Magnetic Resonance Elastography of Liver: Influence of Intravenous Gadolinium Administration on Measured Liver Stiffness

James Thomas Patrick Decourcy Hallinan, Hind Saif Alsaif, Aileen Wee, Sudhakar K Venkatesh

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: To evaluate the effect of intravenous gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA) on estimation of liver stiffness using magnetic resonance elastography (MRE) for detection of liver fibrosis. Materials and methods: Liver MRI with MRE was performed in 210 subjects on a single 1.5 Tesla clinical MRI scanner. Liver MRE was performed before intravenous Gd-DTPA injection (NC-MRE) and 5 minutes post injection (PC-MRE) using a modified phase-contrast gradient-echo sequence (TR/TE=100/27ms, FOV=30-46cm, 4x10mm slices, gap 5mm) which automatically generated stiffness maps. Two readers’ blinded to clinical details independently performed liver stiffness measurements (LSM) by drawing 2 or more regions of interest (ROI) on the stiffness maps on each of the four slices of NC-MRE and PC-MRE obtained for each patient. The mean LSM in kilopascals (kPa) for NC-MRE and PC-MRE was calculated. The correlation between NC-MRE and PC-MRE LSM was evaluated with a paired t test and Pearson’s correlation analysis, and the inter-observer correlation was evaluated using intra class coefficient (ICC) analysis. A receiver operating curve analysis (ROC) was performed to compare accuracies for detection and staging of liver fibrosis in a subgroup of 72 subjects with histological confirmation of liver fibrosis. Results: There was an excellent correlation between NC-MRE and PC-MRE LSM (R<sup>2</sup>=0.98, p<0.001) with no significant differences. The interobserver agreement was also excellent (ICC, 0.94-0.99). There were no significant differences in the cut-off LSM value/accuracy/sensitivity/specificity for detection of significant liver fibrosis with NC-MRE and PC-MRE (2.98kPa/98.5%/100%/88%, p<0.001 and 3.1kPa/98.2%/98%/88%, p<0.001 respectively). Conclusion: Intravenous Gd-DTPA had no significant influence on LSM with MRE and does not significantly affect the diagnostic performance of MRE for fibrosis detection.

Original languageEnglish (US)
Pages (from-to)783-788
Number of pages6
JournalAbdominal Imaging
Volume40
Issue number4
DOIs
StatePublished - Oct 21 2014

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Elasticity Imaging Techniques
Gadolinium
Intravenous Administration
Liver
Liver Cirrhosis
Rubiaceae
Acetic Acid
Injections

Keywords

  • Intravenous Gd-DTPA
  • Liver fibrosis
  • Liver stiffness
  • Magnetic resonance elastography

ASJC Scopus subject areas

  • Gastroenterology
  • Urology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Magnetic Resonance Elastography of Liver : Influence of Intravenous Gadolinium Administration on Measured Liver Stiffness. / Hallinan, James Thomas Patrick Decourcy; Alsaif, Hind Saif; Wee, Aileen; Venkatesh, Sudhakar K.

In: Abdominal Imaging, Vol. 40, No. 4, 21.10.2014, p. 783-788.

Research output: Contribution to journalArticle

Hallinan, James Thomas Patrick Decourcy ; Alsaif, Hind Saif ; Wee, Aileen ; Venkatesh, Sudhakar K. / Magnetic Resonance Elastography of Liver : Influence of Intravenous Gadolinium Administration on Measured Liver Stiffness. In: Abdominal Imaging. 2014 ; Vol. 40, No. 4. pp. 783-788.
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title = "Magnetic Resonance Elastography of Liver: Influence of Intravenous Gadolinium Administration on Measured Liver Stiffness",
abstract = "Purpose: To evaluate the effect of intravenous gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA) on estimation of liver stiffness using magnetic resonance elastography (MRE) for detection of liver fibrosis. Materials and methods: Liver MRI with MRE was performed in 210 subjects on a single 1.5 Tesla clinical MRI scanner. Liver MRE was performed before intravenous Gd-DTPA injection (NC-MRE) and 5 minutes post injection (PC-MRE) using a modified phase-contrast gradient-echo sequence (TR/TE=100/27ms, FOV=30-46cm, 4x10mm slices, gap 5mm) which automatically generated stiffness maps. Two readers’ blinded to clinical details independently performed liver stiffness measurements (LSM) by drawing 2 or more regions of interest (ROI) on the stiffness maps on each of the four slices of NC-MRE and PC-MRE obtained for each patient. The mean LSM in kilopascals (kPa) for NC-MRE and PC-MRE was calculated. The correlation between NC-MRE and PC-MRE LSM was evaluated with a paired t test and Pearson’s correlation analysis, and the inter-observer correlation was evaluated using intra class coefficient (ICC) analysis. A receiver operating curve analysis (ROC) was performed to compare accuracies for detection and staging of liver fibrosis in a subgroup of 72 subjects with histological confirmation of liver fibrosis. Results: There was an excellent correlation between NC-MRE and PC-MRE LSM (R2=0.98, p<0.001) with no significant differences. The interobserver agreement was also excellent (ICC, 0.94-0.99). There were no significant differences in the cut-off LSM value/accuracy/sensitivity/specificity for detection of significant liver fibrosis with NC-MRE and PC-MRE (2.98kPa/98.5{\%}/100{\%}/88{\%}, p<0.001 and 3.1kPa/98.2{\%}/98{\%}/88{\%}, p<0.001 respectively). Conclusion: Intravenous Gd-DTPA had no significant influence on LSM with MRE and does not significantly affect the diagnostic performance of MRE for fibrosis detection.",
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T2 - Influence of Intravenous Gadolinium Administration on Measured Liver Stiffness

