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Technical report: gadoxetate-disodium-enhanced 2D R2* mapping: a novel approach for assessing bile ducts in living donors

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Abstract

Purpose

Gadoxetate-disodium (Gd-EOB-DTPA)-enhanced 3D T1- weighted (T1w) MR cholangiography (MRC) is an efficient method to evaluate biliary anatomy due to T1 shortening of excreted contrast in the bile. A method that exploits both T1 shortening and T2* effects may produce even greater bile duct conspicuity. The aim of our study is to determine feasibility and compare the diagnostic performance of two-dimensional (2D) T1w multi-echo (ME) spoiled gradient-recalled-echo (SPGR) derived R2* maps against T1w MRC for bile duct visualization in living liver donor candidates.

Materials and methods

Ten potential living liver donor candidates underwent pretransplant 3T MRI and were included in our study. Following injection of Gd-EOBDTPA and a 20-min delay, 3D T1w MRC and 2D T1w ME SPGR images were acquired. 2D R2* maps were generated inline by the scanner assuming exponential decay. The 3D T1w MRC and 2D R2* maps were retrospectively and independently reviewed in two separate sessions by three radiologists. Visualization of eight bile duct segments was scored using a 4-point ordinal scale. The scores were compared using mixed effects regression model.

Results

Imaging was tolerated by all donors and R2* maps were successfully generated in all cases. Visualization scores of 2D R2* maps were significantly higher than 3D T1w MRC for right anterior (p = 0.003) and posterior (p = 0.0001), segment 2 (p < 0.0001), segment 3 (p = 0.0001), and segment 4 (p < 0.0001) ducts.

Conclusions

Gd-EOB-DTPA-enhanced 2D R2* mapping is a feasible method for evaluating the bile ducts in living donors and may be a valuable addition to the living liver donor MR protocol for delineating intrahepatic biliary anatomy.

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Authors and Affiliations

  1. Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA

    Soudabeh Fazeli Dehkordy, Saya Igarashi, Carolina P. Lamas Constantino, Jonathan C. Hooker, Cheng W. Hong, Adrija Mamidipalli & Claude B. Sirlin

  2. Department of Radiology, Washington University, Saint Louis, MO, USA

    Kathryn J. Fowler

  3. Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, CA, USA

    Tanya Wolfson & Anthony C. Gamst

  4. Dimagem Diagnóstico por Imagem, Rio de Janeiro, Brazil

    Carolina P. Lamas Constantino

  5. Department of Surgery, University of California San Diego, San Diego, CA, USA

    Alan Hemming

Authors
  1. Soudabeh Fazeli Dehkordy
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  2. Kathryn J. Fowler
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  3. Tanya Wolfson
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  4. Saya Igarashi
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  5. Carolina P. Lamas Constantino
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  6. Jonathan C. Hooker
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  7. Cheng W. Hong
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  8. Adrija Mamidipalli
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  9. Anthony C. Gamst
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  10. Alan Hemming
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  11. Claude B. Sirlin
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Corresponding author

Correspondence to Soudabeh Fazeli Dehkordy.

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Funding

National Institutes of Health Grant T32 EB005970-09.

Conflicts of interest

SFD was supported by a T32 Grant from the NIH (4T32EB005970-09) at the time of the study. KF declares that she has no conflict of interest. TW declares that she has no conflict of interest. SI declares that she has no conflict of interest. CLP declares that she has no conflict of interest. JH declares that he has no conflict of interest. CH declares that he has no conflict of interest. AM declares that she has no conflict of interest. AG declares that he has no conflict of interest. AH declares that he has no conflict of interest. CS has received research grants from Siemens, GE, and Guerbet. CS also consults and advises for Alexion, AstraZeneca, Bioclinica, BMS, Fibrogen, Galmed, Genzyme, Gilead, Fibrogen, Icon, Intercept, Isis, Janssen, NuSirt, Perspectum, Pfizer, Profil, Sanofi, Shire, Synageva, Tobira, Takeda, Virtual Scopics.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Due to retrospective and observational nature of our study, patient consent was not required by the IRB.

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Fazeli Dehkordy, S., Fowler, K.J., Wolfson, T. et al. Technical report: gadoxetate-disodium-enhanced 2D R2* mapping: a novel approach for assessing bile ducts in living donors. Abdom Radiol 43, 1656–1660 (2018). https://doi.org/10.1007/s00261-017-1365-3

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  • DOI: https://doi.org/10.1007/s00261-017-1365-3

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