Hepatic arterial phase in gadoxetic acid-enhanced liver magnetic resonance imaging: Analysis of respiratory patterns and their effect on image quality

Yang Shin Park, Chang-Hee Lee, Jung Lim Yoo, In Seong Kim, Berthold Kiefer, Seung Tae Woo, Kyeong Ah Kim, Cheol Min Park

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: The aims of this study were to objectively evaluate patient respiration and breathing change after contrast injection and to assess its potential impact on image quality for the hepatic arterial phase in gadoxetic acid-enhanced magnetic resonance imaging. Materials and Methods: This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. One hundred fifty-four patients underwent gadoxetic acid-enhanced liver magnetic resonance imaging with a 13-second breath-hold hepatic arterial phase. During the acquisition of precontrast and hepatic arterial phases, the respiratory motion signal was acquired and graded on a 4-point scale based on the SD of the respiratory waveform, with the highest grade indicating the worst breathhold. Breath-holding grades 3 and 4 for the hepatic arterial phases were considered as breath-holding difficulty during the hepatic arterial phase. Gadoxetic acid-related dyspneawas defined as when the SD value of respiratory waveform during the hepatic arterial phase was 200 greater than that of the precontrast image. Then, the precontrast and hepatic arterial phase images were evaluated with respect to overall image quality and motion artifact using a 5-point scale, with the highest score indicating the worst image quality. In the hepatic arterial phase, the correlation between breath-holding degree and image quality parameters was evaluated using Pearson correlation. The differences in mean image quality scores between patients with and without gadoxetic acid-related dyspnea were evaluated using Student t test. Results: Based on the analysis of the respiratory waveforms, the incidence of breath-holding difficulty during the hepatic arterial phase was 23.4% (33/154), and the incidence of gadoxetic acid-related dyspnea was 6.5% (10/154). By image analysis, the incidence of a degraded hepatic arterial phase (overall image quality score ≥4) was 5.2% (8/154). During the hepatic arterial phase, the breath-holding degree correlated with overall image quality and motion artifacts (r = 0.564 and 0.578, respectively). Patients with gadoxetic acid-related dyspnea showed significantly worse image qualities of the hepatic arterial phase than patients without gadoxetic acid-related dyspnea (all, P < 0.001), although image qualities for the precontrast image were not statistically significant between the 2 groups (all, P > 0.05). Conclusions: 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.

Original languageEnglish
Pages (from-to)127-133
Number of pages7
JournalInvestigative Radiology
Volume51
Issue number2
DOIs
Publication statusPublished - 2016 Jan 1

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Magnetic Resonance Imaging
Liver
Breath Holding
Dyspnea
gadolinium ethoxybenzyl DTPA
Artifacts
Incidence
Respiration
Research Ethics Committees
Informed Consent
Retrospective Studies
Students
Injections

Keywords

  • Arterial phase
  • Breath-Hold
  • Dyspnea
  • Gadoxetic acid
  • Liver
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Hepatic arterial phase in gadoxetic acid-enhanced liver magnetic resonance imaging : Analysis of respiratory patterns and their effect on image quality. / Park, Yang Shin; Lee, Chang-Hee; Yoo, Jung Lim; Kim, In Seong; Kiefer, Berthold; Woo, Seung Tae; Kim, Kyeong Ah; Park, Cheol Min.

In: Investigative Radiology, Vol. 51, No. 2, 01.01.2016, p. 127-133.

Research output: Contribution to journalArticle

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abstract = "Objective: The aims of this study were to objectively evaluate patient respiration and breathing change after contrast injection and to assess its potential impact on image quality for the hepatic arterial phase in gadoxetic acid-enhanced magnetic resonance imaging. Materials and Methods: This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. One hundred fifty-four patients underwent gadoxetic acid-enhanced liver magnetic resonance imaging with a 13-second breath-hold hepatic arterial phase. During the acquisition of precontrast and hepatic arterial phases, the respiratory motion signal was acquired and graded on a 4-point scale based on the SD of the respiratory waveform, with the highest grade indicating the worst breathhold. Breath-holding grades 3 and 4 for the hepatic arterial phases were considered as breath-holding difficulty during the hepatic arterial phase. Gadoxetic acid-related dyspneawas defined as when the SD value of respiratory waveform during the hepatic arterial phase was 200 greater than that of the precontrast image. Then, the precontrast and hepatic arterial phase images were evaluated with respect to overall image quality and motion artifact using a 5-point scale, with the highest score indicating the worst image quality. In the hepatic arterial phase, the correlation between breath-holding degree and image quality parameters was evaluated using Pearson correlation. The differences in mean image quality scores between patients with and without gadoxetic acid-related dyspnea were evaluated using Student t test. Results: Based on the analysis of the respiratory waveforms, the incidence of breath-holding difficulty during the hepatic arterial phase was 23.4{\%} (33/154), and the incidence of gadoxetic acid-related dyspnea was 6.5{\%} (10/154). By image analysis, the incidence of a degraded hepatic arterial phase (overall image quality score ≥4) was 5.2{\%} (8/154). During the hepatic arterial phase, the breath-holding degree correlated with overall image quality and motion artifacts (r = 0.564 and 0.578, respectively). Patients with gadoxetic acid-related dyspnea showed significantly worse image qualities of the hepatic arterial phase than patients without gadoxetic acid-related dyspnea (all, P < 0.001), although image qualities for the precontrast image were not statistically significant between the 2 groups (all, P > 0.05). Conclusions: 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.",
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author = "Park, {Yang Shin} and Chang-Hee Lee and Yoo, {Jung Lim} and Kim, {In Seong} and Berthold Kiefer and Woo, {Seung Tae} and Kim, {Kyeong Ah} and Park, {Cheol Min}",
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AU - Kim, In Seong

AU - Kiefer, Berthold

AU - Woo, Seung Tae

AU - Kim, Kyeong Ah

AU - Park, Cheol Min

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KW - Arterial phase

KW - Breath-Hold

KW - Dyspnea

KW - Gadoxetic acid

KW - Liver

KW - Magnetic resonance imaging

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