Skip to main content
SpringerLink
Log in

Reduction in respiratory motion artefacts on gadoxetate-enhanced MRI after training technicians to apply a simple and more patient-adapted breathing command

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To investigate whether a trained group of technicians using a modified breathing command during gadoxetate-enhanced liver MRI reduces respiratory motion artefacts compared to non-trained technicians using a traditional breathing command.

Materials and methods

The gadoxetate-enhanced liver MR images of 30 patients acquired using the traditional breathing command and the subsequent 30 patients after training the technicians to use a modified breathing command were analyzed. A subgroup of patients (n = 8) underwent scans both by trained and untrained technicians. Images obtained using the traditional and modified breathing command were compared for the presence of breathing artefacts [respiratory artefact-based image quality scores from 1 (best) to 5 (non-diagnostic)].

Results

There was a highly significant improvement in the arterial phase image quality scores in patients using the modified breathing command compared to the traditional one (P < 0.001). The percentage of patients with severe and extensive breathing artefacts in the arterial phase decreased from 33.3 % to 6.7 % after introducing the modified breathing command (P = 0.021). In the subgroup that underwent MRI using both breathing commands, arterial phase image quality improved significantly (P = 0.008) using the modified breathing command.

Conclusion

Training technicians to use a modified breathing command significantly improved arterial phase image quality of gadoxetate-enhanced liver MRI.

Key Points

• A modified breathing command reduced respiratory artefacts on arterial-phase gadoxetate-enhanced MRI (P < 0.001).

• The modified command decreased severe and extensive arterial-phase breathing artefacts (P = 0.021).

• Training technicians to use a modified breathing command improved arterial-phase images.

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
Fig. 3

Similar content being viewed by others

References

  1. Thian YL, Riddell AM, Koh DM (2013) Liver-specific agents for contrast-enhanced MRI: role in oncological imaging. Cancer Imaging 13:567

    Article  PubMed  PubMed Central  Google Scholar 

  2. Van Beers BE, Pastor CM, Hussain HK (2012) Primovist, Eovist: what to expect? J Hepatol 57:421–429

    Article  PubMed  Google Scholar 

  3. Kim B, Byun J, Kim H et al (2015) Enhancement patterns and pseudo-washout of hepatic haemangiomas on gadoxetate disodium-enhanced liver MRI. Eur Radiol. doi:10.1007/s00330-015-3798-9

    Google Scholar 

  4. Kim R, Lee J, Shin CI et al (2015) Differentiation of intrahepatic mass-forming cholangiocarcinoma from hepatocellular carcinoma on gadoxetic acid-enhanced liver MR imaging. Eur Radiol. doi:10.1007/s00330-015-4005-8

    Google Scholar 

  5. Song K, Kim S, Lim H, Jung SH, Sohn I, Kim H (2015) Subcentimeter hypervascular nodule with typical imaging findings of hepatocellular carcinoma in patients with history of hepatocellular carcinoma: natural course on serial gadoxetic acid-enhanced MRI and diffusion-weighted imaging. Eur Radiol 25:2789–2796

    Article  PubMed  Google Scholar 

  6. Scharitzer M, Ba-Ssalamah A, Ringl H et al (2013) Preoperative evaluation of colorectal liver metastases: comparison between gadoxetic acid-enhanced 3.0-T MRI and contrast-enhanced MDCT with histopathological correlation. Eur Radiol 23:2187–2196

    Article  CAS  PubMed  Google Scholar 

  7. Koh J, Chung Y, Nahm J et al (2015) Intrahepatic mass-forming cholangiocarcinoma: prognostic value of preoperative gadoxetic acid-enhanced MRI. Eur Radiol. doi:10.1007/s00330-015-3846-5

    PubMed Central  Google Scholar 

  8. Joo I, Lee J, Lee D, Jeon J, Han J, Choi B (2015) Noninvasive diagnosis of hepatocellular carcinoma on gadoxetic acid-enhanced MRI: can hypointensity on the hepatobiliary phase be used as an alternative to washout? Eur Radiol 25:2859–2868

    Article  PubMed  Google Scholar 

  9. Davenport MS, Viglianti BL, Al-Hawary MM et al (2013) Comparison of acute transient dyspnea after intravenous administration of gadoxetate disodium and gadobenate dimeglumine: effect on arterial phase image quality. Radiology 266:452–461

    Article  PubMed  Google Scholar 

  10. Davenport MS, Caoili EM, Kaza RK, Hussain HK (2014) Matched within-patient cohort study of transient arterial phase respiratory motion–related artifact in MR imaging of the liver: gadoxetate disodium versus gadobenate dimeglumine. Radiology 272:123–131

    Article  PubMed  Google Scholar 

  11. Davenport MS, Bashir MR, Pietryga JA, Weber JT, Khalatbari S, Hussain HK (2014) Dose-toxicity relationship of gadoxetate disodium and transient severe respiratory motion artifact. Am J Roentgenol 203:796–802

