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Continuous Hepatic Arterial Multiphase Magnetic Resonance Imaging During Free-Breathing

Weiss, Jakob, MD*; Notohamiprodjo, Mike, MD*; Taron, Jana, MD*; Martirosian, Petros, PhD*; Nickel, Dominik, PhD; Bamberg, Fabian, MD*; Nikolaou, Konstantin, MD*; Othman, Ahmed E., MD*

doi: 10.1097/RLI.0000000000000459
Original Articles

Purpose The aim of this study was to evaluate the feasibility of a prototype volume-interpolated breath-hold examination (VIBE) sequence using compressed sensing (VIBECS) for rapid multiphase arterial magnetic resonance imaging (MRI) at different temporal resolution during free-breathing in comparison with a conventional breath-hold approach (VIBESTD).

Material and Methods A total of 40 patients with liver malignancies were prospectively included in this study and underwent contrast-enhanced liver MRI at 1.5 T to evaluate the performance of VIBECS for rapid arterial multiphase imaging. An additional 40 patients examined with a VIBESTD were included serving as standard of reference. The VIBECS study cohort was subdivided into 2 groups (each n = 20). In both groups, VIBECS was continuously acquired for 60 seconds starting with the contrast agent administration (group A, temporal resolution 4 seconds; group B, temporal resolution 8 seconds). Subsequently, the time point with the subjectively best image quality was selected and defined as hepatic arterial dominant (HAD) phase. Overall image quality, lesion conspicuity, vessel contrast, and artifacts of HAD phase were assessed by 2 radiologists independently on a 5-point Likert scale (5 = excellent) and compared with arterial phase images of VIBESTD. In addition, signal attenuation/time curves of VIBECS were plotted for each patient to quantify the hepatic arterial enhancement.

Results No patients were excluded and all HAD phases were reliably recorded in the investigated VIBECS cohort. Most commonly, HAD was observed at the ninth time point (36 seconds after intravenous contrast injection) in group A and at the fifth time point (40 seconds after intravenous contrast injection) in group B. Timing with VIBESTD was only adequate in 65% (26/40). Image quality, lesion conspicuity, and vessel contrast were good to excellent without significant differences between both VIBECS groups (P ≥ 0.2) and with significantly higher reading scores as compared with VIBESTD with respect to lesion conspicuity (P ≤ 0.006) and image quality (group B; P < 0.001). VIBECS showed reconstruction artifacts, which were significantly higher in group A (P = 0.001). Mean peak arterial enhancement was observed at the ninth time point (36 seconds) in group A and at the sixth (48 seconds) in group B.

Conclusion VIBECS allows for robust multiphase arterial imaging during free-breathing at high spatial and temporal resolution (preferably 8 seconds) with improved image quality and lesion conspicuity as compared with VIBESTD.

From the *Department of Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, Tuebingen; and

MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany.

Received for publication November 21, 2017; and accepted for publication, after revision, January 29, 2018.

Conflicts of interest and source of funding: K. Nikolaou received research grant by Siemens Healthcare and is on the speaker's bureau of Siemens Healthcare. D. Nickel is an employee of Siemens Healthcare, who provided technical background support but was not involved in conception, data acquisition and final analysis. For the remaining authors, none declared.

Correspondence to: Ahmed E. Othman, MD, Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany. E-mail: Ahmed.Othman@med.uni-tuebingen.de.

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