21,947 results on '"Gadolinium DTPA"'
Search Results
2. Consensus report from the 9th International Forum for Liver Magnetic Resonance Imaging: applications of gadoxetic acid-enhanced imaging
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Koh, Dow-Mu, Ba-Ssalamah, Ahmed, Brancatelli, Giuseppe, Fananapazir, Ghaneh, Fiel, M Isabel, Goshima, Satoshi, Ju, Sheng-Hong, Kartalis, Nikolaos, Kudo, Masatoshi, Lee, Jeong Min, Murakami, Takamichi, Seidensticker, Max, Sirlin, Claude B, Tan, Cher Heng, Wang, Jin, Yoon, Jeong Hee, Zeng, Mengsu, Zhou, Jian, and Taouli, Bachir
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Rare Diseases ,Liver Disease ,Digestive Diseases ,Biomedical Imaging ,Chronic Liver Disease and Cirrhosis ,Cancer ,Liver Cancer ,Orphan Drug ,Oral and gastrointestinal ,Carcinoma ,Hepatocellular ,Consensus ,Contrast Media ,Gadolinium DTPA ,Humans ,Liver Neoplasms ,Magnetic Resonance Imaging ,Magnetic Resonance Spectroscopy ,Retrospective Studies ,Sensitivity and Specificity ,Gadoxetic acid ,Hepatocellular carcinoma ,Magnetic resonance imaging ,Metastatic liver disease ,Clinical Sciences ,Nuclear Medicine & Medical Imaging - Abstract
ObjectivesThe 9th International Forum for Liver Magnetic Resonance Imaging (MRI) was held in Singapore in September 2019, bringing together radiologists and allied specialists to discuss the latest developments in and formulate consensus statements for liver MRI, including the applications of gadoxetic acid-enhanced imaging.MethodsAs at previous Liver Forums, the meeting was held over 2 days. Presentations by the faculty on days 1 and 2 and breakout group discussions on day 1 were followed by delegate voting on consensus statements presented on day 2. Presentations and discussions centered on two main meeting themes relating to the use of gadoxetic acid-enhanced MRI in primary liver cancer and metastatic liver disease.Results and conclusionsGadoxetic acid-enhanced MRI offers the ability to monitor response to systemic therapy and to assist in pre-surgical/pre-interventional planning in liver metastases. In hepatocellular carcinoma, gadoxetic acid-enhanced MRI provides precise staging information for accurate treatment decision-making and follow-up post therapy. Gadoxetic acid-enhanced MRI also has potential, currently investigational, indications for the functional assessment of the liver and the biliary system. Additional voting sessions at the Liver Forum debated the role of multidisciplinary care in the management of patients with liver disease, evidence to support the use of abbreviated imaging protocols, and the importance of standardizing nomenclature in international guidelines in order to increase the sharing of scientific data and improve the communication between centers.Key points• Gadoxetic acid-enhanced MRI is the preferred imaging method for pre-surgical or pre-interventional planning for liver metastases after systemic therapy. • Gadoxetic acid-enhanced MRI provides accurate staging of HCC before and after treatment with locoregional/biologic therapies. • Abbreviated protocols for gadoxetic acid-enhanced MRI offer potential time and cost savings, but more evidence is necessary. The use of gadoxetic acid-enhanced MRI for the assessment of liver and biliary function is under active investigation.
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- 2021
3. Gadolinium deposition in the brain of patients with relapsingremitting multiple sclerosis after 10 years of follow-up.
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Kostić, Dejan, Mišović, Miroslav, Vučković, Filip, Crevar, Djuro, Sekulić, Igor, Georgievski-Brkić, Biljana, Kostić, Smiljana, and Dinčić, Evica
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GADOLINIUM , *MULTIPLE sclerosis , *CORPUS callosum , *CEREBELLAR cortex , *MAGNETIC resonance imaging - Abstract
Background/Aim. Since 2014 and the publication of the results of the first study on the accumulation of gadolinium contrast, we have witnessed a growing body of evidence on the deposition and retention of gadolinium in the brain after the use of gadolinium-based contrast agents (GBCAs). However, there is still no strong clinical evidence of the adverse effects of GBCAs on the brain parenchyma. The aim of the study was to determine the existence of gadolinium deposits in the brain of patients with relapsing-remitting multiple sclerosis after a ten-year follow-up period. During this period, the patients have regularly, each year, undergone magnetic resonance imaging (MRI) with the administration of gadolinium contrast (gadopentetate dimeglumine – Magnevist®) in order to follow the course of the disease. Methods. A cohort of 20 patients was formed for the purpose of this study. The ratio of the values of the signal intensity (SI) of different regions of the brain-to-cerebrospinal fluid (CSF) was compared for each patient on the initial MRI examination and the MRI examination ten years later. Results. Frontal cortex-to-CSF (p < 0.01), occipital cortex-to-CSF (p < 0.01), the white matter of the corona radiata-to-CSF (p < 0.01), parietal cortex-to-CSF (p < 0.05), thalamus-to-CSF (p = 0.051), putamen-to-CSF (p = 0.06), and anterior and posterior limb of the capsula interna-to-CSF (p = 0.062) SI ratios increased after multiple gadopentetate administrations. An increase in the absolute values of the T1- weighted (T1W) signal in three-quarters of patients was registered in the frontal and occipital cortex and cerebellar hemispheres. A slightly smaller increase in SI, but still greater than 55–65%, was registered in structures of the parietal cortex, putamen, cornu anterior and posterior of the capsula interna, corpus callosum (CC) splenium, pons, thalamus, nucleus caudatus, substantia nigra, CC genu, and temporal cortex. Conclusion. In the cohort of 20 patients, there was a statistically significant increase in SI in the precontrast T1W sequence in the following structures: frontal, parietal, and occipital cortex, as well as supratentorial white matter. This result speaks in favor of the existence of chronic accumulation of gadolinium contrast agent gadopentetate dimeglumine in brain structures. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Impact of portal‐phase signal intensity of dynamic gadoxetic acid‐enhanced magnetic resonance imaging in hepatocellular carcinoma.
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Tomino, Takahiro, Itoh, Shinji, Okamoto, Daisuke, Yoshiya, Shohei, Nagao, Yoshihiro, Harada, Noboru, Fujita, Nobuhiro, Ushijima, Yasuhiro, Ishigami, Kousei, and Yoshizumi, Tomoharu
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Purpose: To evaluate the prognostic impact of dynamic gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd‐EOB‐DTPA)‐enhanced magnetic resonance imaging (MRI) in patients with hepatocellular carcinoma (HCC). Methods: We retrospectively reviewed the data of 206 patients with HCC who underwent preoperative Gd‐EOB‐DTPA‐enhanced MRI and hepatectomy and quantitatively evaluated the signal intensity ratio of the tumor to the surrounding liver tissue in the portal phase (SIRPP). We verified the survival rates and assessed the prognostic factors associated with overall survival (OS) and recurrence‐free survival (RFS) using SIRPP. Results: Multivariate analysis revealed that the independent predictive factors for poorly‐differentiated HCC were α‐fetoprotein > 20 ng/mL (hazard ratio [HR]: 3.1909, 95% confidence interval [CI]: 1.3464–7.5622, p =.0084) and SIRPP ≤ 0.85 (HR: 3.7155, 95% CI: 1.521–9.076, p =.004). The 5‐year OS and RFS rates in the high and low SIRPP groups were 83.2 and 52.1%, respectively (p <.0001) and 49.7 and 18.5%, respectively (p =.0003). Multivariate analysis revealed that SIRPP ≤ 0.68 was an independent prognostic factor related to OS (HR: 4.4537, 95% CI: 1.6581–11.9626, p =.003). Conclusion: The SIRPP of preoperative Gd‐EOB‐DTPA‐enhanced MRI might predict the histological differentiation and prognosis of HCC. [ABSTRACT FROM AUTHOR]
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- 2023
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5. LI-RADS version 2018 for hepatocellular carcinoma < 1.0 cm on gadoxetate disodium–enhanced magnetic resonance imaging.
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Jang, Hyeon Ji, Choi, Sang Hyun, Choi, Se Jin, Choi, Won-Mook, Byun, Jae Ho, Won, Hyung Jin, and Shin, Yong Moon
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MAGNETIC resonance imaging , *DIFFUSION magnetic resonance imaging , *GENERALIZED estimating equations , *LOGISTIC regression analysis - Abstract
Objectives: We aimed to develop and evaluate a modified Liver Imaging Reporting and Data System (LI-RADS) version 2018 using significant ancillary features for diagnosing hepatocellular carcinoma (HCC) < 1.0 cm on gadoxetate disodium–enhanced magnetic resonance imaging (MRI). Methods: Patients who underwent preoperative gadoxetate disodium–enhanced MRI for focal solid nodules < 2.0 cm within 1 month of MRI between January 2016 and December 2020 were retrospectively analyzed. Major and ancillary features were compared between HCCs of < 1.0 cm and 1.0–1.9 cm using the chi-square test. Significant ancillary features associated with HCC < 1.0 cm were determined by univariable and multivariable logistic regression analysis. The sensitivity and specificity of LR-5 were compared between LI-RADS v2018 and our modified LI-RADS (applying the significant ancillary feature) using generalized estimating equations. Results: Of 796 included nodules, 248 were < 1.0 cm and 548 were 1.0–1.9 cm. HCC < 1.0 cm less frequently showed an enhancing capsule (7.1% vs. 31.1%, p <.001) and threshold growth (0% vs. 8.3%, p =.007) than HCC of 1.0−1.9 cm. Restricted diffusion was the only ancillary feature significant for diagnosing HCC < 1.0 cm (adjusted odds ratio = 11.50, p <.001). In the diagnosis of HCC, our modified LI-RADS using restricted diffusion had significantly higher sensitivity than LI-RADS v2018 (61.8% vs. 53.5%, p <.001), with similar specificity (97.3% vs. 97.8%, p =.157). Conclusion: Restricted diffusion was the only significant independent ancillary feature for diagnosing HCC < 1.0 cm. Our modified LI-RADS using restricted diffusion can improve the sensitivity for HCC < 1.0 cm. Key Points: • The imaging features of hepatocellular carcinoma (HCC) < 1.0 cm differed from those of HCC of 1.0–1.9 cm. • Restricted diffusion was the only significant independent ancillary feature for HCC < 1.0 cm. • Modified Liver Imaging Reporting and Data System (LI-RADS) with the addition of restricted diffusion can improve the sensitivity for HCC < 1.0 cm. [ABSTRACT FROM AUTHOR]
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- 2023
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6. Characterization of hepatobiliary phase hypointense nodules without arterial phase hyperenhancement on gadoxetic acid-enhanced MRI via contrast-enhanced ultrasound using perfluorobutane.
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Bae, Jae Seok, Lee, Jae Young, Suh, Kyung-Suk, Hong, Suk Kyun, Yoon, Jung-Hwan, Kim, Yoon Jun, Yu, Su Jong, Lee, Jeong-Hoon, Cho, Eun Ju, Lee, Yun Bin, and Han, Joon Koo
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CONTRAST-enhanced magnetic resonance imaging , *CONTRAST-enhanced ultrasound , *LOGISTIC regression analysis , *MAGNETIC resonance imaging , *ODDS ratio - Abstract
Purpose: Hepatobiliary phase (HBP) hypointense nodules without arterial phase hyperenhancement (APHE) on gadoxetic acid-enhanced MRI (GA-MRI) may be nonmalignant cirrhosis-associated nodules or hepatocellular carcinomas (HCCs). We aimed to characterize HBP hypointense nodules without APHE on GA-MRI by performing contrast-enhanced ultrasound using perfluorobutane (PFB-CEUS). Methods: In this prospective, single-center study, participants at high-risk of HCC having HBP hypointense nodules without APHE at GA-MRI were enrolled. All participants underwent PFB-CEUS; if APHE and late, mild washout or washout in the Kupffer phase were present, the diagnosis of HCC was established according to the v2022 Korean guidelines. The reference standard consisted of histopathology or imaging. The sensitivity, specificity, and positive/negative predictive values of PFB-CEUS for detecting HCC were calculated. Associations between clinical/imaging features and the diagnosis of HCC were evaluated with logistic regression analyses. Results: In total, 67 participants (age, 67.0 years ± 8.4; 56 men) with 67 HBP hypointense nodules without APHE (median size, 1.5 cm [range, 1.0–3.0 cm]) were included. The prevalence of HCC was 11.9% (8/67). The sensitivity, specificity, and positive and negative predictive values of PFB-CEUS for detecting HCC were 12.5%(1/8), 96.6%(57/59), 33.3%(1/3) and 89.1%(57/64), respectively. Mild-moderate T2 hyperintensity on GA-MRI (odds ratio, 5.756; P = 0.042) and washout in the Kupffer phase on PFB-CEUS (odds ratio, 5.828; P = 0.048) were independently associated with HCC. Conclusion: Among HBP hypointense nodules without APHE, PFB-CEUS was specific for detecting HCC, which had a low prevalence. Mild-moderate T2 hyperintensity on GA-MRI and washout in the Kupffer phase on PFB-CEUS may be useful to detect HCC in those nodules. [ABSTRACT FROM AUTHOR]
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- 2023
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7. A Grade Ⅲ Severe Hypersensitivity Caused by Gadopentatic Acid Injection: A Case Report.