    Article  Google Scholar 

  12. Pietryga JA, Burke LMB, Marin D, Jaffe TA, Bashir MR (2014) Respiratory motion artifact affecting hepatic arterial phase imaging with gadoxetate disodium: examination recovery with a multiple arterial phase acquisition. Radiology 271:426–434

    Article  PubMed  Google Scholar 

  13. Bashir MR, Castelli P, Davenport MS et al (2015) Respiratory motion artifact affecting hepatic arterial phase MR imaging with gadoxetate disodium is more common in patients with a prior episode of arterial phase motion associated with gadoxetate disodium. Radiology 274:141–148

    Article  PubMed  Google Scholar 

  14. Motosugi U (2015) Gadoxetic acid-induced acute transient dyspnea: the perspective of japanese radiologists. Magn Reson Med Sci 14:163–164

    Article  PubMed  Google Scholar 

  15. Bergmann K, Agris J, Balzer T (2013) Does intravenous administration of gadoxetate disodium have any effect on breath-hold times. Radiology 268:926–927

    Article  PubMed  Google Scholar 

  16. Hayashi T, Saitoh S, Tsuji Y et al (2015) Influence of gadoxetate disodium on oxygen saturation and heart rate during dynamic contrast-enhanced MR imaging. Radiology 276:756–765

    Article  PubMed  Google Scholar 

  17. Luetkens J, Kupczyk P, Doerner J et al (2015) Respiratory motion artefacts in dynamic liver MRI: a comparison using gadoxetate disodium and gadobutrol. Eur Radiol. doi:10.1007/s00330-015-3736-x

    PubMed  Google Scholar 

  18. Fujinaga Y, Ohya A, Tokoro H et al (2014) Radial volumetric imaging breath-hold examination (VIBE) with k-space weighted image contrast (KWIC) for dynamic gadoxetic acid (Gd-EOB-DTPA)-enhanced MRI of the liver: advantages over cartesian VIBE in the arterial phase. Eur Radiol 24:1290–1299

    Article  PubMed  Google Scholar 

  19. Chandarana H, Feng L, Ream J et al (2015) Respiratory motion-resolved compressed sensing reconstruction of free-breathing radial acquisition for dynamic liver magnetic resonance imaging. Investig Radiol. doi:10.1097/RLI.0000000000000179

    Google Scholar 

  20. Budjan J, Ong M, Riffel P et al (2014) CAIPIRINHA-Dixon-TWIST (CDT)-volume-interpolated breath-hold examination (VIBE) for dynamic liver imaging: comparison of gadoterate meglumine, gadobutrol and gadoxetic acid. Eur J Radiol 83:2007–2012

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Andreas Gutzeit. The authors of this manuscript declare relationships with the following companies: Johannes M. Froehlich works as a consultant for a contrast media company. The other authors had full control of data and information that might have represented a conflict of interest for the author who is a consultant of a company. The authors state that this work has not received any funding. The professional biostatistician Nicole Graf (www.biostatistics.ch) kindly provided statistical advice for this manuscript. The institutional review board had generally approved retrospective studies. Written informed consent concerning anonymized data evaluation had been obtained from all subjects (patients) in this study. Neither this cohort nor a subset thereof has been published elsewhere. Methodology: retrospective, observational, performed at one institution. We would like to thank our innovative and wonderful technician team, who helped us examine all the patients: Sara Schwarz MT, Sarah Suter MT, Florentina Podrimaj MT, Christian Meier MT, Barbara Eichenberger MT and Katrin Pucher MT. We would also like to thank Rene Patzwahl MD, who gave us the idea for this project after intense discussion of the first paper by Davenport et al. [9].

Author information

Authors and Affiliations

  1. Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria

    Andreas Gutzeit, Simon Matoori, Johannes M. Froehlich, Constantin von Weymarn, Carolin Reischauer, Matthias Goyen, Klaus Hergan, Matthias Meissnitzer & Rosemarie Forstner

  2. Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland

    Andreas Gutzeit, Orpheus Kolokythas, Jan D. Soyka & Aleksis Doert

  3. Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zurich, Vladimir-Prelog-Weg 1-5 / 10, 8093, Zurich, Switzerland

    Johannes M. Froehlich

  4. Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton, Surrey, SM2 5PT, Great Britain, UK

    Dow-Mu Koh

Authors
  1. Andreas Gutzeit
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Simon Matoori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Johannes M. Froehlich
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Constantin von Weymarn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carolin Reischauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Orpheus Kolokythas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Matthias Goyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Klaus Hergan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Matthias Meissnitzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Rosemarie Forstner
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jan D. Soyka
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Aleksis Doert
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Dow-Mu Koh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andreas Gutzeit.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gutzeit, A., Matoori, S., Froehlich, J.M. et al. Reduction in respiratory motion artefacts on gadoxetate-enhanced MRI after training technicians to apply a simple and more patient-adapted breathing command. Eur Radiol 26, 2714–2722 (2016). https://doi.org/10.1007/s00330-015-4086-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-015-4086-4

Keywords

Search

Navigation