Skip to main content
SpringerLink
Log in

Free-breathing radial stack-of-stars three-dimensional Dixon gradient echo sequence in abdominal magnetic resonance imaging in sedated pediatric patients

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

There is a strong need for improvements in motion robust T1-weighted abdominal imaging sequences in children to enable high-quality, free-breathing imaging.

Objective

To compare imaging time and quality of a radial stack-of-stars, free-breathing T1-weighted gradient echo acquisition (volumetric interpolated breath-hold examination [VIBE]) three-dimensional (3-D) Dixon sequence in sedated pediatric patients undergoing abdominal magnetic resonance imaging (MRI) against conventional Cartesian T1-weighed sequences.

Materials and methods

This study was approved by the institutional review board with informed consent obtained from all subjects. Study subjects included 31 pediatric patients (19 male, 12 female; median age: 5 years; interquartile range: 5 years) undergoing abdominal MRI at 3 tesla with a free-breathing T1-weighted radial stack-of-stars 3-D VIBE Dixon prototype sequence, StarVIBE Dixon (radial technique), between October 2018 and June 2019 with previous abdominal MR imaging using conventional Cartesian T1-weighed imaging (traditional technique). MRI component times were recorded as well as the total number of non-contrast T1-weighted sequences. Two radiologists independently rated images for quality using a scale from 1 to 5 according to the following metrics: overall image quality, hepatic edge sharpness, hepatic vessel clarity and respiratory motion robustness. Scores were compared between the groups.

Results

Mean T1-weighted imaging times for all subjects were 3.63 min for radial exams and 8.01 min for traditional exams (P<0.001), and total non-contrast imaging time was 32.7 min vs. 43.9 min (P=0.002). Adjusted mean total MRI time for all subjects was 60.2 min for radial exams and 65.7 min for traditional exams (P=0.387). The mean number of non-contrast T1-weighted sequences performed in radial MRI exams was 1.0 compared to 1.9 (range: 0–6) in traditional exams (P<0.001). StarVIBE Dixon outperformed Cartesian methods in all quality metrics. The mean overall image quality (scale 1–5) was 3.95 for radial exams and 3.31 for traditional exams (P<0.001).

Conclusion

Radial stack-of-stars 3-D VIBE Dixon during free-breathing abdominal MRI in pediatric patients offers improved image quality compared to Cartesian T1-weighted imaging techniques with decreased T1-weighted and total non-contrast imaging time. This has important implications for children undergoing sedation for imaging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Chavhan GB, Babyn PS, Vasanawala SS (2013) Abdominal MR imaging in children: motion compensation, sequence optimization, and protocol organization. Radiographics 33:703–719

    Article  Google Scholar 

  2. Michael R (2008) Potential of MR-imaging in the paediatric abdomen. Eur J Radiol 68:235–244

    Article  Google Scholar 

  3. Vasanawala SS, Iwadate Y, Church DG et al (2010) Navigated abdominal T1-W MRI permits free-breathing image acquisition with less motion artifact. Pediatr Radiol 40:340–344

    Article  Google Scholar 

  4. Jaimes C, Kirsch JE, Gee MS (2018) Fast, free-breathing and motion-minimized techniques for pediatric body magnetic resonance imaging. Pediatr Radiol 48:1197–1208

    Article  Google Scholar 

  5. Darge K, Anupindi SA, Jaramillo D (2011) MR imaging of the abdomen and pelvis in infants, children, and adolescents. Radiology 261:12–29

    Article  Google Scholar 

  6. Rofsky NM, Lee VS, Laub G et al (1999) Abdominal MR imaging with a volumetric interpolated breath-hold examination. Radiology 212:876–884