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Chen, Qinlan and Qian, Qian
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Gadopentetic acid is a common contrast agent for enhanced magnetic resonance imaging. Adverse reactions due to gadolinium-based contrast agents are rare and easily overlooked by medical staff. A patient developed a rash as the first symptom and quickly developed a severe allergic reaction after receiving gadopentetic acid. A 74-year-old female patient was admitted on January 11, 2022, for femur magnetic resonance imaging. At 12:05 pm , a routine intravenous rapid injection of gadopentetic acid (15 ml) was given. Two minutes after administration, the patient developed skin itching. No obvious rash was found, but a 10 mg intravenous injection of dexamethasone was given. After 1 minute, skin pruritus had not improved significantly, saliva secretion had increased significantly, and a general discomfort appeared. At 12:10 pm , outside the scanning room, the patient suddenly became unconscious; 1 mg of EPINEPHrine was injected intramuscularly, and oxygen was given through a mask. Heart rate, blood pressure, and oxygen saturation steadily dropped. The patient was transferred to the intensive care unit. After EPINEPHrine, norepinephrine, terlipressin, and dexamethasone treatments, the vital signs eventually stabilized. The patient was judged to have had a grade III severe allergic reaction according to the first aid guidelines for severe allergic reactions in China. The patient was discharged from the hospital on the morning of January 14. This case stresses the importance of being equipped with the medicines, items, supplies, and equipment needed for emergency treatments in all departments where contrast agents are used. Patients with apparently mild adverse reactions to contrast agents should not be overlooked. [ABSTRACT FROM AUTHOR]
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- 2023
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8. VALUE OF GD-EOB-DTPA-ENHANCED MRI T1 MAPPING IN EVALUATING THE PATHOLOGICAL GRADE OF HEPATOCELLULAR CARCINOMA
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LYU Qingqing, XU Bing, CHEN Jingjing
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carcinoma, hepatocellular ,magnetic resonance imaging ,gadolinium dtpa ,t1 mapping ,neoplasm gra-ding ,diagnosis ,Medicine - Abstract
Objective To investigate the value of T1 value before and after Gd-EOB-DTPA-enhanced MRI in evaluating the pathological grade of hepatocellular carcinoma (HCC). Methods A retrospective analysis was performed for the plain scan and Gd-EOB-DTPA-enhanced MRI images of 75 HCC patients (75 lesions in total) who were admitted to The Affiliated Hospital of Qingdao University from March 2019 to June 2020. According to Edmondson-Steiner grading, lesions were divided into low-grade group (grade Ⅰ-Ⅱ) and high-grade group (grade Ⅲ-Ⅳ). The T1 mapping technique was used to measure pre-enhanced T1 value (T1pre) and hepatobiliary-specific T1 value (T1-HBP), and the reduction in T1 value (△T1) and the reduction rate of T1 value (△T1%) were calculated. T1pre, T1-HBP, △T1, and △T1% were compared between the lesions with different pathological grades, and the correlation between each quantitative index and pathological grade was analyzed. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to analyze the efficiency of each statistically significant index. Results There were significant differences in T1pre, T1-HBP, and △T1% between the low-grade group and the high-grade group (t=-3.725-2.551,P0.05). Correlation analysis showed that T1pre and T1-HBP were positively correlated with the pathological grade of HCC (r=0.293,0.472,P
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- 2023
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9. Transcatheter Intraarterial Perfusion MRI Approaches to Differentiate Reversibly Electroporated Penumbra From Irreversibly Electroporated Zones in Rabbit Liver
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Pan, Liang, Sun, Chong, Zhou, Kang, Figini, Matteo, Wang, Bin, Shangguan, Junjie, Hu, Su, Yang, Jia, Xing, Wei, Wang, Jian, Velichko, Yury, Yaghmai, Vahid, and Zhang, Zhuoli
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Biomedical and Clinical Sciences ,Clinical Sciences ,Rare Diseases ,Biomedical Imaging ,Animals ,Gadolinium DTPA ,Hepatic Artery ,Liver Neoplasms ,Magnetic Resonance Angiography ,Rabbits ,Irreversible electroporation ,Liver ,Rabbit ,Reversible electroporation ,Transcatheter intraarterial perfusion MRI ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
Rationale and objectivesTo investigate whether transcatheter intraarterial perfusion (TRIP) magnetic resonance imaging (MRI) can differentiate reversible electroporation (RE) zones from irreversible electroporation (IRE) zones immediately after IRE procedure in the rabbit liver.Materials and methodsAll studies were approved by the institutional animal care and use committee and performed in accordance with institutional guidelines. A total of 13 healthy New Zealand White rabbits were used. After selective catheterization of the hepatic artery under X-ray fluoroscopy, we acquired TRIP-MRI at 20 minutes post-IRE using 3 mL of 5% intraarterial gadopentetate dimeglumine. Semi-quantitative (peak enhancement, PE; time to peak, TTP; wash-in slope, WIS; areas under the time-intensity curve, AUT, over 30, 60, 90, 120, 150, and 180 seconds after the initiation of enhancement) and quantitative (Ktrans, ve, and vp) TRIP-MRI parameters were calculated. The relationships between TRIP-MRI parameters and histological measurements and the differential ability of TRIP-MRI parameters was assessed.ResultsPE, AUT60, AUT90, AUT120, AUT150, AUT180, Ktrans, and ve were significantly higher in RE zones than in IRE zones (all P < 0.05), and AUC for these parameters ranged from 0.91(95% CI, 0.80, 1.00) to 0.99 (95% CI, 0.98, 1.00). There was no significant difference in AUC between any two parameters (Z, 0-1.47; P, 0.14-1.00). Hepatocyte apoptosis strongly correlated with PE, AUT60, AUT90, AUT120, AUT150, AUT180, Ktrans, and vp (the absolute value r, 0.6-0.7, all P < 0.0001).ConclusionAUT150 or AUT180 could be a potential imaging biomarker to differentiate RE from IRE zones, and TRIP-MRI permits to differentiate RE from IRE zones immediately after IRE procedure in the rabbit liver.
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- 2020
10. Hepatobiliary-Specific MRI Contrast Agent Detection of Subvesical Duct (Luschka's) Injury Post-Laparoscopic Cholecystectomy: A Case Report
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Ahmet Bozer
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bile duct injury ,gadolinium dtpa ,contrast agent ,luschka’s duct ,mri ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Post-laparoscopic cholecystectomy bile duct injuries, especially involving Luschka’s duct, are concerning. Biliary tree anomalies and the efficacy of intravenous administration of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in detecting bile leakage are reported based on a case. Teaching Point: Hepatobiliary-specific MRI-contrast agents prove valuable for noninvasive assessment of bile leakage after cholecystectomy.
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- 2024
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11. Performance of free-breathing dynamic T1-weighted sequences in patients at risk of developing motion artifacts undergoing gadoxetic acid–enhanced liver MRI.
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Park, So Hyun, Yoon, Jeong Hee, Park, Jin Young, Shim, Young Sup, Lee, Sang Min, Choi, Seung Joon, Nickel, Marcel Dominik, and Lee, Jeong Min
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CONTRAST-enhanced magnetic resonance imaging , *MAGNETIC resonance imaging , *LIVER , *HEPATOCELLULAR carcinoma - Abstract
Objectives: To evaluate the recall rate and performance of free-breathing T1W dynamic imaging in patients who underwent gadoxetic acid–enhanced liver MRI. Methods: We retrospectively reviewed patients who underwent free-breathing dynamic T1WI liver MRI using Cartesian (XD-VIBE) or self-gated radial (SG-GRASP) sequences at two institutions. Four radiologists independently reviewed the overall image quality, streak, and motion artifacts for precontrast, arterial, and portal venous phases on a 4-point scale. Hepatic observations were annotated and assessed according to LI-RADS v2018. Results: In total, 360 patients were included (XD-VIBE [n = 253], SG-GRASP [n = 107]). The overall image quality of free-breathing T1WI was 3.4 ± 0.4, 3.2 ± 0.4, and 3.5 ± 0.4 for precontrast, arterial, and portal venous phases, respectively. The actual recall rate was 0.6% (2/360). The SG-GRASP group showed fewer motion artifacts and more streak artifacts than the XD-VIBE group in all phases (p < 0.001 for all). The overall image quality was not significantly different between the two sequences in arterial (3.2 ± 0.4 in both, p = 0.607) and portal venous phases (3.5 ± 0.4 in XD-VIBE, 3.4 ± 0.4 in SG-GRASP, p = 0.214). Two sequences did not show significant differences in the lesion detection rate (figure of merit, FOM: 0.67 vs. 0.68, p = 0.876) or diagnostic performance for hepatocellular carcinoma (FOM: 0.55 vs. 0.62, p = 0.105). Conclusions: Both XD-VIBE and SG-GRASP provided sufficient image quality for patients at risk of developing motion artifacts, without significant differences in image quality or the lesion detection rate between sequences. Key Points: • The overall image quality of free-breathing T1-weighted images using Cartesian or radial sequences was 3.4 ± 0.4, 3.2 ± 0.4, and 3.5 ± 0.4 for precontrast, arterial, and portal venous phases, respectively. • Only 0.3% (1/360) had undiagnostic exams and the actual recall rate was 0.6% (2/360) in patients who underwent free-breathing dynamic T1WI. • The overall lesion detection rate was 0.67 without a significant difference between Cartesian and radial sequences (figure of merit: 0.67 vs. 0.68, respectively, p = 0.876). [ABSTRACT FROM AUTHOR]
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- 2023
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12. Magnetnorezonantna urografija (MRU) i funkcionalna magnetnorezonantna urografija (fMRU) u dječjoj dobi.
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Roić, Goran, Murn, Filip, Palčić, Iva, Grmoja, Tonći, Bobinec, Dubravko, Batoš, Ana Tripalo, and Roić, Andrea Cvitković
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KIDNEYS ,DIAGNOSTIC imaging ,URINARY organs ,CHILD patients ,MAGNETIC resonance ,KIDNEY physiology - Abstract
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- 2023
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13. Sequential Targeting in Crosslinking Nanotheranostics for Tackling the Multibarriers of Brain Tumors
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Wu, Hao, Lu, Hongwei, Xiao, Wenwu, Yang, Jinfan, Du, Hongxu, Shen, Yingbin, Qu, Haijing, Jia, Bei, Manna, Suman K, Ramachandran, Mythili, Xue, Xiangdong, Ma, Zhao, Xu, Xiaobao, Wang, Zhongling, He, Yixuan, Lam, Kit S, Zawadzki, Robert J, Li, Yuanpei, and Lin, Tzu‐Yin
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Engineering ,Chemical Sciences ,Physical Sciences ,Cancer ,Brain Disorders ,Bioengineering ,Nanotechnology ,Neurosciences ,Brain Cancer ,Orphan Drug ,Rare Diseases ,5.1 Pharmaceuticals ,Development of treatments and therapeutic interventions ,Animals ,Antineoplastic Agents ,Blood-Brain Barrier ,Boronic Acids ,Brain ,Brain Neoplasms ,Carbocyanines ,Cell Line ,Tumor ,Disaccharides ,Drug Carriers ,Gadolinium DTPA ,Glioma ,Humans ,Hydrogen-Ion Concentration ,Kaplan-Meier Estimate ,Mice ,Mice ,Inbred BALB C ,Nanoparticles ,Transcytosis ,Xenograft Model Antitumor Assays ,blood-brain barrier ,diffuse intrinsic pontine glioma ,pH response ,sequential targeting ,Nanoscience & Nanotechnology ,Chemical sciences ,Physical sciences - Abstract
The efficacy of therapeutics for brain tumors is seriously hampered by multiple barriers to drug delivery, including severe destabilizing effects in the blood circulation, the blood-brain barrier/blood-brain tumor barrier (BBB/BBTB), and limited tumor uptake. Here, a sequential targeting in crosslinking (STICK) nanodelivery strategy is presented to circumvent these important physiological barriers to improve drug delivery to brain tumors. STICK nanoparticles (STICK-NPs) can sequentially target BBB/BBTB and brain tumor cells with surface maltobionic acid (MA) and 4-carboxyphenylboronic acid (CBA), respectively, and simultaneously enhance nanoparticle stability with pH-responsive crosslinkages formed by MA and CBA in situ. STICK-NPs exhibit prolonged circulation time (17-fold higher area under curve) than the free agent, allowing increased opportunities to transpass the BBB/BBTB via glucose-transporter-mediated transcytosis by MA. The tumor acidic environment then triggers the transformation of the STICK-NPs into smaller nanoparticles and reveals a secondary CBA targeting moiety for deep tumor penetration and enhanced uptake in tumor cells. STICK-NPs significantly inhibit tumor growth and prolong the survival time with limited toxicity in mice with aggressive and chemoresistant diffuse intrinsic pontine glioma. This formulation tackles multiple physiological barriers on-demand with a simple and smart STICK design. Therefore, these features allow STICK-NPs to unleash the potential of brain tumor therapeutics to improve their treatment efficacy.
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- 2020
14. Convolutional neural network-automated hepatobiliary phase adequacy evaluation may optimize examination time
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Cunha, Guilherme Moura, Hasenstab, Kyle A, Higaki, Atsushi, Wang, Kang, Delgado, Timo, Brunsing, Ryan L, Schlein, Alexandra, Schwartzman, Armin, Hsiao, Albert, Sirlin, Claude B, and Fowler, Katie J
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Biomedical and Clinical Sciences ,Clinical Sciences ,Biomedical Imaging ,Adult ,Aged ,Algorithms ,Area Under Curve ,Contrast Media ,Efficiency ,Female ,Gadolinium DTPA ,Humans ,Image Interpretation ,Computer-Assisted ,Liver ,Liver Neoplasms ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Neural Networks ,Computer ,ROC Curve ,Retrospective Studies ,Time ,Workflow ,Magnetic resonance imaging ,Gd-EOB-DTPA ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
PurposeTo develop and evaluate the performance of a fully-automated convolutional neural network (CNN)-based algorithm to evaluate hepatobiliary phase (HBP) adequacy of gadoxetate disodium (EOB)-enhanced MRI. Secondarily, we explored the potential of the proposed CNN algorithm to reduce examination length by applying it to EOB-MRI examinations.MethodsWe retrospectively identified EOB-enhanced MRI-HBP series from examinations performed 2011-2018 (internal and external datasets). Our algorithm, comprising a liver segmentation and classification CNN, produces an adequacy score. Two abdominal radiologists independently classified series as adequate or suboptimal. The consensus determination of HBP adequacy was used as ground truth for CNN model training and validation. Reader agreement was evaluated with Cohen's kappa. Performance of the algorithm was assessed by receiver operating characteristics (ROC) analysis and computation of the area under the ROC curve (AUC). Potential examination duration reduction was evaluated descriptively.Results1408 HBP series from 484 patients were included. Reader kappa agreement was 0.67 (internal dataset) and 0.80 (external dataset). AUCs were 0.97 (0.96-0.99) for internal and 0.95 (0.92-96) for external and were not significantly different from each other (p = 0.24). 48 % (50/105) examinations could have been shorter by applying the algorithm.ConclusionA proposed CNN-based algorithm achieves higher than 95 % AUC for classifying HBP images as adequate versus suboptimal. The application of this algorithm could potentially shorten examination time and aid radiologists in recognizing technically suboptimal images, avoiding diagnostic pitfalls.
