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Does transient arterial-phase respiratory-motion-related artifact impact on diagnostic performance? An intra-patient comparison of extracellular gadolinium versus gadoxetic acid

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

Abstract

Objective

To compare the frequency of transient arterial-phase respiratory-motion-related artifacts in liver MRI after extracellular gadolinium and gadoxetic acid injection, and to determine the impact of these artifacts on the detection of focal areas of enhancement on arterial-phase images.

Materials and methods

Intra-patient comparison of 82 cirrhotic patients who prospectively underwent liver MR with extracellular gadolinium and with gadoxetic acid within 1 month. Two readers independently assessed the quality of dynamic T1-weighted MR images (pre-contrast, arterial, and portal-venous phases), rating respiratory-motion-related artifacts on four-point scale (0 [none]–3 [non-diagnostic]). We dichotomized these assessments, which were compared using McNemar’s test, defining transient arterial-phase respiratory-motion-related artifacts as a study with a pre-contrast score < 2 and arterial-phase score ≥ 2. Readers also recorded whether at least one focal area of enhancement ≥ 10 mm on arterial phase was present.

Results

The quality of arterial-phase images was worse when obtained after gadoxetic acid than after extracellular gadolinium (p < 0.01), and transient arterial-phase respiratory-motion-related artifacts were more common after gadoxetic acid than after extracellular gadolinium (p < 0.02). At least one area of arterial-phase enhancement ≥ 10 mm was detected more often after extracellular gadolinium than after gadoxetic acid. We observed significant differences on the comparison of the distributions of the presence of arterial-phase artifacts against the presence of arterial-phase enhancement ≥ 10 mm between the two contrast agents (p < 0.0001).

Conclusion

In cirrhotic patients, transient arterial-phase respiratory-motion-related artifacts are more common after gadoxetic acid than after extracellular gadolinium. Worse detection of arterial-phase enhancement on gadoxetic acid is only partly due to these artifacts.

Key Points

• In a patient-by-patient analysis, the quality of arterial-phase liver MR images was significantly worse with gadoxetic acid than with extracellular gadolinium.

• The frequency of transient arterial-phase artifacts was significantly higher after gadoxetic acid injection than after extracellular gadolinium injection.

• Differences in the detection of areas of arterial-phase enhancement between MRI studies done with extracellular gadolinium and those done with gadoxetic acid might not be related only to image quality.

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Abbreviations

AASLD:

American Association for the Study of Liver Diseases

CI:

Confidence interval

EASL:

European Association for the Study of the Liver

HCC:

Hepatocellular carcinoma

IQR:

Interquartile range

MR:

Magnetic resonance

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Funding

This study has not received funding.

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Authors and Affiliations

  1. Radiology Department, BCLC group, C/Villarroel 170 Escala 3 Planta 1, 08036, Barcelona, Spain

    Jordi Rimola, Anna Darnell, Ernest Belmonte, Carla Caparroz & Carmen Ayuso

  2. University of Barcelona, Barcelona, Spain

    Anna Darnell, Alejandro Forner, Jordi Bruix & Carmen Ayuso

  3. Statistics Core, BCLC group, Barcelona, Spain

    Victor Sapena

  4. Liver Unit, BCLC group, Barcelona, Spain

    Neus Llarch, Maria Reig, Alejandro Forner & Jordi Bruix

  5. IDIBAPS, Barcelona, Spain

    Maria Reig, Alejandro Forner, Jordi Bruix & Carmen Ayuso

Authors
  1. Jordi Rimola
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  2. Anna Darnell
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  3. Ernest Belmonte
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  4. Victor Sapena
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  5. Carla Caparroz
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  6. Neus Llarch
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  7. Maria Reig
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  8. Alejandro Forner
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  9. Jordi Bruix
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  10. Carmen Ayuso
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Corresponding author

Correspondence to Jordi Rimola.

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Guarantor

The scientific guarantor of this publication is Jordi Rimola.

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

Victor Sapena kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained (HCB/2019/1021).

Methodology

• prospective

• diagnostic or prognostic study

• performed at one institution

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Rimola, J., Darnell, A., Belmonte, E. et al. Does transient arterial-phase respiratory-motion-related artifact impact on diagnostic performance? An intra-patient comparison of extracellular gadolinium versus gadoxetic acid. Eur Radiol 30, 6694–6701 (2020). https://doi.org/10.1007/s00330-020-07039-6

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  • DOI: https://doi.org/10.1007/s00330-020-07039-6

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