Tess Armstrong1,2, Karrie V Ly3, Smruthi Murthy3, Shahnaz Ghahremani1, Grace Hyun J Kim1, Kara L Calkins3, Holden H Wu4,5. 1. Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. 2. Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, CA, USA. 3. Department of Pediatrics, Division of Neonatology, David Geffen School of Medicine, University of California Los Angeles, Mattel Children's Hospital, Los Angeles, CA, USA. 4. Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. holdenwu@mednet.ucla.edu. 5. Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, CA, USA. holdenwu@mednet.ucla.edu.
Abstract
BACKGROUND: In adults, noninvasive chemical shift encoded Cartesian magnetic resonance imaging (MRI) and single-voxel magnetic resonance (MR) spectroscopy (SVS) accurately quantify hepatic steatosis but require breath-holding. In children, especially young and sick children, breath-holding is often limited or not feasible. Sedation can facilitate breath-holding but is highly undesirable. For these reasons, there is a need to develop free-breathing MRI technology that accurately quantifies steatosis in all children. OBJECTIVE: This study aimed to compare non-sedated free-breathing multi-echo 3-D stack-of-radial (radial) MRI versus standard breath-holding MRI and SVS techniques in a group of children for fat quantification with respect to image quality, accuracy and repeatability. MATERIALS AND METHODS: Healthy children (n=10, median age [±interquartile range]: 10.9 [±3.3] years) and overweight children with nonalcoholic fatty liver disease (NAFLD) (n=9, median age: 15.2 [±3.2] years) were imaged at 3 Tesla using free-breathing radial MRI, breath-holding Cartesian MRI and breath-holding SVS. Acquisitions were performed twice to assess repeatability (within-subject mean difference, MDwithin). Images and hepatic proton-density fat fraction (PDFF) maps were scored for image quality. Free-breathing and breath-holding PDFF were compared using linear regression (correlation coefficient, r and concordance correlation coefficient, ρc) and Bland-Altman analysis (mean difference). P<0.05 was considered significant. RESULTS: In patients with NAFLD, free-breathing radial MRI demonstrated significantly less motion artifacts compared to breath-holding Cartesian (P<0.05). Free-breathing radial PDFF demonstrated a linear relationship (P<0.001) versus breath-holding SVS PDFF and breath-holding Cartesian PDFF with r=0.996 and ρc=0.994, and r=0.997 and ρc=0.995, respectively. The mean difference in PDFF between free-breathing radial MRI, breath-holding Cartesian MRI and breath-holding SVS was <0.7%. Repeated free-breathing radial MRI had MDwithin=0.25% for PDFF. CONCLUSION: In this pediatric study, non-sedated free-breathing radial MRI provided accurate and repeatable hepatic PDFF measurements and improved image quality, compared to standard breath-holding MR techniques.
BACKGROUND: In adults, noninvasive chemical shift encoded Cartesian magnetic resonance imaging (MRI) and single-voxel magnetic resonance (MR) spectroscopy (SVS) accurately quantify hepatic steatosis but require breath-holding. In children, especially young and sick children, breath-holding is often limited or not feasible. Sedation can facilitate breath-holding but is highly undesirable. For these reasons, there is a need to develop free-breathing MRI technology that accurately quantifies steatosis in all children. OBJECTIVE: This study aimed to compare non-sedated free-breathing multi-echo 3-D stack-of-radial (radial) MRI versus standard breath-holding MRI and SVS techniques in a group of children for fat quantification with respect to image quality, accuracy and repeatability. MATERIALS AND METHODS: Healthy children (n=10, median age [±interquartile range]: 10.9 [±3.3] years) and overweight children with nonalcoholic fatty liver disease (NAFLD) (n=9, median age: 15.2 [±3.2] years) were imaged at 3 Tesla using free-breathing radial MRI, breath-holding Cartesian MRI and breath-holding SVS. Acquisitions were performed twice to assess repeatability (within-subject mean difference, MDwithin). Images and hepatic proton-density fat fraction (PDFF) maps were scored for image quality. Free-breathing and breath-holding PDFF were compared using linear regression (correlation coefficient, r and concordance correlation coefficient, ρc) and Bland-Altman analysis (mean difference). P<0.05 was considered significant. RESULTS: In patients with NAFLD, free-breathing radial MRI demonstrated significantly less motion artifacts compared to breath-holding Cartesian (P<0.05). Free-breathing radial PDFF demonstrated a linear relationship (P<0.001) versus breath-holding SVS PDFF and breath-holding Cartesian PDFF with r=0.996 and ρc=0.994, and r=0.997 and ρc=0.995, respectively. The mean difference in PDFF between free-breathing radial MRI, breath-holding Cartesian MRI and breath-holding SVS was <0.7%. Repeated free-breathing radial MRI had MDwithin=0.25% for PDFF. CONCLUSION: In this pediatric study, non-sedated free-breathing radial MRI provided accurate and repeatable hepatic PDFF measurements and improved image quality, compared to standard breath-holding MR techniques.
Authors: C Malamateniou; S J Malik; S J Counsell; J M Allsop; A K McGuinness; T Hayat; K Broadhouse; R G Nunes; A M Ederies; J V Hajnal; M A Rutherford Journal: AJNR Am J Neuroradiol Date: 2012-05-10 Impact factor: 3.825
Authors: Takeshi Yokoo; Masoud Shiehmorteza; Gavin Hamilton; Tanya Wolfson; Michael E Schroeder; Michael S Middleton; Mark Bydder; Anthony C Gamst; Yuko Kono; Alexander Kuo; Heather M Patton; Santiago Horgan; Joel E Lavine; Jeffrey B Schwimmer; Claude B Sirlin Journal: Radiology Date: 2011-01-06 Impact factor: 11.105
Authors: Sevgi Gokce Kafali; Tess Armstrong; Shu-Fu Shih; Grace J Kim; Joseph L Holtrop; Robert S Venick; Shahnaz Ghahremani; Bradley D Bolster; Claudia M Hillenbrand; Kara L Calkins; Holden H Wu Journal: Pediatr Radiol Date: 2022-04-02