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- 2020
15. Inter- and intra-reader agreement for gadoxetic acid–enhanced MRI parameter readings in patients with chronic liver diseases
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Beer, Lucian, Mandorfer, Mattias, Bastati, Nina, Poetter-Lang, Sarah, Tamandl, Dietmar, Stoyanova, Dilyana Plamenova, Elmer, Michael Christoph, Semmler, Georg, Simbrunner, Benedikt, Hodge, Jacqueline C, Sirlin, Claude B, Reiberger, Thomas, and Ba-Ssalamah, Ahmed
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Digestive Diseases ,Hepatitis ,Chronic Liver Disease and Cirrhosis ,Biomedical Imaging ,Liver Disease ,Prevention ,Oral and gastrointestinal ,Good Health and Well Being ,Adolescent ,Adult ,Aged ,Aged ,80 and over ,Chronic Disease ,Contrast Media ,Female ,Gadolinium DTPA ,Humans ,Liver Diseases ,Magnetic Resonance Imaging ,Male ,Middle Aged ,ROC Curve ,Reproducibility of Results ,Retrospective Studies ,Young Adult ,Liver ,Magnetic resonance imaging ,Liver diseases ,Gadoxetic acid ,Liver function tests ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
ObjectivesTo examine inter- and intra-observer agreement for four simple hepatobiliary phase (HBP)-based scores on gadoxetic acid (GA)-enhanced MRI and their correlation with liver function in patients with mixed chronic liver disease (CLD).MethodsThis single-center, retrospective study included 287 patients (62% male, 38% female, mean age 53.5 ± 13.7 years) with mixed CLD (20.9% hepatitis C, 19.2% alcoholic liver disease, 8% hepatitis B) who underwent GA-enhanced MRI of the liver for clinical care between 2010 and 2015. Relative liver enhancement (RLE), contrast uptake index (CUI), hepatic uptake index (HUI), and liver-to-spleen contrast index (LSI) were calculated by two radiologists independently using unenhanced and GA-enhanced HPB (obtained 20 min after GA administration) images; 50 patients selected at random were reviewed twice by one reader to assess intra-observer reliability. Agreement was assessed by intraclass correlation coefficient (ICC). The albumin-bilirubin (ALBI) score, the model of end-stage liver disease (MELD), and the Child-Turcotte-Pugh (CTP) score were calculated as standards of reference for hepatic function.ResultsIntra-observer ICCs ranged from 0.814 (0.668-0.896) for CUI to 0.969 (0.945-0.983) for RLE. Inter-observer ICCs ranged from 0.777 (0.605-0.874) for HUI to 0.979 (0.963-0.988) for RLE. All HBP-based scores correlated significantly (all p
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- 2019
16. Gadoxetate-enhanced Abbreviated MRI for Hepatocellular Carcinoma Surveillance: Preliminary Experience
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Brunsing, Ryan L, Chen, Dennis H, Schlein, Alexandra, Wolfson, Tanya, Gamst, Anthony, Mamidipalli, Adrija, Vietti Violi, Naik, Marks, Robert M, Taouli, Bachir, Loomba, Rohit, Kono, Yuko, and Sirlin, Claude B
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Liver Cancer ,Cancer ,Liver Disease ,Biomedical Imaging ,Digestive Diseases ,Rare Diseases ,Clinical Research ,Hepatitis ,Chronic Liver Disease and Cirrhosis ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Good Health and Well Being ,Adult ,Carcinoma ,Hepatocellular ,Contrast Media ,Female ,Gadolinium DTPA ,Hepatitis B ,Chronic ,Humans ,Image Enhancement ,Liver Cirrhosis ,Liver Neoplasms ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Preliminary Data ,Reference Standards ,Retrospective Studies ,Sensitivity and Specificity - Abstract
PurposeTo describe a single-center preliminary experience with gadoxetate disodium-enhanced abbreviated MRI for hepatocellular carcinoma (HCC) screening and surveillance in patients with cirrhosis or chronic hepatitis B virus (cHBV).Materials and methodsThis was a retrospective study of consecutive patients aged 18 years and older with cirrhosis or cHBV who underwent at least one gadoxetate-enhanced abbreviated MRI examination for HCC surveillance from 2014 through 2016. Examinations were interpreted prospectively by one of six abdominal radiologists for clinical care. Clinical, imaging, and other data were extracted from electronic medical records. Diagnostic adequacy was assessed in all patients. Diagnostic accuracy was assessed in the subset of patients who could be classified as having HCC or not having HCC on the basis of a composite reference standard.ResultsIn this study, 330 patients (93% with cirrhosis; 45% women; mean age, 59 years) underwent gadoxetate-enhanced abbreviated MRI. In the 330 patients, 311 (94.2%) baseline gadoxetate-enhanced abbreviated MRI examinations were diagnostically adequate. Of 141 (43%) of the 330 patients, 91.4% (129 of 141) could be classified as not having HCC and 8.6% (12 of 141) could be classified as having HCC. Baseline gadoxetate-enhanced abbreviated MRI had 0.92 sensitivity (95% confidence interval [CI]: 0.62, 1.00) and 0.91 specificity (95% CI: 0.84, 0.95) for detection of HCC. Of the 330 patients who underwent baseline gadoxetate-enhanced abbreviated MRI, 187 (57%) were lost to follow-up.ConclusionGadoxetate-enhanced abbreviated MRI is feasible clinically, has a high diagnostic adequacy rate, and, on the basis of our preliminary experience, accurately depicts HCC in high-risk patients. Strategies to enhance follow-up compliance are needed.© RSNA, 2019Keywords: Abdomen/GI, Cirrhosis, Liver, MR-Imaging, Oncology, ScreeningSupplemental material is available for this article.
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- 2019
17. Myocardial native-T1 times are elevated as a function of hypertrophy, HbA1c, and heart rate in diabetic adults without diffuse fibrosis
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Lam, Bonnie, Stromp, Tori A, Hui, Zhengxiong, and Vandsburger, Moriel
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Diabetes ,Heart Disease ,Cardiovascular ,Autoimmune Disease ,Clinical Research ,Adult ,Contrast Media ,Diabetes Mellitus ,Female ,Gadolinium DTPA ,Glycated Hemoglobin ,Heart ,Heart Rate ,Heart Ventricles ,Humans ,Hypertrophy ,Left Ventricular ,Image Enhancement ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Predictive Value of Tests ,T1 relaxation time ,Hypertrophy ,HbA1c ,Biomedical Engineering ,Clinical Sciences ,Cognitive Sciences ,Nuclear Medicine & Medical Imaging - Abstract
PurposeCardiac native-T1 times have correlated to extracellular volume fraction in patients with confirmed fibrosis. However, whether other factors that can occur either alongside or independently of fibrosis including increased intracellular water volume, altered magnetization transfer (MT), or glycation of hemoglobin, lengthen T1 times in the absence of fibrosis remains unclear. The current study examined whether native-T1 times are elevated in hypertrophic diabetics with elevated hemoglobin A1C (HbA1c) without diffuse fibrosis.MethodsNative-T1 times were quantified in 27 diabetic and 10 healthy adults using a modified Look-Locker imaging (MOLLI) sequence at 1.5 T. The MT ratio (MTR) was quantified using dual flip angle cine balanced steady-state free precession. Gadolinium (0.2 mmol/kg Gd-DTPA) was administered as a bolus and post-contrast T1-times were quantified after 15 min. Means were compared using a two-tailed student's t-test, while correlations were assessed using Pearson's correlations.ResultsWhile left ventricular volumes, ejection fraction, and cardiac output were similar between groups, left ventricular mass and mass-to-volume ratio (MVR) were significantly higher in diabetic adults. Mean ECV (0.25 ± 0.02 Healthy vs. 0.25 ± 0.03 Diabetic, P = 0.47) and MTR (125 ± 16% Healthy vs. 125 ± 9% Diabetic, P = 0.97) were similar, however native-T1 times were significantly higher in diabetics (1016 ± 21 ms Healthy vs. 1056 ± 31 ms Diabetic, P = 0.00051). Global native-T1 times correlated with MVR (ρ = 0.43, P = 0.008) and plasma HbA1c levels (ρ = 0.43, P = 0.0088) but not ECV (ρ = 0.06, P = 0.73). Septal native-T1 times correlated with septal wall thickness (ρ = 0.50, P = 0.001).ConclusionIn diabetic adults with normal ECV values, elevated native-T1 times may reflect increased intracellular water volume and changes secondary to increased hemoglobin glycation.
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- 2019
18. Is It Time to Expand the Definition of Washout Appearance in LI-RADS?
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Fowler, Kathryn J and Sirlin, Claude B
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Humans ,Carcinoma ,Hepatocellular ,Liver Neoplasms ,Gadolinium DTPA ,Magnetic Resonance Imaging ,Nuclear Medicine & Medical Imaging ,Medical and Health Sciences - Published
- 2019
19. Use of gadoxetate disodium in patients with chronic liver disease and its implications for liver imaging reporting and data system (LI‐RADS)
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Chernyak, Victoria, Fowler, Kathryn J, Heiken, Jay P, and Sirlin, Claude B
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Biomedical and Clinical Sciences ,Oncology and Carcinogenesis ,Digestive Diseases ,Biomedical Imaging ,Liver Disease ,Cancer ,Chronic Liver Disease and Cirrhosis ,Liver Cancer ,Rare Diseases ,4.1 Discovery and preclinical testing of markers and technologies ,Detection ,screening and diagnosis ,Oral and gastrointestinal ,Carcinoma ,Hepatocellular ,Contrast Media ,Gadolinium DTPA ,Humans ,Liver ,Liver Neoplasms ,Magnetic Resonance Imaging ,Radiology Information Systems ,Physical Sciences ,Engineering ,Medical and Health Sciences ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
Use of gadoxetate disodium, a hepatobiliary gadolinium-based agent, in patients with chronic parenchymal liver disease offers the advantage of improved sensitivity for detecting hepatocellular carcinoma (HCC). Imaging features of liver observations on gadoxetate-enhanced MRI may also serve as biomarkers of recurrence-free and overall survival following definitive treatment of HCC. A number of technical and interpretative pitfalls specific to gadoxetate exist, however, and needs to be recognized when protocoling and interpreting MRI exams with this agent. This article reviews the advantages and pitfalls of gadoxetate use in patients at risk for HCC, and the potential impact on Liver Imaging Reporting and Data System (LI-RADS) imaging feature assessment and categorization. Level of Evidence: 5 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;49:1236-1252.
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- 2019
20. Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell’s Palsy
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Volkan Yücel, Serra Özbal Güneş, Kemal Keseroğlu, Ömer Bayır, Mehmet Furkan Çırakoğlu, Emel Çadallı Tatar, Güleser Saylam, Sevilay Karahan, Orhan Yılmaz, and Mehmet Hakan Korkmaz
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bell’s palsy ,facial nerve ,magnetic resonance imaging ,gadolinium dtpa ,prognosis ,temporal bone ,radiology ,acoustic reflex ,Otorhinolaryngology ,RF1-547 - Abstract
Objective:To investigate the prognostic value of the magnetic resonance imaging in Bell’s palsy patients.Methods:Patients who were diagnosed and treated with Bell’s palsy between October 2013 and March 2016 retrospectively selected. House–Brackmann grades, pre- and post-treatment pure tone audiograms, stapedial reflexes were analyzed and magnetic resonance imaging (MRI) scans with gadolinium-based contrast agents were evaluated. Contrast-enhanced segments of the facial nerve were determined. MRI findings were compared statistically with pre- and post-treatment grade, recurrence rate of Bell’s palsy, MRI scanning timing, presence of stapes reflexes and posttreatment recovery data.Results:No significant correlation was observed between pretreatment House–Brackmann grades and enhancement (p>0.05). Similarly, there was no significant correlation between clinical recovery and enhancement (p>0.05). Also, no significant correlation was observed between MRI scanning time, the recurrence rate of Bell’s palsy and MRI findings (p>0.05). None of the MRIs showed neoplastic contrast enhancement.Conclusion:The routine use of the contrast-enhanced temporal MRI is not recommended in the diagnosis and monitoring of Bell’s palsy patients, because the contrast enhancement pattern of the facial nerve has no effect on the prognosis of Bell’s palsy. MRI should be used in cases that do not heal despite treatment, for the differential diagnosis of facial nerve tumors and in patients who are candidates for surgical decompression.