    Article  CAS  Google Scholar 

  7. Akisik FM, Sandrasegaran K, Aisen AM et al (2007) Abdominal MR imaging at 3.0 T. Radiographics 27:1433–1444

    Article  Google Scholar 

  8. Azevedo RM, de Campos ROP, Ramalho M et al (2011) Free-breathing 3D T1-weighted gradient-echo sequence with radial data sampling in abdominal MRI: preliminary observations. AJR Am J Roentgenol 197:650–657

    Article  Google Scholar 

  9. Young PM, Brau AC, Iwadate Y et al (2010) Respiratory navigated free-breathing 3D spoiled gradient-recalled echo sequence for contras-enhanced examination of the liver: diagnostic utility and comparison with free breathing and breath-hold conventional examinations. AJR Am J Roentgenol 195:687–691

    Article  Google Scholar 

  10. Chandarana H, Block KT, Rosenkrantz AB et al (2011) Free-breathing radial 3D fat-suppressed T1-weighted gradient echo sequence. Invest Radiol 46:648–653

    Article  Google Scholar 

  11. Block KT, Chandarana H, Milla S et al (2014) Towards routine clinical use of radial stack-of-stars 3D gradient-echo sequences for reducing motion sensitivity. J Korean Soc Magn Reson Med 18:87–106

    Article  Google Scholar 

  12. Chandarana H, Block KT, Winfield MJ et al (2014) Free-breathing contrast-enhanced T1-weighted gradient-echo imaging with radial k-space sampling for paediatric abdominopelvic MRI. Eur Radiol 24:320–326

    Article  Google Scholar 

  13. Balza R, Jaimes C, Risacher S et al (2019) Impact of a fast free-breathing 3T abdominal MRI protocol on improving scan time and image quality for pediatric patients with tuberous sclerosis complex. Pediatr Radiol 49:1788–1797

    Article  Google Scholar 

  14. Dixon WT (1984) Simple proton spectroscopic imaging. Radiology 153:189–194

    Article  CAS  Google Scholar 

  15. Ichikawa S, Motosugi U, Kromrey M-L et al (2020) Utility of stack-of-stars acquisition for hepatobiliary phase imaging without breath-holding. Magn Reson Med Sci 19:99–107

    Article  CAS  Google Scholar 

  16. SAS Institute Inc (2015) SAS/STAT 14.1 User Guide. SAS Institute, Inc., Cary, NC

  17. Fitzmaurice GM, Laird NM, Ware JH (2011) Applied longitudinal analysis, 2nd edn. Wiley, Hoboken, New Jersey

    Book  Google Scholar 

  18. Lin L (2012) Statistical tools for measuring agreement. Springer, New York

    Book  Google Scholar 

  19. Fleiss J (1981) Statistical methods for rates and proportions, 2nd edn. Wiley, New York

    Google Scholar 

  20. Agresti A (2013) Categorical data analysis, 3rd edn. John Wiley & Sons, Hoboken, New Jersey

    Google Scholar 

  21. Uebersax J (1987) Diversity of decision-making models and the measurement of interrater agreement. Psychol Bull 101:140–146

    Article  Google Scholar 

  22. Callahan MJ, MacDougall RD, Bixby SD et al (2018) Ionizing radiation from computed tomography versus anesthesia for magnetic resonance imaging in infants and children: patient safety considerations. Pediatr Radiol 48:21–30

    Article  Google Scholar 

  23. Low RN, Francis IR, Herfkens RJ et al (1993) Fast multiplanar spoiled gradient-recalled imaging of the liver: pulse sequence optimization and comparison with spin-echo MR imaging. AJR Am J Roentgenolog 160:501–509

    Article  CAS  Google Scholar 

  24. Pipe JG (1999) Motion correction with PROPELLER MRI: application to head motion and free-breathing cardiac imaging. Magn Reson Med 42:963–969

    Article  CAS  Google Scholar 

  25. Hirokawa Y, Isoda H, Maetani YS et al (2008) MRI artifact reduction and quality improvement in the upper abdomen with PROPELLER and prospective acquisition correction (PACE) technique. AJR Am J Roentgenol 191:1154–1158

