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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.

  • Author(s): 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
  • Sirlin, Claude B
  • et al.

Published Web Location

https://link.springer.com/content/pdf/10.1007/s00261-016-0992-4.pdf
No data is associated with this publication.
Abstract

PURPOSE:The 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 METHODS:Thirty-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 <10%. Regression parameters were compared (Bonferroni-adjusted bootstrap-based tests). RESULTS:Three of the four MRI-M sequences (pre-Gx low-FA, post-Gx low-FA, post-Gx high-FA) provided relatively unbiased PDFF estimates overall and in the low-PDFF range, with regression slopes close to 1 and intercepts and biases close to zero. Pre-Gx high-FA MRI overestimated PDFF in proportion to MRS-PDFF, with slopes of 0.72 (overall) and 0.63 (low-PDFF range). Based on regression bias closest to 0, the post-Gx high-FA sequence was the most accurate overall and in the low-PDFF range. This sequence provided statistically significant improvements in at least two regression parameters compared to every other sequence. CONCLUSION:In patients undergoing Gx-enhanced MR exams, PDFF estimation accuracy of MRI-M can be improved by using high-FA on post-contrast images.

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