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- 2022
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21. Quantitative monitoring of paramagnetic contrast agents and their allocation in plant tissues via DCE-MRI
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Simon Mayer, Eberhard Munz, Sebastian Hammer, Steffen Wagner, Andre Guendel, Hardy Rolletschek, Peter M. Jakob, Ljudmilla Borisjuk, and Thomas Neuberger
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Hordeum vulgare ,Contrast agent (CA) ,Magnetic resonance imaging (MRI) ,DCE-MRI ,Gadolinium DTPA ,Vascular bundles ,Plant culture ,SB1-1110 ,Biology (General) ,QH301-705.5 - Abstract
Abstract Background Studying dynamic processes in living organisms with MRI is one of the most promising research areas. The use of paramagnetic compounds as contrast agents (CA), has proven key to such studies, but so far, the lack of appropriate techniques limits the application of CA-technologies in experimental plant biology. The presented proof-of-principle aims to support method and knowledge transfer from medical research to plant science. Results In this study, we designed and tested a new approach for plant Dynamic Contrast Enhanced Magnetic Resonance Imaging (pDCE-MRI). The new approach has been applied in situ to a cereal crop (Hordeum vulgare). The pDCE-MRI allows non-invasive investigation of CA allocation within plant tissues. In our experiments, gadolinium-DTPA, the most commonly used contrast agent in medical MRI, was employed. By acquiring dynamic T1-maps, a new approach visualizes an alteration of a tissue-specific MRI parameter T1 (longitudinal relaxation time) in response to the CA. Both, the measurement of local CA concentration and the monitoring of translocation in low velocity ranges (cm/h) was possible using this CA-enhanced method. Conclusions A novel pDCE-MRI method is presented for non-invasive investigation of paramagnetic CA allocation in living plants. The temporal resolution of the T1-mapping has been significantly improved to enable the dynamic in vivo analysis of transport processes at low-velocity ranges, which are common in plants. The newly developed procedure allows to identify vascular regions and to estimate their involvement in CA allocation. Therefore, the presented technique opens a perspective for further development of CA-aided MRI experiments in plant biology.
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- 2022
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22. Gadolinium deposition within the paediatric brain: no increased intrinsic T1-weighted signal intensity within the dentate nucleus following the administration of a minimum of four doses of the macrocyclic agent gadobutrol
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Young, Jonathan R, Qiao, Joe, Orosz, Iren, Salamon, Noriko, Franke, Mark A, Kim, Hyun J, and Pope, Whitney B
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Biomedical and Clinical Sciences ,Clinical Sciences ,Pediatric ,Neurosciences ,Clinical Research ,Biomedical Imaging ,Adolescent ,Cerebellar Nuclei ,Child ,Child ,Preschool ,Contrast Media ,Female ,Gadolinium DTPA ,Humans ,Infant ,Magnetic Resonance Imaging ,Male ,Organometallic Compounds ,Regression Analysis ,Retrospective Studies ,Gadolinium ,Contrast media ,Magnetic resonance imaging ,Cerebellar nuclei ,Paediatrics ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
ObjectivesTo determine whether repeated administration of the macrocyclic gadolinium-based contrast agent (GBCA) gadobutrol in children is associated with T1-weighted hyperintensity within the dentate nucleus, an imaging surrogate for gadolinium deposition.MethodsWith institutional review board approval, we identified a cohort of eight patients aged 18 years or younger who underwent at least four gadobutrol-enhanced magnetic resonance imaging (MRI) examinations of the brain from 2013 to 2017. For comparison, we identified a cohort of 19 patients who underwent at least four gadopentetate dimeglumine-enhanced MRI examinations. For each examination, both dentate nuclei were contoured on unenhanced images; the mean dentate-to-pons signal intensity (DN-P SI) ratio was calculated. DN-P SI ratios from the first and last MRI exams were compared using Wilcoxon signed ranks tests and linear regression analyses.ResultsIn the gadobutrol cohort, there was no significant change in the mean DN-P SI ratio from the first to the last scan (1.02 vs 1.02, p = 1.00). In the gadopentetate dimeglumine cohort, there was a significant increase in the mean DN-P SI ratio from the first to the last scan (1.05 vs 1.13, p = 0.003). After controlling for potentially confounding variables, the change in DN-P SI ratio from the first to the last scan was significantly lower for patients in the gadobutrol group than in the gadopentetate dimeglumine group (β = -0.08, p = 0.04).ConclusionsRepeated administration of the macrocyclic GBCA gadobutrol in children was not associated with T1-weighted dentate hyperintensity, while the repeated administration of the linear GBCA gadopentetate dimeglumine was associated with T1-weighted dentate hyperintensity, presumably due to gadolinium deposition.Key points• Gadolinium-based contrast agents are routinely used in magnetic resonance imaging. • Repeated administration of the macrocyclic agent gadobutrol in children was not associated with T1-weighted dentate hyperintensity.
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- 2018
23. Recommendation for terminology: Nodules without arterial phase hyperenhancement and with hepatobiliary phase hypointensity in chronic liver disease.
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Motosugi, Utaroh, Murakami, Takamichi, Lee, Jeong Min, Fowler, Kathryn J, Heiken, Jay P, Sirlin, Claude B, and LI-RADS HBA Working Group
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LI-RADS HBA Working Group ,Liver ,Humans ,Carcinoma ,Hepatocellular ,Liver Neoplasms ,Liver Cirrhosis ,Gadolinium DTPA ,Contrast Media ,Magnetic Resonance Imaging ,Image Enhancement ,Terminology as Topic ,hepatobiliary contrast agent ,hepatocellular carcinoma ,liver ,magnetic resonance imaging ,Oral and gastrointestinal ,Good Health and Well Being ,Physical Sciences ,Engineering ,Medical and Health Sciences ,Nuclear Medicine & Medical Imaging - Abstract
Level of evidence5 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2018;47:1169-1171.
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- 2018
24. Early animal model evaluation of an implantable contrast agent to enhance magnetic resonance imaging of arterial bypass vein grafts
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Mitsouras, Dimitrios, Tao, Ming, de Vries, Margreet R, Trocha, Kaspar, Miranda, Oscar R, Vemula, Praveen Kumar, Ding, Kui, Imanzadeh, Amir, Schoen, Frederick J, Karp, Jeffrey M, Ozaki, C Keith, and Rybicki, Frank J
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Biomedical and Clinical Sciences ,Clinical Sciences ,Biomedical Imaging ,Bioengineering ,Prevention ,Cardiovascular ,Animals ,Blood Vessel Prosthesis Implantation ,Carotid Arteries ,Contrast Media ,Disease Models ,Animal ,Gadolinium DTPA ,Magnetic Resonance Imaging ,Male ,Mice ,Mice ,Inbred C57BL ,Signal-To-Noise Ratio ,Vena Cava ,Inferior ,Magnetic resonance imaging ,gadolinium ,image enhancement ,contrast media ,signal-to-noise ratio ,vascular grafting ,peripheral vascular diseases ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
Background Non-invasive monitoring of autologous vein graft (VG) bypass grafts is largely limited to detecting late luminal narrowing. Although magnetic resonance imaging (MRI) delineates vein graft intima, media, and adventitia, which may detect early failure, the scan time required to achieve sufficient resolution is at present impractical. Purpose To study VG visualization enhancement in vivo and delineate whether a covalently attached MRI contrast agent would enable quicker longitudinal imaging of the VG wall. Material and Methods Sixteen 12-week-old male C57BL/6J mice underwent carotid interposition vein grafting. The inferior vena cava of nine donor mice was treated with a gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA)-based contrast agent, with control VGs labeled with a vehicle. T1-weighted (T1W) MRI was performed serially at postoperative weeks 1, 4, 12, and 20. A portion of animals was sacrificed for histopathology following each imaging time point. Results MRI signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were significantly higher for treated VGs in the first three time points (1.73 × higher SNR, P = 0.0006, and 5.83 × higher CNR at the first time point, P = 0.0006). However, MRI signal enhancement decreased consistently in the study period, to 1.29 × higher SNR and 2.64 × higher CNR, by the final time point. There were no apparent differences in graft morphometric analyses in Masson's trichrome-stained sections. Conclusion A MRI contrast agent that binds covalently to the VG wall provides significant increase in T1W MRI signal with no observed adverse effects in a mouse model. Further optimization of the contrast agent to enhance its durability is required.
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- 2018
25. Technical report: gadoxetate-disodium-enhanced 2D R2* mapping: a novel approach for assessing bile ducts in living donors
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Fazeli Dehkordy, Soudabeh, Fowler, Kathryn J, Wolfson, Tanya, Igarashi, Saya, Lamas Constantino, Carolina P, Hooker, Jonathan C, Hong, Cheng W, Mamidipalli, Adrija, Gamst, Anthony C, Hemming, Alan, and Sirlin, Claude B
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Biomedical and Clinical Sciences ,Clinical Sciences ,Liver Disease ,Clinical Research ,Digestive Diseases ,Adult ,Bile Ducts ,Cholangiography ,Contrast Media ,Feasibility Studies ,Female ,Gadolinium DTPA ,Humans ,Image Enhancement ,Imaging ,Three-Dimensional ,Living Donors ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Retrospective Studies ,T1w MR Cholangiogram ,Biliary anatomy ,R2*map ,Living donor imaging ,R2* map ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
PURPOSE:Gadoxetate-disodium (Gd-EOB-DTPA)-enhanced 3D T1- weighted (T1w) MR cholangiography (MRC) is an efficient method to evaluate biliary anatomy due to T1 shortening of excreted contrast in the bile. A method that exploits both T1 shortening and T2* effects may produce even greater bile duct conspicuity. The aim of our study is to determine feasibility and compare the diagnostic performance of two-dimensional (2D) T1w multi-echo (ME) spoiled gradient-recalled-echo (SPGR) derived R2* maps against T1w MRC for bile duct visualization in living liver donor candidates. MATERIALS AND METHODS:Ten potential living liver donor candidates underwent pretransplant 3T MRI and were included in our study. Following injection of Gd-EOBDTPA and a 20-min delay, 3D T1w MRC and 2D T1w ME SPGR images were acquired. 2D R2* maps were generated inline by the scanner assuming exponential decay. The 3D T1w MRC and 2D R2* maps were retrospectively and independently reviewed in two separate sessions by three radiologists. Visualization of eight bile duct segments was scored using a 4-point ordinal scale. The scores were compared using mixed effects regression model. RESULTS:Imaging was tolerated by all donors and R2* maps were successfully generated in all cases. Visualization scores of 2D R2* maps were significantly higher than 3D T1w MRC for right anterior (p = 0.003) and posterior (p = 0.0001), segment 2 (p
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- 2018
26. Quantification of liver function by linearization of a two‐compartment model of gadoxetic acid uptake using dynamic contrast‐enhanced magnetic resonance imaging
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Simeth, Josiah, Johansson, Adam, Owen, Dawn, Cuneo, Kyle, Mierzwa, Michelle, Feng, Mary, Lawrence, Theodore S, and Cao, Yue
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Biomedical and Clinical Sciences ,Clinical Sciences ,Biomedical Imaging ,Pediatric Research Initiative ,Liver Disease ,Digestive Diseases ,Bioengineering ,Detection ,screening and diagnosis ,4.1 Discovery and preclinical testing of markers and technologies ,Aged ,Arteries ,Computer Simulation ,Contrast Media ,Female ,Gadolinium DTPA ,Humans ,Indocyanine Green ,Liver ,Magnetic Resonance Imaging ,Male ,Middle Aged ,DCE-MRI ,Gd chelate based contrast agents ,hepatobiliary contrast ,imaging informed treatment planning ,liver function ,quantitative imaging ,Medicinal and Biomolecular Chemistry ,Biomedical Engineering ,Nuclear Medicine & Medical Imaging ,Clinical sciences ,Biomedical engineering - Abstract
Dynamic gadoxetic acid-enhanced magnetic resonance imaging (MRI) allows the investigation of liver function through the observation of the perfusion and uptake of contrast agent in the parenchyma. Voxel-by-voxel quantification of the contrast uptake rate (k1 ) from dynamic gadoxetic acid-enhanced MRI through the standard dual-input, two-compartment model could be susceptible to overfitting of variance in the data. The aim of this study was to develop a linearized, but more robust, model. To evaluate the estimated k1 values using this linearized analysis, high-temporal-resolution gadoxetic acid-enhanced MRI scans were obtained in 13 examinations, and k1 maps were created using both models. Comparison of liver k1 values estimated from the two methods produced a median correlation coefficient of 0.91 across the 12 scans that could be used. Temporally sparse clinical MRI data with gadoxetic acid uptake were also employed to create k1 maps of 27 examinations using the linearized model. Of 20 scans, the created k1 maps were compared with overall liver function as measured by indocyanine green (ICG) retention, and yielded a correlation coefficient of 0.72. In the 27 k1 maps created via the linearized model, the mean liver k1 value was 3.93 ± 1.79 mL/100 mL/min, consistent with previous studies. The results indicate that the linearized model provides a simple and robust method for the assessment of the rate of contrast uptake that can be applied to both high-temporal-resolution dynamic contrast-enhanced MRI and typical clinical multiphase MRI data, and that correlates well with the results of both two-compartment analysis and independent whole liver function measurements.
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- 2018
27. Diagnostic per-lesion performance of a simulated gadoxetate disodium-enhanced abbreviated MRI protocol for hepatocellular carcinoma screening
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Tillman, BG, Gorman, JD, Hru, JM, Lee, MH, King, MC, Sirlin, CB, and Marks, RM
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Bioengineering ,Rare Diseases ,Biomedical Imaging ,Hepatitis ,Liver Cancer ,Digestive Diseases ,Cancer ,Liver Disease ,Clinical Research ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Good Health and Well Being ,Carcinoma ,Hepatocellular ,Contrast Media ,Cross-Sectional Studies ,Female ,Gadolinium DTPA ,Humans ,Liver Neoplasms ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Retrospective Studies ,Sensitivity and Specificity ,Clinical Sciences ,Nuclear Medicine & Medical Imaging - Abstract
AimTo evaluate the diagnostic per-lesion performance of a simulated gadoxetate disodium-enhanced abbreviated MRI (AMRI) in cirrhotic and chronic hepatitis B (CHB) patients for hepatocellular carcinoma (HCC) screening.Materials and methodsSeventy-nine consecutive patients at risk for HCC due to cirrhosis and/or CHB were included in this retrospective study. For each patient, the first gadoxetate disodium-enhanced MRI between 2008 through 2014 was analysed. Two independent readers read an anonymised abbreviated image set comprising axial T1-weighted (W) images with fat saturation in the hepatobiliary phase, 20 minutes or more after gadoxetate injection, and axial T2W single-shot fast spin echo images. Each observation >10 mm was scored as negative or suspicious for HCC. Inter-reader agreement was assessed. A composite reference standard was used to determine the per-lesion diagnostic performance for each reader.ResultsInter-reader agreement was substantial (κ = 0.75). The final reference standard showed 27 HCCs in 13 patients (median 21 mm, range 11-100 mm). The two readers each correctly scored 23 as suspicious for HCC (sensitivity = 85.2%), scored a total of 27 and 32 observations as suspicious for HCC (positive predictive value [PPV] = 85.2% and 71.9%), and scored 83 and 78 observations or complete examinations as negative for HCC (negative predictive value [NPV] = 95.2% and 94.9%).ConclusionsThe AMRI protocol provides higher per-lesion sensitivity and NPV than reported values for ultrasound, the current recommended technique for screening, and similar per-lesion sensitivity and PPV to reported values for complete dynamic contrast-enhanced MRI.
