Experimental studies on artifacts and tumor enhancement on gadoxetic acid-enhanced arterial phase liver MRI in a rabbit VX2 tumor model

Abstract

Background

Rapid injection of gadoxetic acid is reported to produce more frequent artifacts and lower vascular enhancement on arterial phase liver magnetic resonance imaging (MRI). However, its effect on tumor enhancement and the mechanism of the artifacts remain unclear.

Purpose

To evaluate the effect of rapid injection of gadoxetic acid on artifacts and tumor enhancement during arterial phase liver MRI, and on arterial blood gases (ABGs) which may explain the cause of the artifacts.

Material and Methods

ABG analysis was performed in 13 free-breathing rabbits after rapid injection (1 mL/s; injection time = 0.6–0.8 s) of gadoxetic acid (0.025 mmol/kg). Dynamic liver MRI was performed in six anesthetized rabbits with VX2 tumors under a ventilation stoppage after rapid and slow injection (0.25 mL/s; injection time = 2.4–3.2 s) of gadoxetic acid. Artifacts and signal enhancement on arterial phase imaging were compared with those obtained after rapid injection of gadopentetic acid (Gd-DTPA, 0.1 mmol/kg) using a Friedman test or Kruskal–Wallis test.

Results

ABG analysis did not find any significant changes. Artifacts were not related to injection protocols (P = 0.95). Aortic enhancement with slow injection of gadoxetic acid was significantly higher than that with rapid injection (P < 0.05), and was comparable to that with Gd-DTPA injection. Tumor enhancement obtained with gadoxetic acid was not significantly different between rapid and slow injection, and was significantly lower than that with Gd-DTPA injection (P < 0.05).

Conclusion

Rapid injection of gadoxetic acid did not affect ABGs and may not be the cause of the artifacts. It lowered vascular enhancement but not arterial tumor enhancement.

Keywords

Liver magnetic resonance imaging (MRI)gadoxetic acid artifact tumor enhancement

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References

Goodwin

Dobson

Sirlin

et al.

Diagnostic challenges and pitfalls in MR imaging with hepatocyte-specific contrast agents. Radiographics 2011; 31: 1547–1568.

Sirlin

Hussain

Jonas

et al.

Consensus report of the 6th International forum for liver MRI using gadoxetic acid. J Magn Reson Imaging 2014; 40: 516–529.

Tanimoto

Higuchi

Ueno

. Reduction of ringing artifacts in the arterial phase of gadoxetic acid-enhanced dynamic MR imaging. Magn Reson Med Sci 2012; 11: 91–97.

Haradome

Grazioli

Tsunoo

et al.

Can MR fluoroscopic triggering technique and slow rate injection provide appropriate arterial phase images with reducing artifacts on gadoxetic acid-DTPA (Gd-EOB-DTPA)-enhanced hepatic MR imaging?

J Magn Reson Imaging 2010; 32: 334–340.

Motosugi

Ichikawa

Sou

et al.

Dilution method of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). J Magn Reson Imaging 2009; 30: 849–854.

Davenport

Viglianti

Al-Hawary

et al.

Comparison of acute transient dyspnea after intravenous administration of gadoxetate disodium and gadobenate dimeglumine: effect on arterial phase image quality. Radiology 2013; 266: 452–461.

Davenport

Caoili

Kaza

et al.

Matched within-patient cohort study of transient arterial phase respiratory motion-related artifact in MR imaging of the liver: gadoxetate disodium versus gadobenate dimeglumine. Radiology 2014; 272: 123–131.

Davenport

Bashir

Pietryga

et al.

Dose-toxicity relationship of gadoxetate disodium and transient severe respiratory motion artifact. Am J Roentgenol 2014; 203: 796–802.

Kim

Park

et al.

Transient respiratory motion artifact during arterial phase MRI with gadoxetate disodium: risk factor analyses. Am J Roentgenol 2015; 204: 1220–1227.

10.

Bashir

Castelli

Davenport

et al.

Respiratory motion artifact affecting hepatic arterial phase MR imaging with gadoxetate disodium is more common in patients with a prior episode of arterial phase motion associated with gadoxetate disodium. Radiology 2015; 274: 141–148.

11.

Hayashi

Saitoh

Tsuji

et al.

Influence of gadoxetate disodium on oxygen saturation and heart rate during dynamic contrast-enhanced MR Imaging. Radiology 2015; 276: 756–765.

12.

Motosugi

Bannas

Bookwalter

et al.

An investigation of transient severe motion related to gadoxetic acid-enhanced MR imaging. Radiology 2016; 279: 93–102.

13.

Yoo

Lee

Park

et al.

