Matched within-Patient Cohort Study of Transient Arterial Phase Respiratory Motion–related Artifact in MR Imaging of the Liver: Gadoxetate Disodium versus Gadobenate Dimeglumine

Davenport, Matthew S.; Caoili, Elaine M.; Kaza, Ravi K.; Hussain, Hero K.

doi:10.1148/radiol.14132269

Cited by 105 publications

(125 citation statements)

References 13 publications

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“…Davenport et al demonstrated that gadoxetate disodiumassociated TSM is more frequent (15 %) after application of a fixed dose of 20 ml compared to a fixed dose of 10 ml (10 %) [24]. Other studies, however, were not able to confirm a dose-dependent relationship of gadoxetate disodium and TSM [8,10,12].…”

Section: Influence Of Contrast Dosementioning

confidence: 98%

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Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Well

Weinrich

Adam

et al. 2017

Fortschr Röntgenstr

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Background Gadoxetate disodium is an intracellular contrast agent for magnetic resonance imaging (MRI) of the liver. Recent publications revealed that injection of gadoxetate disodium can lead to imaging artifacts due to transient severe motion (TSM) in the arterial phase of contrast-enhanced liver MRI. In this review we present and discuss published frequencies of TSM, contrast injection and image acquisition protocols, potential risk factors, and proposed strategies to avoid or minimize the effects of TSM. Method Two reviewers independently searched the PubMed search engine for “transient severe motion artifact” and related terms. Reference lists of retrieved articles were also searched. The two reviewers selected in consensus nine studies that reported both frequencies of TSM and potential risk factors. Study data were extracted by both reviewers, and disagreement was resolved by consensus. Results and Conclusion TSM is caused by impaired breath-hold ability after gadoxetate disodium injection and occurs in 5 – 22 % of patients. The dose of applied contrast agent, repeated exposure to gadoxetate disodium, high BMI and pulmonary disease have been described as potential risk factors for TSM. However, there are only few concordant results on this topic and the pathophysiology of TSM has not been identified. Proposed strategies for the prevention of TSM are slow injection rates and low doses of diluted gadoxetate disodium. Accelerated and free-breathing MRI sequence protocols and breath-hold training may minimize the effects of TSM. Further prospective studies are needed to confirm these strategies and to identify the underlying mechanism of TSM. Key Points Citation Format

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Section: Influence Of Contrast Dosementioning

confidence: 98%

“…Regarding age, Shah et al found that the risk of arterial phase motion artifacts increases with age [14], but none of the other groups confirmed a predisposition of higher age towards TSM [15,24].…”

Section: Potential Individual Risk Factorsmentioning

confidence: 98%

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Well

Weinrich

Adam

et al. 2017

Fortschr Röntgenstr

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“…4 In addition, the use of gadoxetic acid itself has been reported to result in degraded arterial phase images compared with that using extracellular contrast media, thereby hindering accurate lesion characterization. 5–7 Until now, there have been ample reports documenting “transient dyspnea” or “transient severe motion” frequently occurring after gadoxetic acid administration, although the specific mechanism is not yet fully understood. However, recent studies have shown that the reported incidence based on retrospective image reviews or subjective symptoms 5,6,8 may not reflect the actual incidence.…”

mentioning

confidence: 99%

Evaluation of Transient Motion During Gadoxetic Acid–Enhanced Multiphasic Liver Magnetic Resonance Imaging Using Free-Breathing Golden-Angle Radial Sparse Parallel Magnetic Resonance Imaging

Yoon¹,

Lee²,

et al. 2018

Invest Radiol

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Objectives The aims of this study were to observe the pattern of transient motion after gadoxetic acid administration including incidence, onset, and duration, and to evaluate the clinical feasibility of free-breathing gadoxetic acid–enhanced liver magnetic resonance imaging using golden-angle radial sparse parallel (GRASP) imaging with respiratory gating. Materials and Methods In this institutional review board–approved prospective study, 59 patients who provided informed consents were analyzed. Free-breathing dynamic T1-weighted images (T1WIs) were obtained using GRASP at 3 T after a standard dose of gadoxetic acid (0.025 mmol/kg) administration at a rate of 1 mL/s, and development of transient motion was monitored, which is defined as a distinctive respiratory frequency alteration of the self-gating MR signals. Early arterial, late arterial, and portal venous phases retrospectively reconstructed with and without respiratory gating and with different temporal resolutions (nongated 13.3-second, gated 13.3-second, gated 6-second T1WI) were evaluated for image quality and motion artifacts. Diagnostic performance in detecting focal liver lesions was compared among the 3 data sets. Results Transient motion (mean duration, 21.5 ± 13.0 seconds) was observed in 40.0% (23/59) of patients, 73.9% (17/23) of which developed within 15 seconds after gadoxetic acid administration. On late arterial phase, motion artifacts were significantly reduced on gated 13.3-second and 6-second T1WI (3.64 ± 0.34, 3.61 ± 0.36, respectively), compared with nongated 13.3-second T1WI (3.12 ± 0.51, P < 0.0001). Overall, image quality was the highest on gated 13.3-second T1WI (3.76 ± 0.39) followed by gated 6-second and nongated 13.3-second T1WI (3.39 ± 0.55, 2.57 ± 0.57, P < 0.0001). Only gated 6-second T1WI showed significantly higher detection performance than nongated 13.3-second T1WI (figure of merit, 0.69 [0.63–0.76]) vs 0.60 [0.56–0.65], P = 0.004). Conclusions Transient motion developed in 40% (23/59) of patients shortly after gadoxetic acid administration, and gated free-breathing T1WI using GRASP was able to consistently provide acceptable arterial phase imaging in patients who exhibited transient motion.

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“…However, even after 2 years passed from the first report, this phenomenon has been only reported from United States. [1][2][3] At least, it was not observed in the recent study from Japan which is about gadolinium-based contrast agents-related adverse events in large cohort. 4 I also met some radiologists who even doubted the occurrence of dyspnea, because they had not encountered such cases.…”

mentioning

confidence: 94%

“…Severe motion-related artifacts during the arterial phase were observed in approximately 18% 2 or 10% 3 of patients in whom gadoxetic acid was injected. However, even after 2 years passed from the first report, this phenomenon has been only reported from United States.…”

mentioning

confidence: 99%

Gadoxetic Acid-induced Acute Transient Dyspnea: The Perspective of Japanese Radiologists

MOTOSUGI

2015

magn reson med sci

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Matched within-Patient Cohort Study of Transient Arterial Phase Respiratory Motion–related Artifact in MR Imaging of the Liver: Gadoxetate Disodium versus Gadobenate Dimeglumine

Abstract: Fixed off-label dose (10 or 20 mL) of gadoxetate disodium is associated with arterial phase respiratory motion-related artifact that is sometimes severe and occurs significantly more often than after gadobenate dimeglumine in patients who received both contrast media.

Cited by 105 publications

References 13 publications

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Evaluation of Transient Motion During Gadoxetic Acid–Enhanced Multiphasic Liver Magnetic Resonance Imaging Using Free-Breathing Golden-Angle Radial Sparse Parallel Magnetic Resonance Imaging

Gadoxetic Acid-induced Acute Transient Dyspnea: The Perspective of Japanese Radiologists

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