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- 2018
28. Submillimeter diffusion tensor imaging and late gadolinium enhancement cardiovascular magnetic resonance of chronic myocardial infarction
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Pashakhanloo, Farhad, Herzka, Daniel A, Mori, Susumu, Zviman, Muz, Halperin, Henry, Gai, Neville, Bluemke, David A, Trayanova, Natalia A, and McVeigh, Elliot R
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Biomedical Imaging ,Cardiovascular ,Heart Disease ,Heart Disease - Coronary Heart Disease ,Bioengineering ,Aged ,80 and over ,Animals ,Anisotropy ,Chronic Disease ,Contrast Media ,Diffusion Tensor Imaging ,Disease Models ,Animal ,Female ,Fibrosis ,Gadolinium DTPA ,Humans ,Image Interpretation ,Computer-Assisted ,Imaging ,Three-Dimensional ,Magnetic Resonance Imaging ,Myocardial Infarction ,Myocardium ,Predictive Value of Tests ,Sus scrofa ,Ventricular Remodeling ,Myocardial infarction ,Fiber structure ,Microstructural remodeling ,Diffusion tensor imaging ,Late gadolinium enhancement ,Cardiorespiratory Medicine and Haematology ,Nuclear Medicine & Medical Imaging ,Cardiovascular medicine and haematology - Abstract
BackgroundKnowledge of the three-dimensional (3D) infarct structure and fiber orientation remodeling is essential for complete understanding of infarct pathophysiology and post-infarction electromechanical functioning of the heart. Accurate imaging of infarct microstructure necessitates imaging techniques that produce high image spatial resolution and high signal-to-noise ratio (SNR). The aim of this study is to provide detailed reconstruction of 3D chronic infarcts in order to characterize the infarct microstructural remodeling in porcine and human hearts.MethodsWe employed a customized diffusion tensor imaging (DTI) technique in conjunction with late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) on a 3T clinical scanner to image, at submillimeter resolution, myofiber orientation and scar structure in eight chronically infarcted porcine hearts ex vivo. Systematic quantification of local microstructure was performed and the chronic infarct remodeling was characterized at different levels of wall thickness and scar transmurality. Further, a human heart with myocardial infarction was imaged using the same DTI sequence.ResultsThe SNR of non-diffusion-weighted images was >100 in the infarcted and control hearts. Mean diffusivity and fractional anisotropy (FA) demonstrated a 43% increase, and a 35% decrease respectively, inside the scar tissue. Despite this, the majority of the scar showed anisotropic structure with FA higher than an isotropic liquid. The analysis revealed that the primary eigenvector orientation at the infarcted wall on average followed the pattern of original fiber orientation (imbrication angle mean: 1.96 ± 11.03° vs. 0.84 ± 1.47°, p = 0.61, and inclination angle range: 111.0 ± 10.7° vs. 112.5 ± 6.8°, p = 0.61, infarcted/control wall), but at a higher transmural gradient of inclination angle that increased with scar transmurality (r = 0.36) and the inverse of wall thickness (r = 0.59). Further, the infarcted wall exhibited a significant increase in both the proportion of left-handed epicardial eigenvectors, and in the angle incoherency. The infarcted human heart demonstrated preservation of primary eigenvector orientation at the thinned region of infarct, consistent with the findings in the porcine hearts.ConclusionsThe application of high-resolution DTI and LGE-CMR revealed the detailed organization of anisotropic infarct structure at a chronic state. This information enhances our understanding of chronic post-infarction remodeling in large animal and human hearts.
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- 2017
29. Hypervascular transformation of hepatobiliary phase hypointense nodules without arterial phase hyperenhancement on gadoxetic acid–enhanced MRI: long-term follow-up in a surveillance cohort.
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Park, Hyo Jung, Lee, Tae Young, Kim, So Yeon, Kim, Min-Ju, Singal, Amit G., Lee, So Jung, Won, Hyung Jin, Byun, Jae Ho, and Lim, Young-Suk
- Abstract
Objectives: With the increasing use of gadoxetic acid–enhanced MRI for HCC surveillance, hepatobiliary phase (HBP) hypointense nodules without arterial phase hyperenhancement (APHE) are frequently encountered. We investigated the rate of these nodules with hypervascular transformation, which suggests hepatocarcinogenesis, by using a prospectively collected longitudinal surveillance cohort data. Methods: This study included 382 prospectively enrolled patients at high risk for developing HCC who underwent 1–3 rounds of bi-annual surveillance gadoxetic acid–enhanced MRI. MRI was analyzed to detect HBP hypointense nodules without APHE. Follow-up dynamic CTs and MRIs were evaluated to detect hypervascular transformation of the nodules. Cox proportional hazards regression analyses were used to find predictors for hypervascular transformation. Results: A total of 76 HBP hypointense nodules without APHE were found in 48 patients, giving a prevalence of 12.6% (48/382). The mean nodule size was 10.8 mm, with 43.4% (33/76) being ≥ 10 mm. Over a median follow-up of 78.6 months, 19 nodules (25.0%) showed hypervascular transformation, all of which demonstrated typical imaging features of HCC. On multivariable Cox-regression analysis, size (≥ 10 mm) was the only independent predictor of hypervascular transformation (hazard ratio, 3.31; 95% confidence interval, 1.21–9.05). The cumulative incidence of hypervascular transformation at 12 and 60 months of nodules ≥ 10 mm was 12.3% and 50.4%, respectively, while that of nodules < 10 mm was 2.5% and 13.9%, respectively. Conclusions: About half of the HBP hypointense nodules ≥ 10 mm without APHE transformed to HCC at 5 years of follow-up, indicating the necessity for cautious monitoring with an augmented and extended follow-up schedule for these nodules. Key Points: • The prevalence of HBP hypointense nodules without APHE was 12.6% in a prospectively recruited population at high risk of developing HCC. • Nodule size ≥ 10 mm was significantly associated with hypervascular transformation, and approximately half of the HBP hypointense nodules ≥ 10 mm without APHE transformed to HCC during 5 years of follow-up. • Given the risk of malignant transformation, HBP hypointense nodules ≥ 10 mm without APHE should be closely monitored. [ABSTRACT FROM AUTHOR]
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- 2022
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30. [Diagnostic value of Gd-EOB-DTPA-enhanced MRI radiomics models for dual-phenotype hepatocellular carcinoma].
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Sun HL, Yu YX, Gu WH, Shen BQ, Zhang T, Fan YF, Wu Q, Shi C, Wang XM, and Hu CH
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- Humans, Retrospective Studies, Phenotype, Contrast Media, Male, Radiomics, Liver Neoplasms diagnostic imaging, Carcinoma, Hepatocellular diagnostic imaging, Magnetic Resonance Imaging methods, Gadolinium DTPA
- Abstract
Objective: To develop and validate clinical and radiomics models based on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI of dual-phenotype hepatocellular carcinoma (DPHCC) for preoperative differential diagnosis. Methods: Two hundred and fifty inpatients of hepatocellular carcinoma (HCC) confirmed by postoperative pathology, who underwent Gd-EOB-DTPA-enhanced MRI were retrospectively included. A total of 172 inpatients (72 DPHCC and 100 non-DPHCC) were included in Institution 1 (the First Affiliated Hospital of Soochow University) as a training cohort (between January 2020 and July 2023) and 78 inpatients (44 DPHCC and 34 non-DPHCC) were included in Institution 2 (the Third People's Hospital of Nantong) as an external validation cohort(between January 2019 and July 2023). The regions of interest of the tumor were delineated layer by layer in noncontrast phase, arterial phase (AP), portal venous phase (PP) and hepatobiliary phase (HBP) images. The software of FAE was used to extract the radiomics features of the images. Pearson correlation analysis and recursive feature elimination were used for feature selection. Each phase and combined radiomics models were established using logistic regression, linear discriminant analysis and support vector machine. Receiver operating characteristic curve and the areas under the curve (AUC) were used to evaluate and select the dominant radiomics model. The dominant radiomics model was combined with clinically independent predictors to construct a clinical radiomics model. Delong test was used to compare the performance of the models. Results: The age of the training cohort was (59.6±10.4) years, in which there were 135 men (78.5%). In the external validation cohort, the age was (57.8±9.2) years, including 56 men (71.8%). The maximum diameters of the lesions [ M ( Q
1 , Q3 ), 4.7 (2.6, 7.5) vs 2.7 (1.8, 4.4) cm, P <0.001] and the proportion of the multiple lesions (39.5% vs 16.7%, P <0.001) in the training cohort were higher than those in the external validation cohort. In the training group, the proportion of patients with hepatitis B virus (HBV) infection in the DPHCC subgroup (66.7%,48/172) was higher than that in non-DPHCC subgroup (49.0%,49/78, P =0.021). In the external validation cohort, the AUC (95% CI ) of the PP [0.835 (0.733-0.937)] and combined radiomics models [0.786 (0.681-0.891)] were significantly higher than that of noncontrast phase [0.451 (0.319-0.584)], AP [0.566 (0.435-0.696)] and HBP models [0.496 (0.363-0.629)] (all P <0.05). There was no significant difference in AUC between PP radiomics model and combined radiomics model ( P =0.189). The AUC between the radiomics models and clinical-radiomics models, which were brought into clinically independent variable HBV, showed no significant difference (all P >0.05). Conclusion: Gd-EOB-DTPA-enhanced MRI radiomics model based on portal venous phase may be available for discriminating DPHCC from non-DPHCC before operation.- Published
- 2024
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31. Editorial for "Preoperative Gadoxetic Acid-Enhanced MRI Features for Evaluation of Vessels Encapsulating Tumor Clusters and Microvascular Invasion in Hepatocellular Carcinoma: Creating Nomograms for Risk Assessment".
- Author
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Mulé S
- Subjects
- Humans, Risk Assessment, Nomograms, Preoperative Care methods, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular pathology, Liver Neoplasms diagnostic imaging, Liver Neoplasms pathology, Contrast Media, Magnetic Resonance Imaging methods, Gadolinium DTPA, Neoplasm Invasiveness
- Published
- 2024
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32. Preoperative Gadoxetic Acid-Enhanced MRI Features for Evaluation of Vessels Encapsulating Tumor Clusters and Microvascular Invasion in Hepatocellular Carcinoma: Creating Nomograms for Risk Assessment.
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Qu Q, Liu Z, Lu M, Xu L, Zhang J, Liu M, Jiang J, Gu C, Ma Q, Huang A, Zhang X, and Zhang T
- Subjects
- Humans, Male, Female, Middle Aged, Retrospective Studies, Risk Assessment, Aged, Neoplasm Invasiveness, Prognosis, Microvessels diagnostic imaging, Microvessels pathology, Adult, Preoperative Care, Liver Neoplasms diagnostic imaging, Liver Neoplasms pathology, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular pathology, Gadolinium DTPA, Magnetic Resonance Imaging methods, Contrast Media, Nomograms
- Abstract
Background: Vessels encapsulating tumor cluster (VETC) and microvascular invasion (MVI) have a synergistic effect on prognosis assessment and treatment selection of hepatocellular carcinoma (HCC). Preoperative noninvasive evaluation of VETC and MVI is important., Purpose: To explore the diagnosis value of preoperative gadoxetic acid (GA)-enhanced magnetic resonance imaging (MRI) features for MVI, VETC, and recurrence-free survival (RFS) in HCC., Study Type: Retrospective., Population: 240 post-surgery patients with 274 pathologically confirmed HCC (allocated to training and validation cohorts with a 7:3 ratio) and available tumor marker data from August 2014 to December 2021., Field Strength/sequence: 3-T, T1-, T2-, diffusion-weighted imaging, in/out-phase imaging, and dynamic contrast-enhanced imaging., Assessment: Three radiologists subjectively reviewed preoperative MRI, evaluated clinical and conventional imaging features associated with MVI+, VETC+, and MVI+/VETC+ HCC. Regression-based nomograms were developed for HCC in the training cohort. Based on the nomograms, the RFS prognostic stratification system was further. Follow-up occurred every 3-6 months., Statistical Tests: Chi-squared test or Fisher's exact test, Mann-Whitney U-test or t-test, least absolute shrinkage and selection operator-penalized, multivariable logistic regression analyses, receiver operating characteristic analysis, Harrell's concordance index (C-index), Kaplan-Meier plots. Significance level: P < 0.05., Results: In the training group, 44 patients with MVI+ and 74 patients with VETC+ were histologically confirmed. Three nomograms showed good performance in the training (C-indices: MVI+ vs. VETC+ vs. MVI+/VETC+, 0.892 vs. 0.848 vs. 0.910) and validation (C-indices: MVI+ vs. VETC+ vs. MVI+/VETC+, 0.839 vs. 0.810 vs. 0.855) cohorts. The median follow-up duration for the training cohort was 43.6 (95% CI, 35.0-52.2) months and 25.8 (95% CI, 16.1-35.6) months for the validation cohort. Patients with either pathologically confirmed or nomogram-estimated MVI, VETC, and MVI+/VETC+ suffered higher risk of recurrence., Data Conclusion: GA-enhanced MRI and clinical variables might assist in preoperative estimation of MVI, VETC, and MVI+/VETC+ in HCC., Evidence Level: 4 TECHNICAL EFFICACY: Stage 2., (© 2023 International Society for Magnetic Resonance in Medicine.)
