate dimeglumine. In addition, we evaluate differences in facial nerve enhancement with spin-echo (SE) T1 versus 3D inversion recovery prepared fast spoiled gradient-echo (FSPGR) post-contrast sequences. Methods A total of 140 facial nerves in 70 individuals were evaluated (70 with gadobutrol and 70 with gadopentetate dimeglumine) by two blinded reviewers. Differences in enhancement of facial nerve segments between the two agents were analyzed. Differences in enhancement between SE T1 and FSPGR imaging were also evaluated. Results There was no significant difference in facial nerve enhancement between gadobutrol and gadopentetate dimeglumine. Enhancement was commonly observed in the geniculate, tympanic and mastoid segments (98%–100%) with either contrast agent; enhancement was less common in the labyrinthine segments (9%–14%) and lateral canalicular segment (2%–5%). There was a smaller enhancing proportion of labyrinthine and tympanic segments with FSPGR as compared to SE T1 images with gadobutrol. Conclusion There is no significant difference in overall enhancement of the facial nerve between gadobutrol and gadopentetate dimeglumine. Mild enhancement of the lateral canalicular portion of the facial nerve may be a normal finding. With FSPGR sequence, there is lesser perceived enhancement of the labyrinthine and tympanic segments of the facial nerve with gadobutrol.

scholarly journals MRI characterization of focal liver lesions in non-cirrhotic patients: assessment of added value of gadoxetic acid-enhanced hepatobiliary phase imaging

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Bardia Moosavi ◽  
Anuradha S. Shenoy-Bhangle ◽  
Leo L. Tsai ◽  
Robert Reuf ◽  
Koenraad J. Mortele
Keyword(s):  
Gadoxetic Acid ◽  
Added Value ◽  
Rank Test ◽  
Focal Liver Lesions ◽  
Hepatobiliary Phase ◽  
Liver Lesions ◽  
Enhanced Mri ◽  
Phase Images ◽  
Cirrhotic Patients

Abstract Background To evaluate the added value of the hepatobiliary (HPB) phase in gadoxetic acid-enhanced magnetic resonance imaging (MRI) in characterizing newly discovered indeterminate focal liver lesions in non-cirrhotic patients. Results One-hundred and twenty-five non-cirrhotic patients (median age, 46 years; range, 20–85 years; 100 females) underwent gadoxetic acid-enhanced MRI, including the 20-min delayed HPB phase, for characterization of newly discovered focal liver lesions. Images were independently evaluated by two blinded, board-certified abdominal radiologists (R1 and R2) who characterized liver lesions without and with assessment of the HPB phase images in two separate readout sessions. Confidence in diagnosis was scored on a scale from 0 to 3. Inter-observer agreement was assessed using Cohen κ statistics. Change in diagnosis and confidence in diagnosis were evaluated by Wilcoxon signed rank test. There was no significant change in diagnosis before and after evaluation of the HPB phase for both readers (p = 1.0 for R1; p = 0.34 for R2). Confidence in diagnosis decreased from average 2.8 ± 0.45 to 2.6 ± 0.59 for R1 and increased from 2.6 ± 0.83 to 2.8 ± 0.46 for R2. Change in confidence was only statistically significant for R1 (p = 0.003) but not significant for R2 (p = 0.49). Inter-reader agreement in diagnosis was good without (k = 0.66) and with (k = 0.75) inclusion of the HPB phase images. Conclusions The added information obtained from the HPB phase of gadoxetic acid-enhanced MRI does not change the diagnosis or increase confidence in diagnosis when evaluating new indeterminate focal liver lesions in non-cirrhotic patients.

scholarly journals A radiomics-based model to classify the etiology of liver cirrhosis using gadoxetic acid-enhanced MRI

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aboelyazid Elkilany ◽  
Uli Fehrenbach ◽  
Timo Alexander Auer ◽  
Tobias Müller ◽  
Wenzel Schöning ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Viral Hepatitis ◽  
Alcoholic Cirrhosis ◽  
Gadoxetic Acid ◽  
P Value ◽  
Cholestatic Liver Disease ◽  
Hepatobiliary Phase ◽  
Enhanced Mri ◽  
Wide Range ◽  
Phase Images

AbstractThe implementation of radiomics in radiology is gaining interest due to its wide range of applications. To develop a radiomics-based model for classifying the etiology of liver cirrhosis using gadoxetic acid-enhanced MRI, 248 patients with a known etiology of liver cirrhosis who underwent 306 gadoxetic acid-enhanced MRI examinations were included in the analysis. MRI examinations were classified into 6 groups according to the etiology of liver cirrhosis: alcoholic cirrhosis, viral hepatitis, cholestatic liver disease, nonalcoholic steatohepatitis (NASH), autoimmune hepatitis, and other. MRI examinations were randomized into training and testing subsets. Radiomics features were extracted from regions of interest segmented in the hepatobiliary phase images. The fivefold cross-validated models (2-dimensional—(2D) and 3-dimensional—(3D) based) differentiating cholestatic cirrhosis from noncholestatic etiologies had the best accuracy (87.5%, 85.6%), sensitivity (97.6%, 95.6%), predictive value (0.883, 0.877), and area under curve (AUC) (0.960, 0.910). The AUC was larger in the 2D-model for viral hepatitis, cholestatic cirrhosis, and NASH-associated cirrhosis (P-value of 0.05, 0.05, 0.87, respectively). In alcoholic cirrhosis, the AUC for the 3D model was larger (P = 0.01). The overall intra-class correlation coefficient (ICC) estimates and their 95% confident intervals (CI) for all features combined was 0.68 (CI 0.56–0.87) for 2D and 0.71 (CI 0.61–0.93) for 3D measurements suggesting moderate reliability. Radiomics-based analysis of hepatobiliary phase images of gadoxetic acid-enhanced MRI may be a promising noninvasive method for identifying the etiology of liver cirrhosis with better performance of the 2D- compared with the 3D-generated models.

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