Intra-individual comparison of gadolinium-enhanced MRI using pseudo-golden-angle radial acquisition with gadoxetic acid-enhanced MRI for diagnosis of HCCs using LI-RADS
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To determine the usefulness of extracellular contrast agent (ECA)-enhanced multiphasic liver magnetic resonance imaging (MRI) using a pseudo-golden-angle radial acquisition scheme by intra-individual comparison with gadoxetic acid-MRI (EOB-MRI) with regard to image quality and the diagnosis of hepatocellular carcinoma (HCC).
Materials and methods
This prospective study enrolled 15 patients with 18 HCCs who underwent EOB-MRI using a Cartesian approach and ECA-MRI using the pseudo-golden-angle radial acquisition scheme (free-breathing continuous data acquisition for 64 s following ECA injection, generating six images). Two reviewers evaluated the arterial and portal phases of each MRI for artifacts, organ sharpness, and conspicuity of intrahepatic vessels and the hepatic tumors. A Liver Imaging Reporting and Data System category was also assigned to each lesion.
There were no differences in the subjective image quality analysis between the arterial phases of two MRIs (p > 0.05). However, ghosting artifact was seen only in EOB-MRI (N = 3). Six HCCs showed different signal intensities in the arterial phase or portal phase between the two MRIs; five HCCs showed arterial hyperenhancement on ECA-MRI, but not on EOB-MRI. The capsule was observed in 15 HCCs on ECA-MRI and 6 HCCs on EOB-MRI. Five and one HCC were assigned as LR-5 and LR-4 with ECA-MRI and LR-4 and LR-3 with EOB-MRI, respectively.
Free-breathing ECA-enhanced multiphasic liver MRI using a pseudo-golden-angle radial acquisition was more sensitive in detecting arterial hyperenhancement of HCC than conventional EOB-MRI, and the image quality was acceptable.
• The pseudo-golden-angle radial acquisition scheme can be applied to perform free-breathing multiphasic dynamic liver MRI.
• Adopting the pseudo-golden-angle radial acquisition scheme can improve the detection of arterial enhancement of HCC.
• The pseudo-golden-angle radial acquisition scheme enables motion-free liver MRI.
KeywordsMagnetic resonance imaging Carcinoma Hepatocellular Liver Artifacts
Extracellular contrast agent
Gadoxetic acid-enhanced MRI
Golden-angle radial sparse parallel
Liver Imaging Reporting and Data System
Magnetic resonance imaging
Pseudo-golden-angle radial acquisition scheme
Portal venous phase
Young Kon Kim received institutional research fund from Guerbet.
Compliance with ethical standards
The scientific guarantor of this publication is Sun Jin Lee in Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
Soohyun Ahn (author) who is working as an associate professor at the Department of Mathematics of Ajou University is responsible for the statistical analysis of this study.
Written informed consent was obtained from each patient before enrollment in the study.
This prospective study was approved by our institutional review board and followed the Declaration of Helsinki and subsequent amendments.
• Case-control study
• Performed at one institution
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