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- 2024
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33. Comparison of Sonazoid-Contrast‑Enhanced Ultrasound and Gd‑EOB‑DTPA‑Enhanced MRI for Predicting Microvascular Invasion in Hepatocellular Carcinoma.
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Huang Z, Zhu RH, Li SS, Luo HC, and Li KY
- Subjects
- Humans, Male, Female, Middle Aged, Prospective Studies, Aged, Sensitivity and Specificity, Predictive Value of Tests, Adult, Microvessels diagnostic imaging, Liver diagnostic imaging, Liver pathology, Reproducibility of Results, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular pathology, Liver Neoplasms diagnostic imaging, Liver Neoplasms pathology, Contrast Media, Magnetic Resonance Imaging methods, Gadolinium DTPA, Ultrasonography methods, Ferric Compounds, Iron, Neoplasm Invasiveness diagnostic imaging, Image Enhancement methods, Oxides
- Abstract
Objective: This study aims to evaluate and compare the predictive accuracy of Sonazoid-contrast-enhanced ultrasound (CEUS) and Gd-EOB-DTPA-enhanced MRI for detecting microvascular invasion (MVI) in hepatocellular carcinoma (HCC)., Methods: In this single-center prospective study, we included 64 patients with histopathologically confirmed single HCC lesions. Based on post-operative pathologic data, patients were categorized into two groups: those with MVI (n = 21) and those without MVI (n = 43). The diagnostic efficacy of CEUS was compared with that of MRI in predicting MVI., Results: Multifactorial analysis revealed that US features (tumor size > 4.35 cm, peritumoral enhancement, post-vascular ring enhancement, peak energy in the arterial phase of the difference between the margin area of HCC and distal liver parenchyma <-1.0 × 10
6 a.u), MRI features (rim enhancement, irregular tumor margin, and the halo sign) were all independent predictors of MVI (p < 0.05). The sensitivity and specificity of CEUS features in predicting MVI ranged from 61.9% to 86.4% and from 42.9% to 71.4%, respectively. For MRI features, the sensitivity and specificity ranged from 33.3% to 76.3% and from 54.7% to 90.5%, respectively. No statistically significant differences were observed in the area under the curve between CEUS and MRI (p > 0.05). Notably, peak energy of the difference showed the highest sensitivity at 86.4%, while the halo sign in MRI exhibited the highest specificity at 90.5%., Conclusion: Sonazoid-CEUS and Gd-EOB-DTPA-enhanced MRI demonstrate potential in predicting MVI in HCC lesions. Notably, CEUS showed higher sensitivity, whereas MRI displayed greater specificity in predicting MVI., Competing Interests: Conflict of interest The authors declare no competing interests., (Copyright © 2024 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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34. Gadolinium-based contrast agents aggravate mechanical and thermal hyperalgesia in a nitroglycerine-induced migraine model in male mice.
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Bilgin B, Adam M, Hekim MG, Bulut F, and Ozcan M
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- Animals, Male, Mice, Gadolinium adverse effects, Gadolinium DTPA, Pain Threshold, Contrast Media adverse effects, Nitroglycerin, Hyperalgesia chemically induced, Migraine Disorders chemically induced, Mice, Inbred BALB C, Disease Models, Animal, Meglumine analogs & derivatives, Meglumine administration & dosage, Organometallic Compounds toxicity
- Abstract
In the diagnosis of migraine, which is a neurovascular disease, gadolinium-based contrast agents (GBCAs) are used to rule out more serious conditions. On the other hand, it remains unclear as a scientific gap whether GBCAs may trigger migraine-related pain. The aim of this study was to investigate the effect of GBCAs on mechanical and thermal pain behaviour in a nitroglycerin (NTG)-induced migraine model in mice. NTG (10 mg/kg) was administered intraperitoneally to adult (6-8weeks old) BALB/c mice 2 h before behavioral tests 5 times every other day on days 1st, 3rd, 5th and 9th to induce migraine model (N = 50). As GBCAs, gadobenate dimeglumine (linear-ionic), Gadodiamide (linear-nonionic), and gadobutrol (macrocyclic-nonionic) were delivered intravenously through the tail vein of mice for 5 days on test days. Mechanical pain threshold (plantar and facial withdrawal threshold) was evaluated by plantar von Frey and periorbital von Frey tests on days 1st, 5th, and 9th, and thermal pain threshold (latency) was evaluated by hot plate and cold plate tests on days 3rd and 7th. There was a statistically significant increase in mechanical and thermal hyperalgesia in NTG administered groups compared to the control group. Gadodiamide, gadobutrol and gadobenate dimeglumine administration significantly decreased latency, paw and facial withdrawal threshold (0.18 ± 0.05, 0.17 ± 0.07, 0.16 ± 0.09; 9th day values respectively) compared to NTG group (0.27 ± 0.05). The results of this in vivo study show that GBCAs produce effects that may trigger migraine attacks in migraine. It is recommended that these effects be further investigated and supported by further clinical studies., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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35. Deep learning-based compressed SENSE improved diffusion-weighted image quality and liver cancer detection: A prospective study.
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Duan T, Zhang Z, Chen Y, Bashir MR, Lerner E, Qu Y, Chen J, Zhang X, Song B, and Jiang H
- Subjects
- Humans, Male, Female, Middle Aged, Prospective Studies, Aged, Liver diagnostic imaging, Liver pathology, Contrast Media, Image Interpretation, Computer-Assisted methods, Adult, Gadolinium DTPA, Image Enhancement methods, Liver Neoplasms diagnostic imaging, Deep Learning, Diffusion Magnetic Resonance Imaging methods, Carcinoma, Hepatocellular diagnostic imaging
- Abstract
Purpose: To assess whether diffusion-weighted imaging (DWI) with Compressed SENSE (CS) and deep learning (DL-CS-DWI) can improve image quality and lesion detection in patients at risk for hepatocellular carcinoma (HCC)., Methods: This single-center prospective study enrolled consecutive at-risk participants who underwent 3.0 T gadoxetate disodium-enhanced MRI. Conventional DWI was acquired using parallel imaging (PI) with SENSE (PI-DWI). In CS-DWI and DL-CS-DWI, CS but not PI with SENSE was used to accelerate the scan with 2.5 as the acceleration factor. Qualitative and quantitative image quality were independently assessed by two masked reviewers, and were compared using the Wilcoxon signed-rank test. The detection rates of clinically-relevant (LR-4/5/M based on the Liver Imaging Reporting and Data System v2018) liver lesions for each DWI sequence were independently evaluated by another two masked reviewers against their consensus assessments based on all available non-DWI sequences, and were compared by the McNemar test., Results: 67 participants (median age, 58.0 years; 56 males) with 197 clinically-relevant liver lesions were enrolled. Among the three DWI sequences, DL-CS-DWI showed the best qualitative and quantitative image qualities (p range, <0.001-0.039). For clinically-relevant liver lesions, the detection rates (91.4%-93.4%) of DL-CS-DWI showed no difference with CS-DWI (87.3%-89.8%, p = 0.230-0.231) but were superior to PI-DWI (82.7%-85.8%, p = 0.015-0.025). For lesions located in the hepatic dome, DL-CS-DWI demonstrated the highest detection rates (94.8%-97.4% vs 76.9%-79.5% vs 64.1%-69.2%, p = 0.002-0.045) among the three DWI sequences., Conclusion: In patients at high-risk for HCC, DL-CS-DWI improved image quality and detection for clinically-relevant liver lesions, especially for the hepatic dome., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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36. Gd-EOB-DTPA enhanced MRI nomogram model to differentiate hepatocellular carcinoma and focal nodular hyperplasia both showing iso- or hyperintensity in the hepatobiliary phase.
- Author
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Mao HY, Shen BQ, Zhang JY, Zhang T, Cai W, Fan YF, Wang XM, Yu YX, and Hu CH
- Subjects
- Humans, Female, Male, Middle Aged, Diagnosis, Differential, Adult, Aged, Retrospective Studies, ROC Curve, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular pathology, Gadolinium DTPA, Liver Neoplasms diagnostic imaging, Liver Neoplasms pathology, Nomograms, Focal Nodular Hyperplasia diagnostic imaging, Magnetic Resonance Imaging methods, Contrast Media
- Abstract
Background: To develop and validate a nomogram model based on Gd-EOB-DTPA enhanced MRI for differentiation between hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH) showing iso- or hyperintensity in the hepatobiliary phase (HBP)., Methods: A total of 75 patients with 49 HCCs and 26 FNHs randomly divided into a training cohort (n = 52: 34 HCC; 18 FNH) and an internal validation cohort (n = 23: 15 HCC; 8 FNH). A total of 37 patients (n = 37: 25 HCC; 12 FNH) acted as an external test cohort. The clinical and imaging characteristics between HCC and FNH groups in the training cohort were compared. The statistically significant parameters were included into the FAE software, and a multivariate logistic regression classifier was used to identify independent predictors and establish a nomogram model. Receiver operating characteristic (ROC) curves were used to evaluate the prediction ability of the model, while the calibration and decision curves were used for model validation. Subanalysis was used to compare qualitative and quantitative characteristics of patients with chronic hepatitis and cirrhosis between the HCC and FNH groups., Results: In the training cohort, gender, age, enhancement rate in the arterial phase (AP), focal defects in uptake were significant predictors for HCC showing iso- or hyperintensity in the HBP. In the training cohort, area under the curve (AUC), sensitivity and specificity of the nomogram model were 0.989(95%CI: 0.967-1.000), 97.1% and 94.4%. In the internal validation cohort, the above three indicators were 0.917(95%CI: 0.782-1.000), 93.3% and 87.5%. In the external test cohort, the above three indicators were 0.960(95%CI: 0.905-1.000), 84.0% and 100.0%. The results of subanalysis showed that age was the independent predictor in the patients with chronic hepatitis and cirrhosis between HCC and FNH groups., Conclusions: Gd-EOB-DTPA enhanced MRI nomogram model may be useful for discriminating HCC and FNH showing iso- or hyperintensity in the HBP before surgery., (© 2024. The Author(s).)
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- 2024
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37. Accessory liver lobe: an uncommon abdominal mass mimicker.
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Martinho IA, Vieira J, Vieira AC, and Vieira A
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- Humans, Female, Diagnosis, Differential, Adult, Ultrasonography, Choristoma diagnosis, Choristoma diagnostic imaging, Contrast Media, Gadolinium DTPA, Liver diagnostic imaging, Liver abnormalities, Liver pathology, Magnetic Resonance Imaging
- Abstract
Heterotopic hepatic tissue is a rare development anomaly, exhibiting diverse forms and locations. We present a case report of an asymptomatic woman in her 40s who had an 8 cm mass in the left hypochondrium detected on routine ultrasound, which was initially suspected to be a tumour. Further investigation revealed that the mass had a similar enhancement to the liver on gadoxetate disodium-enhanced MRI and presented a connection with the original liver via vascular pedicle, favouring the diagnosis of accessory liver lobe (ALL). Accurate differentiation of ALL from other abdominal masses poses a diagnostic challenge, potentially leading to misdiagnosis of malignant tumours and unnecessary interventions. Although usually small and asymptomatic, rarely they can present with acute complications, and cross-sectional techniques play an important role in enabling early diagnosis and management. Therefore, radiologists must raise awareness regarding ALL, their imagological findings, and diagnostic pathways, and understand potential associated complications., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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38. PET/CT-Based Absorbed Dose Maps in 90 Y Selective Internal Radiation Therapy Correlate with Spatial Changes in Liver Function Derived from Dynamic MRI.
- Author
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Lu Z, Polan DF, Wei L, Aryal MP, Fitzpatrick K, Wang C, Cuneo KC, Evans JR, Roseland ME, Gemmete JJ, Christensen JA, Kapoor BS, Mikell JK, Cao Y, Mok GSP, and Dewaraja YK
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Liver Neoplasms radiotherapy, Liver Neoplasms diagnostic imaging, Gadolinium DTPA, Liver Function Tests, Radiotherapy Dosage, Liver diagnostic imaging, Positron Emission Tomography Computed Tomography, Yttrium Radioisotopes therapeutic use, Magnetic Resonance Imaging
- Abstract
Functional liver parenchyma can be damaged from treatment of liver malignancies with
90 Y selective internal radiation therapy (SIRT). Evaluating functional parenchymal changes and developing an absorbed dose (AD)-toxicity model can assist the clinical management of patients receiving SIRT. We aimed to determine whether there is a correlation between90 Y PET AD voxel maps and spatial changes in the nontumoral liver (NTL) function derived from dynamic gadoxetic acid-enhanced MRI before and after SIRT. Methods: Dynamic gadoxetic acid-enhanced MRI scans were acquired before and after treatment for 11 patients undergoing90 Y SIRT. Gadoxetic acid uptake rate (k1 ) maps that directly quantify spatial liver parenchymal function were generated from MRI data. Voxel-based AD maps, derived from the90 Y PET/CT scans, were binned according to AD. Pre- and post-SIRT k1 maps were coregistered to the AD map. Absolute and percentage k1 loss in each bin was calculated as a measure of loss of liver function, and Spearman correlation coefficients between k1 loss and AD were evaluated for each patient. Average k1 loss over the patients was fit to a 3-parameter logistic function based on AD. Patients were further stratified into subgroups based on lesion type, baseline albumin-bilirubin scores and alanine transaminase levels, dose-volume effect, and number of SIRT treatments. Results: Significant positive correlations (ρ = 0.53-0.99, P < 0.001) between both absolute and percentage k1 loss and AD were observed in most patients (8/11). The average k1 loss over 9 patients also exhibited a significant strong correlation with AD (ρ ≥ 0.92, P < 0.001). The average percentage k1 loss of patients across AD bins was 28%, with a logistic function model demonstrating about a 25% k1 loss at about 100 Gy. Analysis between patient subgroups demonstrated that k1 loss was greater among patients with hepatocellular carcinoma, higher alanine transaminase levels, larger fractional volumes of NTL receiving an AD of 70 Gy or more, and sequential SIRT treatments. Conclusion: Novel application of multimodality imaging demonstrated a correlation between90 Y SIRT AD and spatial functional liver parenchymal degradation, indicating that a higher AD is associated with a larger loss of local hepatocyte function. With the developed response models, PET-derived AD maps can potentially be used prospectively to identify localized damage in liver and to enhance treatment strategies., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)- Published
- 2024
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39. Clear cell hepatocellular carcinoma: Gd-EOB-DTPA-enhanced MR imaging features and prognosis.
