Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Feasibility of Quadruple Arterial Phase of Motion Insensitive Radial Volumetric Imaging Breath-Hold Examination with k-Space Weighted Image Contrast in the Detection of Hepatocellular Carcinoma in Patients with Chronic Liver Disease

만성 간질환 환자의 간세포암의 발견에 있어 움직임에 덜 민감한 k 공간강조영상대조도의 호흡정지 Radial 체적 영상을 이용한 사중 동맥기 간 자기공명영상의 시행 가능성 분석

  • Lee, Min Ah (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Kim, Bong Soo (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Lee, Jeong Sub (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Kim, Seung Hyoung (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Choi, Guk Myung (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Lee, Ho Kyu (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Lee, Kyung Ryeol (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine)
  • 이민아 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 김봉수 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 이정섭 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 김승형 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 최국명 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 이호규 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 이경렬 (제주대학교 의학전문대학원 제주대학교병원 영상의학과)
  • Received : 2018.03.16
  • Accepted : 2018.06.14
  • Published : 2018.10.01
⟨ Previous Next ⟩

Abstract

Purpose: To evaluate the detection performance of hepatocellular carcinoma and image quality in patients with chronic liver disease with quadruple arterial MR imaging using radial volumetric imaging breath-hold examination (VIBE) with k-space weighted image contrast (KWIC). Materials and Methods: Forty-four patients underwent liver MR examinations with quadruple arterial imaging using radial VIBE-KWIC sequence (full-frame and four sub-frame images). Diagnostic performance was evaluated with receiver operating characteristics (ROC) for detection of hepatocellular carcinoma. The image quality and severity of artifact were scored by using the five-point scale. Results: The area under the ROC curve (Az) value of Hepatocelluar Carcinoma (HCC) detectability was the highest on third sub-frame images, followed by full-frame images. The Az values of third sub-frame and full-frame about the detection of HCC were statistically significantly different from the Az value of first sub-frame images. The full-frame and four sub-frame images showed acceptable image quality and low degree artifact with rating of higher than grade 3. Conclusion: Quadruple arterial MRI using radial VIBE-KWIC is a feasible method for detecting hepatocellular carcinoma in patients with chronic liver disease without deterioration of image quality. The third sub-frame and full-frame image are superior to other sub-frame images in detecting hepatocellular carcinoma.

목적: 만성 간질환 환자에서 radial volumetric imaging breath-hold examination (이하 VIBE) with k-space weighted image contrast (이하 KWIC) 방법을 이용한 사중 동맥기 간 자기공명 영상의 간세포암 발견능과 영상의 질을 평가하고자 한다. 대상과 방법: 총 44명의 환자를 대상으로 radial VIBE-KWIC 사중 조영 증강 동맥기 간 자기공명영상을 시행하였다. 간세포암의 진단능은 receiver operating characteristics (이하 ROC)를, 전반적 영상의 질과 인공물의 정도는 5점 척도를 사용하여 평가하였다. 결과: ROC curve의 아래면적 값은 세 번째 sub-frame에서 가장 큰 값을, full-frame에서 두 번째로 큰 값을 보였으며 첫번째 sub-frame과 비교하여 통계적으로 유의하게 높았다. 전반적 영상의 질 및 인공물의 정도는 모든 영상에서 진단할 만한 정도의 영상을 얻을 수 있었고 full-frame에서 가장 높은 점수를 보였다. 결론: Radial VIBE-KWIC을 이용한 사중 동맥기 간 자기공명영상은 영상의 질의 저하 없이 간세포암을 발견하는데 있어서 유용하며, 세 번째 sub-frame과 full-frame이 다른 sub-frame에 비하여 더 우월하다.

