Gadoxetic acid-enhanced fat suppressed three-dimensional T1-weighted MRI using a multiecho dixon technique at 3 tesla: emphasis on image quality and hepatocellular carcinoma detection

J Magn Reson Imaging. 2013 Aug;38(2):401-10. doi: 10.1002/jmri.23983. Epub 2013 Jan 4.

Abstract

Purpose: To compare the image quality between T1 high-resolution isotropic volume examination using the multi-echo Dixon technique (mDixon-eTHRIVE) and that using spectrally adiabatic inversion recovery (SPAIR-eTHRIVE) in gadoxetic acid-enhanced liver MRI, and to evaluate the detectability of hepatocellular carcinoma (HCC) on mDixon-eTHRIVE.

Materials and methods: Seventy patients with 117 HCCs underwent gadoxetic acid-enhanced liver MRI using mDixon-eTHRIVE. All patients also underwent gadoxetic acid-enhanced MRI using SPAIR-eTHRIVE (mean interval of 96 days). Two radiologists performed a consensus review of MRIs for image quality, homogeneity of fat suppression, artifact, and anatomic sharpness using a four-point scale. The detectability for HCC with mDixon-eTHRIVE was assessed using alternative-free response receiver operating characteristic.

Results: All mDixon-eTHRIVE images received higher scores for homogeneity of fat suppression and image quality (P < 0.05) compared with those for SPAIR-eTHRIVE. With respect to artifact and anatomic sharpness, there was no significant difference between two MRIs (P > 0.05). Diagnostic accuracy (Az) and sensitivity for detecting HCCs with mDixon-eTHRIVE images were mean 0.954 and 93.2%, respectively.

Conclusion: For gadoxetic acid-enhanced liver MRI, mDixon-eTHRIVE showed improved homogeneity of fat suppression and overall image quality compared with SPAIR-eTHRIVE.

Keywords: Dixon imaging; fat suppression; hepatocellular carcinoma; liver; magnetic resonance imaging.

MeSH terms

  • Adipose Tissue / pathology*
  • Adult
  • Aged
  • Algorithms
  • Carcinoma, Hepatocellular / pathology*
  • Contrast Media
  • Female
  • Gadolinium DTPA*
  • Humans
  • Image Enhancement / methods*
  • Image Interpretation, Computer-Assisted / methods*
  • Imaging, Three-Dimensional / methods*
  • Liver Neoplasms / pathology*
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Subtraction Technique

Substances

  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA