T1 mapping for liver function evaluation in gadoxetic acid–enhanced MR imaging: comparison of look-locker inversion recovery and B1 inhomogeneity–corrected variable flip angle method

Kim, Ji Eun; Kim, Hyun Ok; Bae, Kyungsoo; Choi, Dae Seob; Nickel, Dominik

doi:10.1007/s00330-018-5947-4

Cited by 43 publications

(54 citation statements)

References 41 publications

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“…by using a variable flip angle approach, i.e. acquiring spoiled gradient echo images with different flip angles [97,98].…”

Section: Figure 57 Results From a Phantom Showing Correlation Betweementioning

confidence: 99%

“…This could be a possible limitation to creating reliable biomarkers. An alternative strategy is to measure the actual T1 relaxation times, instead of arbitrary signal intensities [97,114,115]. Such a strategy could have the advantage of being less sensitive to differences in scanners, acquisition parameters, and different native T1 levels.…”

Section: Signal Intensity Ratiosmentioning

confidence: 99%

“…The ability of gadoxetate-enhanced MRI to measure liver function has been studied extensively. Firstly, work has been done showing that the gadoxetate uptake is lower in patient groups known to have impaired liver function [110,132], and also showing correlation to other clinical markers of liver functions, such as Child Pugh class [97,133], MELD score [134], and ICG retention rate [135].…”

Section: Correlation With Other Liver Function Measuresmentioning

confidence: 99%

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Non-Invasive Characterization of Liver Disease : By Multimodal Quantitative Magnetic Resonance

Karlsson

2020

Linköping University Medical Dissertations

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There is a large and unmet need for diagnostic tool that can be used to characterize chronic liver diseases (CLD). In the earlier stages of CLD, much of the diagnostics involves performing biopsies, which are evaluated by a histopathologist for the presence of e.g. fat, iron, inflammation, and fibrosis. Performing biopsies, however, have two downsides: i) biopsies are invasive and carries a small but non-negligible risk for serious complications, ii) biopsies only represents a tiny portion of the liver and are thus prone to sampling error. Moreover, in the later stages of CLD, when the disease has progressed far enough, the ability of the liver to perform its basic function will be compromised. In this stage, there is a need for better methods for accurately measuring liver function. Additionally, measures of liver function can also be used when developing new drugs, as biomarkers for drug-induced liver injury (DILI), which is a serious drug-safety issue. Magnetic resonance imaging (MRI) is a non-invasive medical imaging modality, which have shown much promise with regards to characterizing liver disease in all of the above-mentioned aspects. The aim of this PhD project was to develop and validate MR-based methods that can be used to non-invasively characterize liver disease. Paper I investigated if R2* mapping, a MR-method for measuring liver iron content, can be confounded by liver fat. The results show fat does affect R2*. The conclusion was therefore that fat must be taken into account when measuring small amounts of liver iron, as a small increase in R2* could be due to either small amounts of iron or large amounts of fat. Paper II examined whether T1 mapping, which is another MR-method, can be used for staging liver fibrosis. The results of previous research have been mixed; some studies have been very promising, whereas other studies have been less promising. Unfortunately, the results in Paper II belongs to the less promising studies. Paper III focused on measuring liver function by dynamic contrast-enhanced MRI (DCE-MRI) using a liver specific contrast agent, which is taken up the hepatocytes and excreted to the bile. The purpose of the paper was to extend and validate a method for estimating uptake and efflux rates of the contrast agent. The method had previously only been applied in health volunteers. Paper II showed that the method can be applied to CLD patients and that the uptake of the contrast agent is lower in patients with advanced fibrosis.

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“…by using a variable flip angle approach, i.e. acquiring spoiled gradient echo images with different flip angles [97,98].…”

Section: Figure 57 Results From a Phantom Showing Correlation Betweementioning

confidence: 99%

Section: Signal Intensity Ratiosmentioning

confidence: 99%

Section: Correlation With Other Liver Function Measuresmentioning

confidence: 99%

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Non-Invasive Characterization of Liver Disease : By Multimodal Quantitative Magnetic Resonance

Karlsson

2020

Linköping University Medical Dissertations

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“…In our study, DWI or gadoxetic acid-enhanced sequences were additionally acquired in seven cases for planning imaging. These additional sequences are relatively time-consuming, especially since the time until a sufficient hepatobiliary phase for detection of small tumours is reached can significantly affect the procedure duration, as it depends on the hepatic function [ 27 ]. Nevertheless, these additional sequences can be relevant for detection and targeting of small tumours and can affect therapy decisions, as shown in our study where several new small metastases were detected in one patient using DWI during planning imaging.…”

