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. 2015 Oct 7;10(10):e0139863.
doi: 10.1371/journal.pone.0139863. eCollection 2015.

Validation of 10-Minute Delayed Hepatocyte Phase Imaging with 30° Flip Angle in Gadoxetic Acid-Enhanced MRI for the Detection of Liver Metastasis

Dahye Lee  1 , Eun-Suk Cho  1 , Dae Jung Kim  2 , Joo Hee Kim  1 , Jeong-Sik Yu  1 , Jae-Joon Chung  1
Affiliations

Validation of 10-Minute Delayed Hepatocyte Phase Imaging with 30° Flip Angle in Gadoxetic Acid-Enhanced MRI for the Detection of Liver Metastasis

Dahye Lee et al. PLoS One. .

Abstract

Objectives: To compare 10-minute delayed hepatocyte phase imaging using a 30° flip angle (10 min-FA30) and 20-minute hepatocyte phase imaging using a 10° FA (20 min-FA10) in gadoxetic acid-enhanced MRI of patients with possible liver metastases, regarding lesion-to-liver contrast-to-noise ratio (CNR) and focal hepatic lesion (FHL) detection to evaluate whether 10 min-FA30 would be superior to 20 min-FA10.

Materials and methods: Eighty-three patients with 248 liver metastases and 78 benign FHLs who underwent gadoxetic acid-enhanced MRI with 10 min-FA30 and 20 min-FA10 were enrolled. Lesion-to-liver CNRs were compared between the two image groups. Two radiologists independently assessed the presence of FHLs using a four-point scale and detection sensitivity was calculated.

Results: The mean CNR for liver metastases on the 10 min-FA30 (248.5 ± 101.6) were significantly higher than that of the 20 min-FA10 (187.4 ± 77.4) (p < 0.001). The mean CNR difference between the two image groups was 61.2 ± 56.8. There was no significant difference in detection sensitivity of FHLs for two readers between 10 min-FA30 (mean 97.7%) and 20 min-FA10 (mean 97.9%), irrespective of the lesion size or malignancy.

Conclusion: 10 min-FA30 yielded higher CNR with similar sensitivity compared to 20 min-FA10. This finding indicates that 10 min-FA30 can potentially replace 20 min-FA10 with higher diagnostic performance and save 10 minutes of time.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Lesion-to-liver contrast-to-noise ratio (CNR).
Box-and-whisker plots showing the median (middle line of each box), quartiles (top and bottom lines of each box), and upper and lower adjacent (upper and lower whiskers for each box) values of the lesion-to-liver contrast-to-noise ratio (CNR). Liver metastases were imaged according to two different protocols: 10 minute delayed hepatocyte phase imaging with a 30° flip angle (10min-FA30) and 20 minute delayed hepatocyte phase imaging with a 10° flip angle (20min-FA10). The mean CNR for FHLs imaged with the 10min-FA30 protocol was significantly higher than that of FHLs imaged with the 20min-FA10 protocol.
Fig 2
Fig 2. 43-year-old male with pathologically proven liver metastasis from rectal cancer.
Gadoxetic acid-enhanced T1-weighted MR hepatocyte phase images taken with a 10-minute delay and a 30° flip angle (10min-FA30) (a) and a 20-minute delay and a 10° flip angle (20min-FA10) (b). The liver metastasis in segment 4 showed low signal intensity related to liver parenchyma on both images (dark arrows). The lesion-to-liver CNR of the 10min-FA30 image (190.3) was superior to that of the 20min-FA10 image (137.3). Two different radiologists each gave the 10min-FA30 and 20min-FA10 images a mean subjective score for focal hepatic lesion presence of 4.0.
See this image and copyright information in PMC

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