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Simultaneous evaluation of perfusion and morphology using GRASP MRI in hepatic fibrosis

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To determine if golden-angle radial sparse parallel (GRASP) dynamic contrast-enhanced (DCE)-MRI allows simultaneous evaluation of perfusion and morphology in liver fibrosis.

Methods

Participants who were scheduled for liver biopsy or resection were enrolled (NCT02480972). Images were reconstructed at 12-s temporal resolution for morphologic assessment and at 3.3-s temporal resolution for quantitative evaluation. The image quality of the morphologic images was assessed on a four-point scale, and the Liver Imaging Reporting and Data System score was recorded for hepatic observations. Comparisons were made between quantitative parameters of DCE-MRI for the different fibrosis stages, and for hepatocellular carcinoma (HCCs) with different LR features.

Results

DCE-MRI of 64 participants (male = 48) were analyzed. The overall image quality consistently stood at 3.5 ± 0.4 to 3.7 ± 0.4 throughout the exam. Portal blood flow significantly decreased in participants with F2–F3 (n = 18, 175 ± 110 mL/100 mL/min) and F4 (n = 12, 98 ± 47 mL/100 mL/min) compared with those in participants with F0–F1 (n = 34, 283 ± 178 mL/100 mL/min, p < 0.05 for all). In participants with F4, the arterial fraction and extracellular volume were significantly higher than those in participants with F0–F1 and F2–F3 (p < 0.05). Compared with HCCs showing non-LR-M features (n = 16), HCCs with LR-M (n = 5) had a significantly prolonged mean transit time and lower arterial blood flow (p < 0.05).

Conclusions

Liver MRI using GRASP obtains both sufficient spatial resolution for confident diagnosis and high temporal resolution for pharmacokinetic modeling. Significant differences were found between the MRI-derived portal blood flow at different hepatic fibrosis stages.

Key Points

  • A single MRI examination is able to provide both images with sufficient spatial resolution for anatomic evaluation and those with high temporal resolution for pharmacokinetic modeling.

  • Portal blood flow was significantly lower in clinically significant hepatic fibrosis and mean transit time and extracellular volume increased in cirrhosis, compared with those in no or mild hepatic fibrosis.

  • HCCs with different LR features showed different quantitative parameters of DCE-MRI: longer mean transit time and lower arterial flow were observed in HCCs with LR-M features.

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Abbreviations

AF:

Arterial fraction

AIF:

Arterial input function

AUC:

Area under the curve

DCE:

Dynamic contrast-enhanced

ECV:

Extracellular volume

GRASP:

Golden-angle radial sparse parallel

HCC:

Hepatocellular carcinoma

ICC:

Intraclass correlation coefficient

LI-RADS:

Liver Imaging Reporting and Data System

LOA:

Limit of agreement

MRI:

Magnetic resonance imaging

MTT:

Mean transit time

T1WI:

T1-weighted image

VIF:

Venous input function

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Acknowledgements

We thank Benjamin Latimer, BA, for his editorial assistance.

Funding

This study was supported by Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2013R1A1A2A10066037).

Author information

Authors and Affiliations

  1. Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Jeong Hee Yoon & Jeong Min Lee

  2. Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Jeong Hee Yoon & Jeong Min Lee

  3. Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea

    Jeong Min Lee

  4. Radiology, Konkuk University School of Medicine, Seoul, 05080, Republic of Korea

    Mi Hye Yu

  5. Radiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, 06236, Republic of Korea

    Bo Yun Hur

  6. Siemens Healthineers, 91052, Erlangen, Germany

    Robert Grimm

  7. Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK

    Steven Sourbron

  8. Center for Advanced Imaging Innovation and Research (CAI2R), New York, NY, USA

    Hersh Chandarana

  9. Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA

    Hersh Chandarana

  10. Siemens Healthcare Korea, Seoul, 03737, Republic of Korea

    Yohan Son

  11. Biomedical Imaging Sciences Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK

    Susmita Basak

  12. Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea

    Kyoung-Bun Lee

  13. Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea

    Nam-Joon Yi, Kwang-Woong Lee & Kyung-Suk Suh

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  1. Jeong Hee Yoon
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Corresponding author

Correspondence to Jeong Min Lee.

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Guarantor

The scientific guarantor of this publication is Professor Jeong Min Lee.

Conflict of interest

Two authors (R. Grimm and Y. Son) are employees of Siemens Healthineers. Otherwise, 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.

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No complex statistical methods were used for this paper.

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Written informed consent was obtained from all participants.

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Approval from the Institutional Review Board of Seoul National University Hospital was obtained.

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• prospective

• cross-sectional study

• performed at one institution

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Yoon, J.H., Lee, J.M., Yu, M.H. et al. Simultaneous evaluation of perfusion and morphology using GRASP MRI in hepatic fibrosis. Eur Radiol 32, 34–45 (2022). https://doi.org/10.1007/s00330-021-08087-2

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