Hepatic Arterial Phase in Gadoxetic Acid–Enhanced Liver Magnetic Resonance Imaging

Park, Yang Shin; Lee, Changhee; Yoo, Jung Lim; Kim, In Seong; Kiefer, Berthold; Woo, Seung Tae; Kim, Kyeong Ah; Park, Cheol‐Min

doi:10.1097/rli.0000000000000211

Cited by 21 publications

(8 citation statements)

References 15 publications

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“…Fifth, the effect of IPPP was measured only indirectly based on RM image artefacts, which is prone to be biased by subjective interpretation. Although the inter-reader agreement in our study was very good to excellent and matched the results of a recent multi-center trial [36], the assessment of IPPP by dedicated patient questionnaires, respiratory waveform analysis [7,10,14,37,38] or including classification of hyper-and hypovascular liver lesions might have added valuable information and should be addressed in future studies.…”

Section: Plos Onesupporting

confidence: 85%

Respiratory motion artefacts in Gd-EOB-DTPA (Primovist/Eovist) and Gd-DOTA (Dotarem)-enhanced dynamic phase liver MRI after intensified and standard pre-scan patient preparation: A bi-institutional analysis

et al. 2020

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ObjectiveThe objective of this study is to evaluate if intensified pre-scan patient preparation (IPPP) that comprises custom-made educational material on dynamic phase imaging and supervised pre-imaging breath-hold training in addition to standard informative conversation with verbal explanation of breath-hold commands (standard pre-scan patient preparation-SPPP) might reduce the incidence of gadoxetate disodium (Gd-EOB-DTPA)-related transient severe respiratory motion (TSM) and severity of respiratory motion (RM) during dynamic phase liver MRI. Material and methodsIn this bi-institutional study 100 and 110 patients who received Gd-EOB-DTPA for dynamic phase liver MRI were allocated to either IPPP or SPPP at site A and B. The control group comprised 202 patients who received gadoterate meglumine (Gd-DOTA) of which each 101 patients were allocated to IPPP or SPPP at site B. RM artefacts were scored retrospectively in dynamic phase images (1: none-5: extensive) by five and two blinded readers at site A and B, respectively, and in the hepatobiliary phase of the Gd-EOB-DTPA-enhanced scans by two blinded readers at either site. ResultsThe incidence of TSM was 15% at site A and 22.7% at site B (p = 0.157). IPPP did not reduce the incidence of TSM in comparison to SPPP: 16.7% vs. 21.6% (p = 0.366). This PLOS ONE

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Section: Plos Onesupporting

confidence: 85%

Respiratory motion artefacts in Gd-EOB-DTPA (Primovist/Eovist) and Gd-DOTA (Dotarem)-enhanced dynamic phase liver MRI after intensified and standard pre-scan patient preparation: A bi-institutional analysis

et al. 2020

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“…The presence of such artefacts has been reported in a wide range of patients depending on the case series (from 2.4% to 18%). [195][196][197] Whether these artefacts hamper the detection of lesion vascularity on arterial phase has not been not clearly established yet.…”

Section: Specific Issue With Gadoxetic-enhanced Mrimentioning

confidence: 99%

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

Galle¹,

Forner²,

Llovet³

et al. 2018

Journal of Hepatology

6,939

4,351

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Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death globally. Hepatocellular carcinoma represents about 90% of primary liver cancers and constitutes a major global health problem. The following Clinical Practice Guidelines will give up-to-date advice for the clinical management of patients with hepatocellular carcinoma, as well as providing an in-depth review of all the relevant data leading to the conclusions herein.

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“…Motosugi et al found a significantly higher risk of TSM in patients with a high BMI [30]. Hayashi et al confirmed that body weight contributes to the occurrence of TSM [11].…”

Section: Potential Individual Risk Factorsmentioning

confidence: 95%

“…Also, no significant correlation was identified between changes in blood oxygen saturation and the occurrence of TSM [7,11,13,30], neither did any of the studies reveal a significant change in heart rate after injection of gadoxetate disodium [7,11,13]. ▶ Table 4 Frequency of TSM and potential risk factors…”

Section: Effects Of Gadoxetic Disodium Injection On Physiological Parmentioning

confidence: 97%

“…Several studies were able to show that injection of gadoxetate disodium leads to an increased rate of breath-hold failures that are associated with TSM [13,30]. Moreover, McClellan et al revealed that the maximal breath-hold duration is significantly reduced in healthy volunteers after gadoxetate disodium administration.…”

Section: Effects Of Gadoxetic Disodium Injection On Physiological Parmentioning

confidence: 99%

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Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Well

Weinrich

Adam

et al. 2017

Fortschr Röntgenstr

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Background Gadoxetate disodium is an intracellular contrast agent for magnetic resonance imaging (MRI) of the liver. Recent publications revealed that injection of gadoxetate disodium can lead to imaging artifacts due to transient severe motion (TSM) in the arterial phase of contrast-enhanced liver MRI. In this review we present and discuss published frequencies of TSM, contrast injection and image acquisition protocols, potential risk factors, and proposed strategies to avoid or minimize the effects of TSM. Method Two reviewers independently searched the PubMed search engine for “transient severe motion artifact” and related terms. Reference lists of retrieved articles were also searched. The two reviewers selected in consensus nine studies that reported both frequencies of TSM and potential risk factors. Study data were extracted by both reviewers, and disagreement was resolved by consensus. Results and Conclusion TSM is caused by impaired breath-hold ability after gadoxetate disodium injection and occurs in 5 – 22 % of patients. The dose of applied contrast agent, repeated exposure to gadoxetate disodium, high BMI and pulmonary disease have been described as potential risk factors for TSM. However, there are only few concordant results on this topic and the pathophysiology of TSM has not been identified. Proposed strategies for the prevention of TSM are slow injection rates and low doses of diluted gadoxetate disodium. Accelerated and free-breathing MRI sequence protocols and breath-hold training may minimize the effects of TSM. Further prospective studies are needed to confirm these strategies and to identify the underlying mechanism of TSM. Key Points Citation Format

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Hepatic Arterial Phase in Gadoxetic Acid–Enhanced Liver Magnetic Resonance Imaging

Abstract: The objective analysis of respiratory patterns during a breath-hold is feasible and useful for evaluating gadoxetic acid-related dyspnea and its effect on image quality analysis.

Cited by 21 publications

References 15 publications

Respiratory motion artefacts in Gd-EOB-DTPA (Primovist/Eovist) and Gd-DOTA (Dotarem)-enhanced dynamic phase liver MRI after intensified and standard pre-scan patient preparation: A bi-institutional analysis

Respiratory motion artefacts in Gd-EOB-DTPA (Primovist/Eovist) and Gd-DOTA (Dotarem)-enhanced dynamic phase liver MRI after intensified and standard pre-scan patient preparation: A bi-institutional analysis

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

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