- Author
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Song M, Tao Y, He K, Du M, Guo L, Hu C, and Zhang W
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- Humans, Male, Female, Middle Aged, Retrospective Studies, Prognosis, Aged, Image Enhancement methods, Adult, Gadolinium DTPA, Liver Neoplasms diagnostic imaging, Carcinoma, Hepatocellular diagnostic imaging, Magnetic Resonance Imaging methods, Contrast Media
- Abstract
Purpose: To investigate imaging findings on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI) and prognosis of clear cell hepatocellular carcinoma (CCHCC) comparing with non-otherwise specified hepatocellular carcinoma (NOS-HCC)., Methods: The clinical, pathological and MR imaging features of 42 patients with CCHCC and 84 age-matched patients with NOS-HCC were retrospectively analyzed from January 2015 to October 2021. Univariate and multivariate logistic regression and Cox regression analyses were performed to identify independent diagnostic and prognostic factors for CCHCC. Disease-free survival (DFS) and overall survival (OS) were determined by Kaplan-Meier analysis., Results: CCHCC showed fat content more frequently (P < 0.001) and relatively higher Edmondson tumor grade (P = 0.001) compared with NOS-HCC. The lesion-to-muscle ratio (LMR) and lesion-to-liver ratio (LLR) of CCHCC on pre-enhancement T1-weighted imaging (pre-T1WI) (P = 0.001, P = 0.003) and hepatobiliary phase (HBP) (P = 0.007, P = 0.048) were significantly higher than those of NOS-HCC. The area under the curve (AUC) for fat content, LLR on pre-T1WI and their combination with better diagnostic performance in predicting CCHCC were 0.678, 0.666, and 0.750, respectively. There was no statistically significant difference in clinical outcomes between CCHCC and NOS-HCC. Multivariate Cox analysis confirmed that tumor size > 2 cm and enhancing capsule were independent prognostic factors for DFS and OS among CCHCC patients., Conclusion: Fat content and adjusted lesion signal intensity on pre-T1WI and HBP could be used to differentiate CCHCC from NOS-HCC. CCHCC had similar prognosis with NOS-HCC., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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40. Establishment of nomogram prediction model of contrast-enhanced ultrasound and Gd-EOB-DTPA-enhanced MRI for vessels encapsulating tumor clusters pattern of hepatocellular carcinoma.
- Author
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Wang F, Numata K, Funaoka A, Liu X, Kumamoto T, Takeda K, Chuma M, Nozaki A, Ruan L, and Maeda S
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Adult, Retrospective Studies, Liver Neoplasms diagnostic imaging, Liver Neoplasms pathology, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular pathology, Nomograms, Magnetic Resonance Imaging methods, Contrast Media, Gadolinium DTPA, Ultrasonography methods
- Abstract
To establish clinical prediction models of vessels encapsulating tumor clusters (VETC) pattern using preoperative contrast-enhanced ultrasound (CEUS) and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging (EOB-MRI) in patients with hepatocellular carcinoma (HCC). A total of 111 resected HCC lesions from 101 patients were included. Preoperative imaging features of CEUS and EOB-MRI, postoperative recurrence, and survival information were collected from medical records. The best subset regression and multivariable Cox regression were used to select variables to establish the prediction model. The VETC-positive group had a statistically lower survival rate than the VETC-negative group. The selected variables were peritumoral enhancement in the arterial phase (AP), hepatobiliary phase (HBP) on EOB-MRI, intratumoral branching enhancement in the AP of CEUS, intratumoral hypoenhancement in the portal phase of CEUS, incomplete capsule, and tumor size. A nomogram was developed. High and low nomogram scores with a cutoff value of 168 points showed different recurrence-free survival rates and overall survival rates. The area under the curve (AUC) and accuracy were 0.804 and 0.820, respectively, indicating good discrimination. Decision curve analysis showed a good clinical net benefit (threshold probability > 5%), while the Hosmer-Lemeshow test yielded excellent calibration (P = 0.6759). The AUC of the nomogram model combining EOB-MRI and CEUS was higher than that of the models with EOB-MRI factors only (0.767) and CEUS factors only (0.7). The nomogram verified by bootstrapping showed AUC and calibration curves similar to those of the nomogram model. The Prediction model based on CEUS and EOB-MRI is effective for preoperative noninvasive diagnosis of VETC.
- Published
- 2024
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41. Comparative analysis of the performance of hepatobiliary agents in depicting MRI features of microvascular infiltration in hepatocellular carcinoma.
- Author
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Yao WW, Zhang HW, Ma YP, Lee JM, Lee RT, Wang YL, Liu XL, Shen XP, Huang B, and Lin F
- Subjects
- Humans, Male, Female, Retrospective Studies, Middle Aged, Aged, Organometallic Compounds, Adult, Microvessels diagnostic imaging, Microvessels pathology, Image Enhancement methods, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular pathology, Liver Neoplasms diagnostic imaging, Liver Neoplasms pathology, Contrast Media, Magnetic Resonance Imaging methods, Gadolinium DTPA, Meglumine analogs & derivatives
- Abstract
Objective: To compare the ability to depict MRI features of hepatobiliary agents in microvascular infiltration (MVI) of hepatocellular carcinoma (HCC) during different stages of dynamic enhancement MRI., Materials and Methods: A retrospective study included 111 HCC lesions scanned with either Gd-EOB-DTPA or Gd-BOPTA. All cases underwent multiphase dynamic contrast-enhanced scanning before surgery, including arterial phase (AP), portal venous phase (PVP), transitional phase (TP), delayed phase (DP), and hepatobiliary phase (HBP). Two abdominal radiologists independently evaluated MRI features of MVI in HCC, such as peritumoral hyperenhancement, incomplete capsule, non-smooth tumor margins, and peritumoral hypointensity. Finally, the results were reviewed by the third senior abdominal radiologist. Chi-square (χ
2 ) Inspection for comparison between groups. P < 0.05 is considered statistically significant. Receiver operating characteristic (ROC) curve was used to evaluate correlation with pathology, and the area under the curve (AUC) and 95% confidence interval (95% CI) were calculated., Results: Among the four MVI evaluation signs, Gd-BOPTA showed significant differences in displaying two signs in the HBP (P < 0.05:0.000, 0.000), while Gd-EOB-DTPA exhibited significant differences in displaying all four signs (P < 0.05:0.005, 0.006, 0.000, 0.002). The results of the evaluations of the two contrast agents in the DP phase with incomplete capsulation showed the highest correlation with pathology (AUC: 0.843, 0.761). By combining the four MRI features, Gd-BOPTA and Gd-EOB-DTPA have correlated significantly with pathology, and Gd-BOPTA is better (AUC: 0.9312vs0.8712)., Conclusion: The four features of hepatobiliary agent dynamic enhancement MRI demonstrate a good correlation with histopathological findings in the evaluation of MVI in HCC, and have certain clinical significance., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)- Published
- 2024
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42. Bone marrow lesions in knee osteoarthritis assessed by dynamic contrast-enhanced MRI with histopathological correlations.
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Nielsen FK, Sørensen FB, Egund N, Boel LW, Holm C, and Jurik AG
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- Humans, Female, Male, Aged, Middle Aged, Bone Marrow Diseases diagnostic imaging, Bone Marrow Diseases pathology, Knee Joint diagnostic imaging, Knee Joint pathology, Aged, 80 and over, Gadolinium DTPA, Osteoarthritis, Knee diagnostic imaging, Osteoarthritis, Knee pathology, Magnetic Resonance Imaging methods, Contrast Media, Bone Marrow diagnostic imaging, Bone Marrow pathology
- Abstract
Background: Bone marrow lesions (BMLs) in knee osteoarthritis (OA) have been assessed histopathologically and by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI); however, a direct comparison of the results has not been reported., Purpose: To evaluate and compare the findings by DCE-MRI and histopathology of subchondral BMLs in knee OA., Material and Methods: In total, 19 patients with medial tibiofemoral knee OA undergoing total knee arthroplasty were analyzed. Preoperative MRI, including a DCE sequence, was performed, and bone biopsies were obtained from the resected specimens corresponding to BML areas. The contrast enhancement by DCE-MRI was analyzed using semi-quantitative (area under the curve [AUC]), peak enhancement [PE]), and quantitative (Ktrans, Kep) methods. Enhancement in the medial OA compartment was compared with similar areas in a normal lateral compartment, and the DCE characteristics of BMLs were correlated with semi-quantitatively graded histopathological features., Results: AUC and PE were significantly higher in medial tibial and femoral BMLs compared with the values in the lateral condyles; Ktrans and Kep were only significantly higher in the tibial plateau. In the tibia, AUC and PE were significantly correlated with the grade of vascular proliferation, and PE also with the degree of marrow fibrosis. There was no significant correlation between AUC/PE and histopathological findings in the femur and no correlation between quantitative DCE parameters and histopathological findings., Conclusion: BML characteristics by semi-quantitative DCE in the form of AUC and PE may be used as parameters for the degree of histopathological vascularization in the bone marrow whereas quantitative DCE data were less conclusive., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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43. Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell's Palsy.
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Yücel, Volkan, Güneş, Serra Özbal, Keseroğlu, Kemal, Bayır, Ömer, Çırakoğlu, Mehmet Furkan, Tatar, Emel Çadallı, Saylam, Güleser, Karahan, Sevilay, Yılmaz, Orhan, and Korkmaz, Mehmet Hakan
- Subjects
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BELL'S palsy , *MAGNETIC resonance imaging , *FACIAL paralysis , *CONTRAST-enhanced magnetic resonance imaging , *FACIAL nerve , *PROGNOSIS - Abstract
Objective: To investigate the prognostic value of the magnetic resonance imaging in Bell's palsy patients. Methods: Patients who were diagnosed and treated with Bell's palsy between October 2013 and March 2016 retrospectively selected. House-Brackmann grades, pre- and post-treatment pure tone audiograms, stapedial reflexes were analyzed and magnetic resonance imaging (MRI) scans with gadolinium-based contrast agents were evaluated. Contrast-enhanced segments of the facial nerve were determined. MRI findings were compared statistically with pre- and post-treatment grade, recurrence rate of Bell's palsy, MRI scanning timing, presence of stapes reflexes and posttreatment recovery data. Results: No significant correlation was observed between pretreatment House-Brackmann grades and enhancement (p>0.05). Similarly, there was no significant correlation between clinical recovery and enhancement (p>0.05). Also, no significant correlation was observed between MRI scanning time, the recurrence rate of Bell's palsy and MRI findings (p>0.05). None of the MRIs showed neoplastic contrast enhancement. Conclusion: The routine use of the contrast-enhanced temporal MRI is not recommended in the diagnosis and monitoring of Bell's palsy patients, because the contrast enhancement pattern of the facial nerve has no effect on the prognosis of Bell's palsy. MRI should be used in cases that do not heal despite treatment, for the differential diagnosis of facial nerve tumors and in patients who are candidates for surgical decompression. [ABSTRACT FROM AUTHOR]
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- 2022
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44. A New Reporting System for Diagnosis of Hepatocellular Carcinoma in Chronic Hepatitis B With Clinical and Gadoxetic Acid‐Enhanced MRI Features.
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Hwang, Shin Hye, Hong, Seung Baek, Han, Kyunghwa, Seo, Nieun, Choi, Jin‐Young, Lee, Jei Hee, Park, Sumi, Lim, Young‐Suk, Kim, Do Young, Kim, So Yeon, and Park, Mi‐Suk
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CHRONIC hepatitis B ,HEPATOCELLULAR carcinoma ,DISEASE risk factors ,MAGNETIC resonance imaging ,LOGISTIC regression analysis ,DIAGNOSIS - Abstract
Background: Current major guidelines for diagnosis of hepatocellular carcinoma (HCC) based on imaging findings are different from each other and do not include clinical risk factors as a diagnostic criteria. Purpose: To developed and validated a new diagnostic score system using MRI and clinical features as applied in chronic hepatitis B patients. Study Type: Retrospective observational study. Subject: A total of 418 treatment‐naïve patients (out of 902 patients) with chronic hepatitis B having 556 lesions suspected for HCC which were eligible for curative treatment. Field Strength/sequence: T1W GRE in‐ and opposed‐phase, T2W FSE, DWI, and T1W 3D‐GRE dynamic contrast‐enhanced sequences at 1.5 T and 3 T. Assessment: Six radiologists with 7–22 years of experience independently evaluated MR images based on Liver Imaging Reporting and Data System (LI‐RADS) version 2018. Statistical Tests: Based on logistic regression analysis of MRI features and clinical factors, a risk score system was devised in derivation cohorts (268 patients, 352 lesions) and externally validated (150 patients, 204 lesions). The performance of the new score system was assessed by Harell's c‐index. Using cutoff value of 12, maintaining positive predictive value ≥95%, the diagnostic performances of the score system were compared with those of LR‐5. Results: The 15‐point diagnostic scoring system used MRI features (lesion size, nonrim arterial phase hyperenhancement, portal venous phase hypointensity, hepatobiliary phase hypointensity, and diffusion restriction) and clinical factors (alpha‐fetoprotein and platelet). It showed good discrimination in the derivation (c‐index, 0.946) and validation cohorts (c‐index, 0.907). Using a risk score of 12 as a cut‐off, this system yielded higher sensitivity than LR‐5 (derivation cohort, 76.8% vs. 52.1%; validation cohort, 73.4% vs. 49.5%) without significant decrease in specificity (derivation cohort, 93.1% vs. 97.2%, P = 0.074; validation cohort, 91.7% vs. 96.1%, P = 0.299). Data Conclusion: A new score system showed improved sensitivity in chronic hepatitis B patients compared to LI‐RADS without significant compromise in specificity. Evidence Level: 3 Technical Efficacy: Stage 2. [ABSTRACT FROM AUTHOR]
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- 2022
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45. Quantitative monitoring of paramagnetic contrast agents and their allocation in plant tissues via DCE-MRI.
