Application of modifed spinecho-based sequences for hepatic MR elastography: Evaluation, comparison with the conventional gradient-echo sequence, and preliminary clinical experience

Yogesh K. Mariappan, Bogdan Dzyubak, Kevin J. Glaser, Sudhakar K Venkatesh, Claude B. Sirlin, Jonathan Hooker, Kiaran Patrick McGee, Richard Lorne Ehman

Research output: Contribution to journalArticle

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Abstract

Purpose: To (a) evaluate modifed spin-echo (SE) magnetic resonance (MR) elastographic sequences for acquiring MR images with improved signal-to-noise ratio (SNR) in patients in whom the standard gradient-echo (GRE) MR elastographic sequence yields low hepatic signal intensity and (b) compare the stiffness values obtained with these sequences with those obtained with the conventional GRE sequence. Materials and Methods: This HIPAA-compliant retrospective study was approved by the institutional review board; the requirement to obtain informed consent was waived. Data obtained with modifed SE and SE echo-planar imaging (EPI) MR elastographic pulse sequences with short echo times were compared with those obtained with the conventional GRE MR elastographic sequence in two patient cohorts, one that exhibited adequate liver signal intensity and one that exhibited low liver signal intensity. Shear stiffness values obtained with the three sequences in 130 patients with successful GRE-based examinations were retrospectively tested for statistical equivalence by using a 5% margin. In 47 patients in whom GRE examinations were considered to have failed because of low SNR, the SNR and confdence level with the SE-based sequences were compared with those with the GRE sequence. Results: The results of this study helped confrm the equivalence of SE MR elastography and SE-EPI MR elastography to GRE MR elastography (P =.0212 and P =.0001, respectively). The SE and SE-EPI MR elastographic sequences provided substantially improved SNR and stiffness inversion confdence level in 47 patients in whom GRE MR elastography had failed. Conclusion: Modifed SE-based MR elastographic sequences provide higher SNR MR elastographic data and reliable stiffness measurements; thus, they enable quantifcation of stiffness in patients in whom the conventional GRE MR elastographic sequence failed owing to low signal intensity. The equivalence of the three sequences indicates that the current diagnostic thresholds are applicable to SE MR elastographic sequences for assessing liver fbrosis.

Original languageEnglish (US)
Pages (from-to)390-398
Number of pages9
JournalRadiology
Volume282
Issue number2
DOIs
StatePublished - Mar 1 2017

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Elasticity Imaging Techniques
Magnetic Resonance Spectroscopy
Signal-To-Noise Ratio
Liver
Echo-Planar Imaging
Health Insurance Portability and Accountability Act
Research Ethics Committees
Informed Consent
Retrospective Studies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Application of modifed spinecho-based sequences for hepatic MR elastography : Evaluation, comparison with the conventional gradient-echo sequence, and preliminary clinical experience. / Mariappan, Yogesh K.; Dzyubak, Bogdan; Glaser, Kevin J.; Venkatesh, Sudhakar K; Sirlin, Claude B.; Hooker, Jonathan; McGee, Kiaran Patrick; Ehman, Richard Lorne.

In: Radiology, Vol. 282, No. 2, 01.03.2017, p. 390-398.

Research output: Contribution to journalArticle

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abstract = "Purpose: To (a) evaluate modifed spin-echo (SE) magnetic resonance (MR) elastographic sequences for acquiring MR images with improved signal-to-noise ratio (SNR) in patients in whom the standard gradient-echo (GRE) MR elastographic sequence yields low hepatic signal intensity and (b) compare the stiffness values obtained with these sequences with those obtained with the conventional GRE sequence. Materials and Methods: This HIPAA-compliant retrospective study was approved by the institutional review board; the requirement to obtain informed consent was waived. Data obtained with modifed SE and SE echo-planar imaging (EPI) MR elastographic pulse sequences with short echo times were compared with those obtained with the conventional GRE MR elastographic sequence in two patient cohorts, one that exhibited adequate liver signal intensity and one that exhibited low liver signal intensity. Shear stiffness values obtained with the three sequences in 130 patients with successful GRE-based examinations were retrospectively tested for statistical equivalence by using a 5{\%} margin. In 47 patients in whom GRE examinations were considered to have failed because of low SNR, the SNR and confdence level with the SE-based sequences were compared with those with the GRE sequence. Results: The results of this study helped confrm the equivalence of SE MR elastography and SE-EPI MR elastography to GRE MR elastography (P =.0212 and P =.0001, respectively). The SE and SE-EPI MR elastographic sequences provided substantially improved SNR and stiffness inversion confdence level in 47 patients in whom GRE MR elastography had failed. Conclusion: Modifed SE-based MR elastographic sequences provide higher SNR MR elastographic data and reliable stiffness measurements; thus, they enable quantifcation of stiffness in patients in whom the conventional GRE MR elastographic sequence failed owing to low signal intensity. The equivalence of the three sequences indicates that the current diagnostic thresholds are applicable to SE MR elastographic sequences for assessing liver fbrosis.",
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AU - Mariappan, Yogesh K.

AU - Dzyubak, Bogdan

AU - Glaser, Kevin J.

AU - Venkatesh, Sudhakar K

AU - Sirlin, Claude B.

AU - Hooker, Jonathan

AU - McGee, Kiaran Patrick

AU - Ehman, Richard Lorne

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AB - Purpose: To (a) evaluate modifed spin-echo (SE) magnetic resonance (MR) elastographic sequences for acquiring MR images with improved signal-to-noise ratio (SNR) in patients in whom the standard gradient-echo (GRE) MR elastographic sequence yields low hepatic signal intensity and (b) compare the stiffness values obtained with these sequences with those obtained with the conventional GRE sequence. Materials and Methods: This HIPAA-compliant retrospective study was approved by the institutional review board; the requirement to obtain informed consent was waived. Data obtained with modifed SE and SE echo-planar imaging (EPI) MR elastographic pulse sequences with short echo times were compared with those obtained with the conventional GRE MR elastographic sequence in two patient cohorts, one that exhibited adequate liver signal intensity and one that exhibited low liver signal intensity. Shear stiffness values obtained with the three sequences in 130 patients with successful GRE-based examinations were retrospectively tested for statistical equivalence by using a 5% margin. In 47 patients in whom GRE examinations were considered to have failed because of low SNR, the SNR and confdence level with the SE-based sequences were compared with those with the GRE sequence. Results: The results of this study helped confrm the equivalence of SE MR elastography and SE-EPI MR elastography to GRE MR elastography (P =.0212 and P =.0001, respectively). The SE and SE-EPI MR elastographic sequences provided substantially improved SNR and stiffness inversion confdence level in 47 patients in whom GRE MR elastography had failed. Conclusion: Modifed SE-based MR elastographic sequences provide higher SNR MR elastographic data and reliable stiffness measurements; thus, they enable quantifcation of stiffness in patients in whom the conventional GRE MR elastographic sequence failed owing to low signal intensity. The equivalence of the three sequences indicates that the current diagnostic thresholds are applicable to SE MR elastographic sequences for assessing liver fbrosis.

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