Dynamic gadolinium-enhanced rapid acquisition spin-echo MR imaging of the liver.

Mirowitz, Scott A.; Lee, J. K.T.; Gutierrez, E. D.; Brown, Jeffrey J.; Heiken, Jay P.; Eilenberg, S. S.

doi:10.1148/radiology.179.2.2014277

Cited by 60 publications

(19 citation statements)

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“…Studies of contrast agent uptake kinetics are becoming more common in brain, breast, and abdominal imaging; optimal use requires rapid injection and imaging, because equilibration between intravascular and interstitial spaces can be quick (18,19). Alternatively, fast T 2 -weighted imaging with T 2 shortening agents, such as superparamagnetic iron oxide may be useful.…”

Section: Discussionmentioning

confidence: 99%

Fluctuating equilibrium MRI

1999

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Section: Discussionmentioning

confidence: 99%

Fluctuating equilibrium MRI

1999

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“…By the early 1990s, rapid acquisition sequences that allowed whole liver scanning during breath holding became available and gadolinium-enhanced dynamic MRI of the liver began to be used in daily radiologic practice [11]. The speed of data acquisition and contrast agent design of MRI have continued to improve, and it has maintained its status as the most accurate method of examination in the diagnosis of HCCs, which it initially acquired in the mid-1990s.…”

Section: History Of Radiologic Diagnosis Of Hccmentioning

confidence: 99%

Magnetic Resonance Imaging of Hepatocellular Carcinoma

Kanematsu

Kondo²,

Goshima³

et al. 2008

Oncology

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In hepatocellular carcinomas (HCCs), T₁ shortening occurs due to internal protein, fat, copper, iron, hypercellularity, or a combination thereof. T₁-weighted magnetic resonance imaging (MRI) is obtained with a non-fat-suppressed phase shift [in- (4 ms) and opposed- (2 ms) phase] gradient-echo sequence. Internal fat deposition is often (36%) seen in well-differentiated HCCs between 1.1 and 1.5 cm in size. T₂-weighted MRI is crucial in differentiating HCCs from premalignant or borderline lesions in cirrhosis and serves as a tie breaker for small early-enhancing lesions. Gadolinium-enhanced MRI has advantages over contrast-enhanced CT: greater contrast enhancement, smaller volume of contrast, and less frequent adverse reactions. Double hepatic arterial-phase imaging has been performed in many centers, allowing less frequent off-timing arterial-phase imaging and improved temporary resolution. Hypervascular HCCs often show ‘corona’ enhancement in the late hepatic arterial phase, which makes it possible to distinguish small HCCs from enhancing pseudolesions. Liposoluble gadolinium chelate (e.g., Gd-EOB-DTPA) behaving both as an extracellular and hepatobiliary agent is very useful in the diagnosis. Diffusion-weighted imaging has become a routine imaging tool thanks to the parallel imaging technique. However, diffusion-weighted imaging may not significantly improve detection, characterization, or estimation of tumor grade for HCCs, and it should still be supplementary. In summary, we believe MRI outperforms CT in the diagnosis of HCCs.

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“…To increase the information obtained from contrast-enhanced studies, a wide range of dynamic contrast-enhanced T1-weighted imaging sequences, protocols, image processing methods, and interpretation criteria have been developed and evaluated over the last 20 years. 9,10,20,30 Dynamic contrast-enhanced MRI provides a measurement of tissue permeability to the paramagnetic contrast agent. 5 A relatively low dose of Gd is administered (usually a single dose of 0.1 mmol/kg) and repeated acquisitions of a T1-weighted sequence covering the ROI are made at longer intervals before, during, and long after the injection of the paramagnetic contrast medium (typi-cally every 15-30 seconds, for as long as 300 seconds).…”

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confidence: 99%

Using intraoperative dynamic contrast-enhanced T1-weighted MRI to identify residual tumor in glioblastoma surgery

Özduman¹,

Yıldız

Di̇nçer

et al. 2014

JNS

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Object The goal of surgery in high-grade gliomas is to maximize the resection of contrast-enhancing tumor without causing additional neurological deficits. Intraoperative MRI improves surgical results. However, when using contrast material intraoperatively, it may be difficult to differentiate between surgically induced enhancement and residual tumor. The purpose of this study was to assess the usefulness of intraoperative dynamic contrast-enhanced T1-weighted MRI to guide this differential diagnosis and test it against tissue histopathology. Methods Preoperative and intraoperative dynamic contrast-enhanced MRI was performed in 21 patients with histopathologically confirmed WHO Grade IV gliomas using intraoperative 3-T MRI. Standardized regions of interest (ROIs) were placed manually at 2 separate contrast-enhancing areas at the resection border for each patient. Time-intensity curves (TICs) were generated for each ROI. All ROIs were biopsied and the TIC types were compared with histopathological results. Pharmacokinetic modeling was performed in the last 10 patients to confirm nonparametric TIC analysis findings. Results Of the 42 manually selected ROIs in 21 patients, 25 (59.5%) contained solid tumor tissue and 17 (40.5%) retained the brain parenchymal architecture but contained infiltrating tumor cells. Time-intensity curves generated from residual contrast-enhancing tumor and their preoperative counterparts were comparable and showed a quick and persistently increasing slope (“climbing type”). All 17 TICs obtained from regions that did not contain solid tumor tissue were undulating and low in amplitude, compared with those obtained from residual tumors (“low-amplitude type”). Pharmacokinetic findings using the transfer constant, extravascular extracellular volume fraction, rate constant, and initial area under the curve parameters were significantly different for the tumor mass, nontumoral regions, and surgically induced contrast-enhancing areas. Conclusions Intraoperative dynamic contrast-enhanced MRI provides quick, reproducible, high-quality, and simply interpreted dynamic MR images in the intraoperative setting and can aid in differentiating surgically induced enhancement from residual tumor.

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Dynamic gadolinium-enhanced rapid acquisition spin-echo MR imaging of the liver.

Cited by 60 publications

References 0 publications

Fluctuating equilibrium MRI

Fluctuating equilibrium MRI

Magnetic Resonance Imaging of Hepatocellular Carcinoma

Using intraoperative dynamic contrast-enhanced T1-weighted MRI to identify residual tumor in glioblastoma surgery

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