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Mayer, Simon, Munz, Eberhard, Hammer, Sebastian, Wagner, Steffen, Guendel, Andre, Rolletschek, Hardy, Jakob, Peter M., Borisjuk, Ljudmilla, and Neuberger, Thomas
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CONTRAST media , *PLANT cells & tissues , *MAGNETIC resonance imaging , *BARLEY , *BOTANY , *KNOWLEDGE transfer - Abstract
Background: Studying dynamic processes in living organisms with MRI is one of the most promising research areas. The use of paramagnetic compounds as contrast agents (CA), has proven key to such studies, but so far, the lack of appropriate techniques limits the application of CA-technologies in experimental plant biology. The presented proof-of-principle aims to support method and knowledge transfer from medical research to plant science. Results: In this study, we designed and tested a new approach for plant Dynamic Contrast Enhanced Magnetic Resonance Imaging (pDCE-MRI). The new approach has been applied in situ to a cereal crop (Hordeum vulgare). The pDCE-MRI allows non-invasive investigation of CA allocation within plant tissues. In our experiments, gadolinium-DTPA, the most commonly used contrast agent in medical MRI, was employed. By acquiring dynamic T1-maps, a new approach visualizes an alteration of a tissue-specific MRI parameter T1 (longitudinal relaxation time) in response to the CA. Both, the measurement of local CA concentration and the monitoring of translocation in low velocity ranges (cm/h) was possible using this CA-enhanced method. Conclusions: A novel pDCE-MRI method is presented for non-invasive investigation of paramagnetic CA allocation in living plants. The temporal resolution of the T1-mapping has been significantly improved to enable the dynamic in vivo analysis of transport processes at low-velocity ranges, which are common in plants. The newly developed procedure allows to identify vascular regions and to estimate their involvement in CA allocation. Therefore, the presented technique opens a perspective for further development of CA-aided MRI experiments in plant biology. [ABSTRACT FROM AUTHOR]
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- 2022
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46. Combining hyperpolarized 13C MRI with a liver‐specific gadolinium contrast agent for selective assessment of hepatocyte metabolism
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Ohliger, Michael A, von Morze, Cornelius, Marco‐Rius, Irene, Gordon, Jeremy, Larson, Peder EZ, Bok, Robert, Chen, Hsin‐yu, Kurhanewicz, John, and Vigneron, Daniel
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Engineering ,Biomedical Engineering ,Liver Disease ,Biomedical Imaging ,Cancer ,Digestive Diseases ,Bioengineering ,Animals ,Carbon Isotopes ,Carbon-13 Magnetic Resonance Spectroscopy ,Drug Combinations ,Gadolinium DTPA ,Hepatocytes ,Liver ,Magnetic Resonance Imaging ,Molecular Imaging ,Rats ,Rats ,Sprague-Dawley ,Reproducibility of Results ,Sensitivity and Specificity ,hyperpolarized carbon ,liver ,gadoxetate ,pyruvate ,metabolism ,Nuclear Medicine & Medical Imaging ,Biomedical engineering - Abstract
PurposeHyperpolarized 13 C MRI is a powerful tool for studying metabolism, but can lack tissue specificity. Gadoxetate is a gadolinium-based MRI contrast agent that is selectively taken into hepatocytes. The goal of this project was to investigate whether gadoxetate can be used to selectively suppress the hyperpolarized signal arising from hepatocytes, which could in future studies be applied to generate specificity for signal from abnormal cell types.MethodsBaseline gadoxetate uptake kinetics were measured using T1 -weighted contrast enhanced imaging. Relaxivity of gadoxetate was measured for [1-13 C]pyruvate, [1-13 C]lactate, and [1-13 C]alanine. Four healthy rats were imaged with hyperpolarized [1-13 C]pyruvate using a three-dimensional (3D) MRSI sequence prior to and 15 min following administration of gadoxetate. The lactate:pyruvate ratio and alanine:pyruvate ratios were measured in liver and kidney.ResultsOverall, the hyperpolarized signal decreased approximately 60% as a result of pre-injection of gadoxetate. In liver, the lactate:pyruvate and alanine:pyruvate ratios decreased 42% and 78%, respectively (P
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- 2017
47. Change in Liver Imaging Reporting and Data System Characterization of Focal Liver Lesions Using Gadoxetate Disodium Magnetic Resonance Imaging Compared With Contrast-Enhanced Computed Tomography
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Hope, Thomas A, Aslam, Rizwan, Weinstein, Stefanie, Yeh, Benjamin M, Corvera, Carlos U, Monto, Alex, and Yee, Judy
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Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Liver Disease ,Clinical Research ,Rare Diseases ,Biomedical Imaging ,Cancer ,Liver Cancer ,Digestive Diseases ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Contrast Media ,Gadolinium DTPA ,Humans ,Image Enhancement ,Liver ,Liver Neoplasms ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Radiographic Image Enhancement ,Radiology Information Systems ,Tomography ,X-Ray Computed ,hepatocellular carcinoma ,MRI ,hepatobiliary phase ,Nuclear Medicine & Medical Imaging ,Clinical sciences ,Computer vision and multimedia computation - Abstract
PurposeThe aim of this study was to determine whether gadoxetate-enhanced magnetic resonance imaging (MRI) improves lesion characterization in patients at risk for hepatocellular carcinoma compared with computed tomography (CT).Materials and methodsForty-nine patients with indeterminate lesions found at contrast-enhanced CT were prospectively enrolled and imaged using gadoxetate-enhanced hepatobiliary phase (HBP) MRI within 30 days of their initial CT. Three readers graded each lesion at CT and MRI using the Liver Imaging Reporting and Data System (LI-RADS) v2014 major criteria and HBP characterization as an ancillary feature. Patients were followed for an average of 1.8 years to document growth or stability of each lesion.ResultsThe Liver Imaging Reporting and Data System categorization changed for 71% (52/73) of lesions based on HBP MRI compared with CT, with 30% (22/73) of lesions upgraded and 41% (30/73) of lesions downgraded. There was almost perfect agreement between readers for arterial phase hyperintensity and HBP hypointensity, with lower interreader agreement for washout and capsule appearance. On the basis of composite clinical follow-up, lesions that were subsequently classified as hepatocellular carcinoma were assigned a higher LI-RADS category on HBP MRI when compared with CT.ConclusionsFor patients with indeterminate lesions seen on contrast-enhanced CT, HBP MRI using gadoxetate improves lesion characterization when using LI-RADS v2014 criteria.
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- 2017
48. Effect of intravenous gadoxetate disodium and flip angle on hepatic proton density fat fraction estimation with six-echo, gradient-recalled-echo, magnitude-based MR imaging at 3T
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Park, Charlie C, Hamilton, Gavin, Desai, Ajinkya, Zand, Kevin A, Wolfson, Tanya, Hooker, Jonathan C, Costa, Eduardo, Heba, Elhamy, Clark, Lisa, Gamst, Anthony, Loomba, Rohit, Middleton, Michael S, and Sirlin, Claude B
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Biomedical and Clinical Sciences ,Clinical Sciences ,Biomedical Imaging ,Clinical Research ,Adult ,Aged ,Contrast Media ,Fatty Liver ,Female ,Gadolinium DTPA ,Humans ,Image Enhancement ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Prospective Studies ,Protons ,Gadoxetate disodium ,Eovist ,MRI ,PDFF ,Flip angle ,Hepatic steatosis ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
PurposeThe aim of the study was to determine in patients undergoing gadoxetate disodium (Gx)-enhanced MR exams whether proton density fat fraction (PDFF) estimation accuracy of magnitude-based multi-gradient-echo MRI (MRI-M) could be improved by using high flip angle (FA) on post-contrast images.Materials and methodsThirty-one adults with known or suspected hepatic steatosis undergoing 3T clinical Gx-enhanced liver MRI were enrolled prospectively. MR spectroscopy (MRS), the reference standard, was performed before Gx to measure MRS-PDFF. Low (10°)- and high (50°)-flip angle (FA) MRI-M sequences were acquired before and during the hepatobiliary phase after Gx administration; MRI-PDFF was estimated in the MRS-PDFF voxel location. Linear regression parameters (slope, intercept, average bias, R 2) were calculated for MRS-PDFF as a function of MRI-PDFF for each MRI-M sequence (pre-Gx low-FA, pre-Gx high-FA, post-Gx low-FA, post-Gx high-FA) for all patients and for patients with MRS-PDFF
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- 2017
49. Agreement between region-of-interest- and parametric map-based hepatic proton density fat fraction estimation in adults with chronic liver disease
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Manning, Paul M, Hamilton, Gavin, Wang, Kang, Park, Chulhyun, Hooker, Jonathan C, Wolfson, Tanya, Gamst, Anthony, Haufe, William M, Schlein, Alex N, Middleton, Michael S, and Sirlin, Claude B
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Biomedical and Clinical Sciences ,Clinical Sciences ,Biomedical Imaging ,Chronic Liver Disease and Cirrhosis ,Digestive Diseases ,Liver Disease ,Oral and gastrointestinal ,Adult ,Aged ,Algorithms ,Chronic Disease ,Contrast Media ,Cross-Sectional Studies ,Fatty Liver ,Female ,Gadolinium DTPA ,Humans ,Image Interpretation ,Computer-Assisted ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Prospective Studies ,MRI ,Fat quantification ,Hepatic steatosis ,Proton density fat fraction ,PDFF ,Quantitative imaging biomarker ,QIB ,Analysis methods ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
PurposeTo compare agreement between region-of-interest (ROI)- and parametric map-based methods of hepatic proton density fat fraction (PDFF) estimation in adults with known or suspected hepatic steatosis secondary to chronic liver disease over a range of imaging and analysis conditions.Materials and methodsIn this IRB approved HIPAA compliant prospective single-site study, 31 adults with chronic liver disease undergoing clinical gadoxetic acid-enhanced liver magnetic resonance imaging at 3 T were recruited. Multi-echo gradient-echo imaging at flip angles of 10° and 50° was performed before and after administration of gadoxetic acid. Six echoes were acquired at successive nominally out-of-phase and in-phase echo times. PDFF was estimated with a nonlinear fitting algorithm using the first two, three, four, five, and (all) six echoes. Hence, 20 different imaging and analysis conditions were used (pre/post contrast x low/high flip angle x 2/3/4/5/6 echoes). For each condition, PDFF estimation was done in corresponding liver locations using two methods: a region-of-interest (ROI)-based method in which mean signal intensity values within ROIs were run through the fitting algorithm, and a parametric map-based method in which individual signal intensities were run through the fitting algorithm pixel by pixel. Agreement between ROI- and map-based PDFF estimation was assessed by Bland-Altman and intraclass correlation (ICC) analysis.ResultsDepending on the condition and method, PDFF ranged from -2.52% to 45.57%. Over all conditions, mean differences between ROI- and map-based PDFF estimates ranged from 0.04% to 0.24%, with all ICCs ≥0.999.ConclusionAgreement between ROI- and parametric map-based PDFF estimation is excellent over a wide range of imaging and analysis conditions.
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- 2017
50. Multiple arterial phase MRI of arterial hypervascular hepatic lesions: improved arterial phase capture and lesion enhancement
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Ikram, Nabia S, Yee, Judy, Weinstein, Stefanie, Yeh, Benjamin M, Corvera, Carlos U, Monto, Alexander, and Hope, Thomas A
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Biomedical and Clinical Sciences ,Clinical Sciences ,Biomedical Imaging ,Clinical Research ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Aged ,Artifacts ,Carcinoma ,Hepatocellular ,Contrast Media ,Female ,Gadolinium DTPA ,Humans ,Liver Neoplasms ,Magnetic Resonance Angiography ,Male ,Middle Aged ,Organometallic Compounds ,Retrospective Studies ,Liver MRI ,Arterial phase imaging ,Respiratory motion ,Hepatocellular carcinoma ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
PurposeTo establish if triple-phase arterial imaging improves the detection of arterial phase hyperintense lesions based on arterial phase capture, motion artifact degradation, and lesion enhancement when compared to single-phase imaging.Materials and methodsPatients at risk for hepatocellular carcinoma were imaged at 3.0T. Seventy-three consecutive patients with a standard single-phase MRI and eighty-five consecutive patients were imaged using extracellular contrast with triple arterial phase MRI using three sequential accelerated acquisitions of 8 s. Arterial phase capture and image quality were qualitatively categorized. Forty single-phase and forty-four triple-phase studies contained arterially enhancing lesions > 1 cm with washout appearance. The contrast-to-noise ratio (CNR) of the lesions was calculated. We compared the differences in means with Student t-tests and those in arterial phase capture with a Chi squared test with Yates correction.ResultsThe triple-phase acquisitions captured the early or late arterial phases more frequently than did the single-phase acquisition (99% vs 86%; P value = 0.006). Triple-phase also provided greater number of patients with early or late arterial phase imaging without motion artifact (92% vs 79%, P-value = 0.05). The lesion analysis revealed increased maximum CNR in the triple-phase imaging (704.4) vs. single-phase imaging (517.2), P-value
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- 2017
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