Keywords

Acknowledgement

Supported by : 지멘스 헬시니어스

References

  1. Hawighorst H, Schoenberg SO, Knopp MV, Essig M, Miltner P, van Kaick G. Hepatic lesions: morphologic and functional characterization with multiphase breath-hold 3D gadolinium-enhanced MR angiography--initial results. Radiology 1999;210:89-96
  2. Elsayes KM, Narra VR, Yin Y, Mukundan G, Lammle M, Brown JJ. Focal hepatic lesions: diagnostic value of enhancement pattern approach with contrast-enhanced 3D gradient-echo MR imaging. Radiographics 2005;25:1299-1320
  3. Kim BK, Kim MJ, Park BJ, Sung DJ, Cho SB. [Triple arterial phase hepatic MRI using four dimensional T1-weighted high resolutions imaging with volume excitation keyhole techniques: feasibility and initial clinical experience in focal liver lesions]. J Korean Soc Radiol 2013;69:223-234
  4. Hong HS, Kim HS, Kim MJ, De Becker J, Mitchell DG, Kanematsu M. Single breath-hold multiarterial dynamic MRI of the liver at 3T using a 3D fat-suppressed keyhole technique. J Magn Reson Imaging 2008;28:396-402
  5. Kanematsu M, Semelka RC, Matsuo M, Kondo H, Enya M, Goshima S, et al. Gadolinium-enhanced MR imaging of the liver: optimizing imaging delay for hepatic arterial and portal venous phases--a prospective randomized study in patients with chronic liver damage. Radiology 2002;225:407-415
  6. Goshima S, Kanematsu M, Kondo H, Yokoyama R, Miyoshi T, Nishibori H, et al. MDCT of the liver and hypervascular hepatocellular carcinomas: optimizing scan delays for bolus-tracking techniques of hepatic arterial and portal venous phases. AJR Am J Roentgenol 2006;187:W25-W32
  7. Kim KW, Lee JM, Jeon YS, Kang SE, Baek JH, Han JK, et al. Free-breathing dynamic contrast-enhanced MRI of the abdomen and chest using a radial gradient echo sequence with K-space weighted image contrast (KWIC). Eur Radiol 2013;23:1352-1360
  8. Fujinaga Y, Ohya A, Tokoro H, Yamada A, Ueda K, Ueda H, et al. Radial volumetric imaging breath-hold examination (VIBE) with k-space weighted image contrast (KWIC) for dynamic gadoxetic acid (Gd-EOB-DTPA)-enhanced MRI of the liver: advantages over Cartesian VIBE in the arterial phase. Eur Radiol 2014;24:1290-1299
  9. Brodsky EK, Bultman EM, Johnson KM, Horng DE, Schelman WR, Block WF, et al. High-spatial and high-temporal resolution dynamic contrast-enhanced perfusion imaging of the liver with time-resolved three-dimensional radial MRI. Magn Reson Med 2014;71:934-941
  10. Zech CJ, Vos B, Nordell A, Urich M, Blomqvist L, Breuer J, 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
  11. Park YS, Lee CH, Yoo JL, Kim IS, Kiefer B, Woo ST, 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
  12. Hope TA, Saranathan M, Petkovska I, Hargreaves BA, Herfkens RJ, Vasanawala SS. Improvement of gadoxetate arterial phase capture with a high spatio-temporal resolution multiphase three-dimensional SPGR-Dixon sequence. J Magn Reson Imaging 2013;38:938-945
  13. Beck GM, De Becker J, Jones AC, von Falkenhausen M, Willinek WA, Gieseke J. Contrast-enhanced timing robust acquisition order with a preparation of the longitudinal signal component (CENTRA plus) for 3D contrast-enhanced abdominal imaging. J Magn Reson Imaging 2008;27:1461-1467
  14. Hadizadeh DR, Gieseke J, Beck G, Geerts L, Kukuk GM, Bostrom A, et al. View-sharing in keyhole imaging: partially compressed central k-space acquisition in time-resolved MRA at 3.0 T. Eur J Radiol 2011;80:400-406
  15. Agrawal MD, Spincemaille P, Mennitt KW, Xu B, Wang Y, Dutruel SP, et al. Improved hepatic arterial phase MRI with 3-second temporal resolution. J Magn Reson Imaging 2013; 37:1129-1136
  16. Kim BS, Lee KR, Goh MJ. New imaging strategies using a motion-resistant liver sequence in uncooperative patients. Biomed Res Int 2014;2014:142658
  17. Budjan J, Riffel P, Ong MM, Schoenberg SO, Attenberger UI, Hausmann D. Rapid Cartesian versus radial acquisition: comparison of two sequences for hepatobiliary phase MRI at 3 tesla in patients with impaired breath-hold capabilities. BMC Med Imaging 2017;17:32
  18. Yu MH, Lee JM, Yoon JH, Kiefer B, Han JK, Choi BI. Clinical application of controlled aliasing in parallel imaging results in a higher acceleration (CAIPIRINHA)-volumetric interpolated breathhold (VIBE) sequence for gadoxetic acid-enhanced liver MR imaging. J Magn Reson Imaging 2013;38: 1020-1026
  19. Li H, Xiao Y, Wang S, Li Y, Zhong X, Situ W, et al. TWIST-VIBE five-arterial-phase technology decreases transient severe motion after bolus injection of Gd-EOB-DTPA. Clin Radiol 2017;72:800.e1-800.e6
  20. Theilmann RJ, Gmitro AF, Altbach MI, Trouard TP. View-ordering in radial fast spin-echo imaging. Magn Reson Med 2004;51:768-774
  21. Spuentrup E, Katoh M, Buecker A, Manning WJ, Schaeffter T, Nguyen TH, et al. Free-breathing 3D steady-state free precession coronary MR angiography with radial k-space sampling: comparison with cartesian k-space sampling and cartesian gradient-echo coronary MR angiography--pilot study. Radiology 2004;231:581-586
  22. Clarke SE, Saranathan M, Rettmann DW, Hargreaves BA, Vasanawala SS. High resolution multi-arterial phase MRI improves lesion contrast in chronic liver disease. Clin Invest Med 2015;38:E90-E99
  23. Pietryga JA, Burke LM, Marin D, Jaffe TA, Bashir MR. Respiratory motion artifact affecting hepatic arterial phase imaging with gadoxetate disodium: examination recovery with a multiple arterial phase acquisition. Radiology 2014;271:426-434