Cecilia Besa1, Octavia Bane2, Guido Jajamovich2, Joseph Marchione3, Bachir Taouli4. 1. Department of Radiology, Body MRI, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029; Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029. Electronic address: cecilia.besacorrea@mountsinai.org. 2. Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029. 3. Department of Radiology, Body MRI, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029. 4. Department of Radiology, Body MRI, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029; Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029.
Abstract
PURPOSE: To assess the diagnostic value of a 3D dual-flip-angle (DFA) T1 mapping technique with whole liver coverage before and after gadoxetic acid injection for assessment of cirrhosis and liver function, compared to blood tests (APRI: aspartate aminotransferase-to-platelet ratio index). MATERIALS AND METHODS: A total of 133 patients who underwent gadoxetic acid-enhanced liver MRI including a 3D FLASH DFA-T1 mapping sequence before and 20min post-contrast (hepatobiliary phase, HBP) were included in this retrospective IRB approved study. T1 values (msec) were measured on pre-contrast and during HBP in liver parenchyma, ΔT1 (%) was calculated as [(T1 pre-T1 post)/T1 pre]×100. T1 and ΔT1 values were compared between cirrhotic and non-cirrhotic patients and between patients stratified using Child-Pugh and Model for End-Stage Liver Disease (MELD) scores using Mann-Whitney U test. Diagnostic performance of T1 mapping parameters vs. APRI for diagnosing cirrhosis and for assessing degree of liver dysfunction was evaluated using ROC analysis. RESULTS: Fifty non-cirrhotic and 83 cirrhotic patients [Child-Pugh A (n=41), B (n=31) and C (n=11)] were included. There was no significant difference in pre-contrast T1 values between cirrhotic and non-cirrhotic patients. T1-HBP and ΔT1 values were significantly different in patients with cirrhosis (p<0.0001) and higher MELD scores (>17) (p=0.003). ΔT1 showed significant strong correlations with Child-Pugh and MELD scores (r=-0.7, p<0.0001; r=-0.56, p<0.001 respectively). Similar AUCs (p=0.9) for detection of liver cirrhosis were observed for T1 HBP (0.83), ΔT1 (0.86) and APRI (0.85); however APRI showed limited sensitivity (≤55%) in comparison with ΔT1 (74.7%) and T1 HBP (80.7%). CONCLUSION: 3D DFA-T1 mapping sequence used before and after gadoxetic acid injection is useful for the diagnosis of cirrhosis and for the assessment of liver function.
PURPOSE: To assess the diagnostic value of a 3D dual-flip-angle (DFA) T1 mapping technique with whole liver coverage before and after gadoxetic acid injection for assessment of cirrhosis and liver function, compared to blood tests (APRI: aspartate aminotransferase-to-platelet ratio index). MATERIALS AND METHODS: A total of 133 patients who underwent gadoxetic acid-enhanced liver MRI including a 3D FLASH DFA-T1 mapping sequence before and 20min post-contrast (hepatobiliary phase, HBP) were included in this retrospective IRB approved study. T1 values (msec) were measured on pre-contrast and during HBP in liver parenchyma, ΔT1 (%) was calculated as [(T1 pre-T1 post)/T1 pre]×100. T1 and ΔT1 values were compared between cirrhotic and non-cirrhotic patients and between patients stratified using Child-Pugh and Model for End-Stage Liver Disease (MELD) scores using Mann-Whitney U test. Diagnostic performance of T1 mapping parameters vs. APRI for diagnosing cirrhosis and for assessing degree of liver dysfunction was evaluated using ROC analysis. RESULTS: Fifty non-cirrhotic and 83 cirrhotic patients [Child-Pugh A (n=41), B (n=31) and C (n=11)] were included. There was no significant difference in pre-contrast T1 values between cirrhotic and non-cirrhotic patients. T1-HBP and ΔT1 values were significantly different in patients with cirrhosis (p<0.0001) and higher MELD scores (>17) (p=0.003). ΔT1 showed significant strong correlations with Child-Pugh and MELD scores (r=-0.7, p<0.0001; r=-0.56, p<0.001 respectively). Similar AUCs (p=0.9) for detection of liver cirrhosis were observed for T1 HBP (0.83), ΔT1 (0.86) and APRI (0.85); however APRI showed limited sensitivity (≤55%) in comparison with ΔT1 (74.7%) and T1 HBP (80.7%). CONCLUSION: 3D DFA-T1 mapping sequence used before and after gadoxetic acid injection is useful for the diagnosis of cirrhosis and for the assessment of liver function.
Authors: Jeanne M Horowitz; Sudhakar K Venkatesh; Richard L Ehman; Kartik Jhaveri; Patrick Kamath; Michael A Ohliger; Anthony E Samir; Alvin C Silva; Bachir Taouli; Michael S Torbenson; Michael L Wells; Benjamin Yeh; Frank H Miller Journal: Abdom Radiol (NY) Date: 2017-08
Authors: Octavia Bane; Stefanie J Hectors; Mathilde Wagner; Lori L Arlinghaus; Madhava P Aryal; Yue Cao; Thomas L Chenevert; Fiona Fennessy; Wei Huang; Nola M Hylton; Jayashree Kalpathy-Cramer; Kathryn E Keenan; Dariya I Malyarenko; Robert V Mulkern; David C Newitt; Stephen E Russek; Karl F Stupic; Alina Tudorica; Lisa J Wilmes; Thomas E Yankeelov; Yi-Fei Yen; Michael A Boss; Bachir Taouli Journal: Magn Reson Med Date: 2017-09-14 Impact factor: 4.668