Section: Discussionmentioning

confidence: 99%

MR-Guided High-Power Microwave Ablation in Hepatic Malignancies: Initial Results in Clinical Routine

Winkelmann

Gohla

Kübler

et al. 2020

Cardiovasc Intervent Radiol

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Purpose Evaluation of technique effectiveness, patient safety and ablation parameters of MR-guided microwave ablation in hepatic malignancies using an MR-conditional high-power microwave ablation system. Materials and Methods Institutional review board approval and informed patient consent were obtained. Patients who underwent MR-guided microwave ablation of hepatic malignancies in a 1.5T wide-bore scanner using a perfusion-cooled high-power microwave ablation system with a maximum generator power of 150 W were included. Ablation parameters comprising procedure durations, net ablation duration, applicator positions and ablation zone dimensions were recorded. Adverse events were classified according to the CIRSE classification system. Technique effectiveness was assessed after 1 month. Follow-up was conducted with contrast-enhanced MRI and ranged from 1 to 20 months (mean: 6.1 ± 5.4 months). Results Twenty-one consecutive patients (age: 63.4 ± 10.5 years; 5 female) underwent 22 procedures for 28 tumours (9 hepatocellular carcinomas, 19 metastases) with a mean tumour diameter of 14.6 ± 5.4 mm (range: 6–24 mm). Technique effectiveness was achieved in all lesions. Tumours were treated using 1.7 ± 0.7 applicator positions (range: 1–3). Mean energy and ablation duration per tumour were 75.3 ± 35.4 kJ and 13.3 ± 6.2 min, respectively. Coagulation zone short- and long-axis diameters were 29.1 ± 6.4 mm and 39.9 ± 7.4 mm, respectively. Average procedure duration was 146.4 ± 26.2 min (range: 98–187 min). One minor complication was reported. Five patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed during initial follow-up. Conclusion MR-guided high-power microwave ablation provides safe and effective treatment of hepatic malignancies with short ablation times and within acceptable procedure durations.

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“…MOLLI sequence was originally proposed for measuring T1 values of myocardium in cardiac imaging 13 . Since MOLLI can generate high resolution T1 maps in single breath-hold with good reproducibility, there have been several attempts to apply MOLLI sequence to obtain hepatic T1 maps in previous studies 8 , 14 , 15 . However, theses previous studies about hepatic T1 mapping using the MOLLI sequence have been conducted in adult patients with a breath-hold 5 , 8 , 16 .…”

Section: Introductionmentioning

confidence: 99%

Validation and feasibility of liver T1 mapping using free breathing MOLLI sequence in children and young adults

Cho

Kim

Choi

et al. 2020

Sci Rep

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We investigated the feasibility of free-breathing modified Look-Locker inversion recovery (MOLLI) sequence for measuring hepatic T1 values in children and young adults. To investigate the accuracy and the reproducibility of the T1 maps, a phantom study was performed with 12 different gadoterate meglumine concentrations and the T1 relaxation times of phantoms measured with the MOLLI sequence were compared against those measured with three different sequences: spin-echo inversion recovery, variable flip angle (VFA), and VFA with B1 correction. To evaluate the feasibility of free-breathing MOLLI sequence, hepatic T1 relaxation times obtained by free-breathing and breath-hold technique in twenty patients were compared. The phantom study revealed the excellent accuracy and reproducibility of MOLLI. In twenty patients, the mean value of hepatic T1 values obtained by free-breathing (606.7 ± 64.5 ms) and breath-hold (609.8 ± 64.0 ms) techniques showed no significant difference (p > 0.05). The Bland–Altman plot between the free-breathing and breath-hold revealed that the mean difference of T1 values was − 3.0 ms (− 0.5%). Therefore, T1 relaxation times obtained by MOLLI were comparable to the values obtained using the standard inversion recovery method. The hepatic T1 relaxation times measured by MOLLI technique with free-breathing were comparable to those obtained with breath-hold in children and young adults.

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T1 mapping for liver function evaluation in gadoxetic acid–enhanced MR imaging: comparison of look-locker inversion recovery and B1 inhomogeneity–corrected variable flip angle method

Cited by 43 publications

References 41 publications

Non-Invasive Characterization of Liver Disease : By Multimodal Quantitative Magnetic Resonance

Non-Invasive Characterization of Liver Disease : By Multimodal Quantitative Magnetic Resonance

MR-Guided High-Power Microwave Ablation in Hepatic Malignancies: Initial Results in Clinical Routine

Validation and feasibility of liver T1 mapping using free breathing MOLLI sequence in children and young adults

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