Journal Article

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

Belmonte, Ernest, Caparroz Carla, Llarch Neus, Rimola Jordi, ner Alejandro, Ayuso, Carmen, Darnell, Anna, Sapena Victor, Reig, Maria, Bruix Jordi

2020

Overview

ObjectiveTo 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 methodsIntra-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.ResultsThe 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).ConclusionIn 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.

• Publisher: Springer Nature B.V
• Subject: Acids / Contrast agents / Contrast media / Diagnostic systems / Gadolinium / Image contrast / Image enhancement / Image quality / Liver / Magnetic resonance imaging / Medical diagnosis / Medical imaging / Quality assessment