    Article  Google Scholar 

  26. Bayramoglu S, Kilickesmez O, Cimilli T et al (2010) T2-weighted MRI of the upper abdomen: comparison of four fat-suppressed T2-weighted sequences including PROPELLER (BLADE) technique. Acad Radiol 17:368–374

    Article  Google Scholar 

  27. Shin HJ, Kim M-J, Lee M-J, Kim HG (2016) Comparison of image quality between conventional VIBE and radial VIBE in free-breathing paediatric abdominal MRI. Clin Radiol 71:1044–1049

    Article  CAS  Google Scholar 

  28. Kaltenbach B, Roman A, Polkowski C et al (2017) Free-breathing dynamic liver examination using a radial 3D T1-weighted gradient echo sequence with moderate undersampling for patients with limited breath-holding capacity. Eur J Radiol 86:26–32

    Article  Google Scholar 

  29. Zhong X, Hu HH, Armstrong T et al (2020) Free-breathing volumetric liver R 2 * and proton density fat fraction quantification in pediatric patients using stack-of-radial MRI with self-gating motion compensation. J Magn Reson Imaging 53:118–129

    Article  Google Scholar 

  30. Armstrong T, Ly KV, Ghahremani S et al (2019) Free-breathing 3-D quantification of infant body composition and hepatic fat using a stack-of-radial magnetic resonance imaging technique. Pediatr Radiol 49:876–888

    Article  Google Scholar 

  31. Armstrong T, Ly KV, Murthy S et al (2018) Free-breathing quantification of hepatic fat in healthy children and children with nonalcoholic fatty liver disease using a multi-echo 3-D stack-of-radial MRI technique. Pediatr Radiol 48:941–953

    Article  Google Scholar 

  32. Armstrong T, Dregely I, Stemmer A et al (2018) Free-breathing liver fat quantification using a multiecho 3D stack-of-radial technique. Magn Reson Med 79:370–382

    Article  CAS  Google Scholar 

  33. Machado-Rivas F, Leitman E, Jaimes C et al (2020) Predictors of anesthetic exposure in pediatric MRI. AJR Am J Roentgenol. https://doi.org/10.2214/AJR.20.23601

  34. Cravero JP, Blike GT, Beach M et al (2006) Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the pediatric sedation research consortium. Pediatrics 118:1087–1096

    Article  Google Scholar 

  35. Cravero JP, Beach ML, Blike GT et al (2009) The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the pediatric sedation research consortium. Anesth Analg 108:795–804

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The research reported in this publication was supported in part by the National Institute of Biomedical Imaging and Bioengineering for the National Institutes of Health under award number R01EB019483.

Author information

Authors and Affiliations

  1. Department of Radiology, Boston Children’s Hospital, 300 Longwood Ave., Boston, MA, 02115, USA

    Patrick B. Duffy, Michael J. Callahan, Patrick R. Johnston, Simon K. Warfield & Sarah D. Bixby

  2. Siemens Healthineers, Erlangen, Germany

    Alto Stemmer

  3. Department of Anesthesiology, Boston Children’s Hospital, Boston, MA, USA

    Joseph P. Cravero

Authors
  1. Patrick B. Duffy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alto Stemmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael J. Callahan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joseph P. Cravero
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Patrick R. Johnston
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Simon K. Warfield
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sarah D. Bixby
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarah D. Bixby.

Ethics declarations

Conflict of interests

Alto Stemmer works for Siemens Healthineers.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Duffy, P.B., Stemmer, A., Callahan, M.J. et al. Free-breathing radial stack-of-stars three-dimensional Dixon gradient echo sequence in abdominal magnetic resonance imaging in sedated pediatric patients. Pediatr Radiol 51, 1645–1653 (2021). https://doi.org/10.1007/s00247-021-05054-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-021-05054-3

Keywords

Search

Navigation