The short breath-hold technique, controlled aliasing in parallel imaging results in higher acceleration, can be the first step to overcoming a degraded hepatic arterial phase in liver magnetic resonance imaging: a prospective randomized control study. Invest Radiol 2016; 51: 440–446.

14.

Park

Lee

Yoo

et al.

Hepatic arterial phase in gadoxetic acid enhanced liver magnetic resonance imaging: analysis of respiratory patterns and their effect on image quality. Invest Radiol 2016; 51: 127–133.

15.

Skow

Day

Fuller

et al.

The ins and outs of breath holding: simple demonstration of complex respiratory physiology. Adv Physiol Educ 2015; 39: 223–231.

16.

Parks

. Breath-holding and its breakpoint. Exp Physiol 2006; 91: 1–15.

17.

Tamada

Ito

Sone

et al.

Dynamic contrast-enhanced magnetic resonance imaging of abdominal solid organ and major vessel: comparison of enhancement effect between Gd-EOB-DTPA and Gd-DTPA. J Magn Reson lmaging 2009; 29: 636–640.

18.

Brismar

Dahlstrom

Edsborg

et al.

Liver vessel enhancement by Gd-BOPTA and Gd- EOB-DTPA: a comparison in healthy volunteers. Acta Radiol 2009; 50: 709–715.

19.

Park

Kim

et al.

Diagnostic efficacy of gadoxetic acid-enhanced MRI in the detection of hepatocellular carcinomas: comparison with gadopentetate dimeglumine. Br J Radiol 2010; 83: 1010–1016.

20.

Besa

Kakite

Cooper

et al.

Comparison of gadoxetic acid and gadopentetate dimeglumine-enhanced MRI for HCC detection: prospective crossover study at 3 T. Acta Radiol Open 2015; 4. 10.1177/2047981614561285.

21.

Tirkes

Mehta

Aisen

et al.

Comparison of dynamic phase enhancement of hepatocellular carcinoma using gadoxetate disodium vs gadobenate dimeglumine. J Comput Assist Tomogr 2015; 39: 479–482.

22.

Zech

Vos

Nordell

et al.

Vascular enhancement in early dynamic liver MR imaging in an animal model: comparison of two injection regimen and two different doses Gd-EOB-DTPA (gadoxetic acid) with standard Gd-DTPA. Invest Radiol 2009; 44: 305–310.

23.

Tamada

Ito

Yoshida

et al.

Comparison of three different injection methods for arterial phase of Gd-EOB-DTPA enhanced MR imaging of the liver. Eur J Radiol 2011; 80: e284–288.

24.

Chung

Kim

Choi

et al.

Comparison of two different injection rates of gadoxetic acid for arterial phase MRI of the liver. J Magn Reson Imaging 2010; 31: 365–372.

25.

Kim

Heo

Kim

et al.

Hepatic arterial phase on gadoxetic acid-enhanced liver MR imaging: a randomized comparison of 0.5 mL/s and 1 mL/s injection rates. Korean J Radiol 2014; 15: 605–612.

26.

Nakamura

Nakaura

Kidoh

et al.

Timing of the hepatic arterial phase at Gd-EOB-DTPA-enhanced hepatic dynamic MRI; comparison of the test-injection and the fixed time delay method. J Magn Reson Imaging 2013; 38: 548–554.

27.

Conover

. Practical nonparametric statistics, 3rd edition. New York, NY: John Wiley & Sons, 1999.

28.

Pietryga

Burke

Marin

et al.

Respiratory motion artifact affecting hepatic arterial phase imaging with gadoxetate disodium: examination recovery with a multiple arterial phase acquisition. Radiology 2014; 271: 426–434.

29.

Park

Lee

Kim

et al.

Usefulness of controlled aliasing in parallel imaging results in higher acceleration in gadoxetic acid-enhanced liver magnetic resonance imaging to clarify the hepatic arterial phase. Invest Radiol 2014; 49: 183–188.

30.

Luetkens

Kupczyk

Doerner

et al.

Respiratory motion artefacts in dynamic liver MRI: a comparison using gadoxetate disodium and gadobutrol. Eur Radiol 2015; 25: 3207–3213.

31.

Gutzeit

Matoori

Froehlich

et al.

Reduction in respiratory motion artefacts on gadoxetate-enhanced MRI after training technicians to apply a simple and more patient-adapted breathing command. Eur Radiol 2016; 26: 2714–2722.

32.

Motosugi

Ichikawa

Sano

et al.

Double-dose gadoxetic acid-enhanced magnetic resonance imaging in patients with chronic liver disease. Invest Radiol 2011; 46: 141–145.