AU - Hallinan, James Thomas Patrick Decourcy

AU - Alsaif, Hind Saif

AU - Wee, Aileen

AU - Venkatesh, Sudhakar K

PY - 2014/10/21

Y1 - 2014/10/21

N2 - Purpose: To evaluate the effect of intravenous gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA) on estimation of liver stiffness using magnetic resonance elastography (MRE) for detection of liver fibrosis. Materials and methods: Liver MRI with MRE was performed in 210 subjects on a single 1.5 Tesla clinical MRI scanner. Liver MRE was performed before intravenous Gd-DTPA injection (NC-MRE) and 5 minutes post injection (PC-MRE) using a modified phase-contrast gradient-echo sequence (TR/TE=100/27ms, FOV=30-46cm, 4x10mm slices, gap 5mm) which automatically generated stiffness maps. Two readers’ blinded to clinical details independently performed liver stiffness measurements (LSM) by drawing 2 or more regions of interest (ROI) on the stiffness maps on each of the four slices of NC-MRE and PC-MRE obtained for each patient. The mean LSM in kilopascals (kPa) for NC-MRE and PC-MRE was calculated. The correlation between NC-MRE and PC-MRE LSM was evaluated with a paired t test and Pearson’s correlation analysis, and the inter-observer correlation was evaluated using intra class coefficient (ICC) analysis. A receiver operating curve analysis (ROC) was performed to compare accuracies for detection and staging of liver fibrosis in a subgroup of 72 subjects with histological confirmation of liver fibrosis. Results: There was an excellent correlation between NC-MRE and PC-MRE LSM (R2=0.98, p<0.001) with no significant differences. The interobserver agreement was also excellent (ICC, 0.94-0.99). There were no significant differences in the cut-off LSM value/accuracy/sensitivity/specificity for detection of significant liver fibrosis with NC-MRE and PC-MRE (2.98kPa/98.5%/100%/88%, p<0.001 and 3.1kPa/98.2%/98%/88%, p<0.001 respectively). Conclusion: Intravenous Gd-DTPA had no significant influence on LSM with MRE and does not significantly affect the diagnostic performance of MRE for fibrosis detection.

AB - Purpose: To evaluate the effect of intravenous gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA) on estimation of liver stiffness using magnetic resonance elastography (MRE) for detection of liver fibrosis. Materials and methods: Liver MRI with MRE was performed in 210 subjects on a single 1.5 Tesla clinical MRI scanner. Liver MRE was performed before intravenous Gd-DTPA injection (NC-MRE) and 5 minutes post injection (PC-MRE) using a modified phase-contrast gradient-echo sequence (TR/TE=100/27ms, FOV=30-46cm, 4x10mm slices, gap 5mm) which automatically generated stiffness maps. Two readers’ blinded to clinical details independently performed liver stiffness measurements (LSM) by drawing 2 or more regions of interest (ROI) on the stiffness maps on each of the four slices of NC-MRE and PC-MRE obtained for each patient. The mean LSM in kilopascals (kPa) for NC-MRE and PC-MRE was calculated. The correlation between NC-MRE and PC-MRE LSM was evaluated with a paired t test and Pearson’s correlation analysis, and the inter-observer correlation was evaluated using intra class coefficient (ICC) analysis. A receiver operating curve analysis (ROC) was performed to compare accuracies for detection and staging of liver fibrosis in a subgroup of 72 subjects with histological confirmation of liver fibrosis. Results: There was an excellent correlation between NC-MRE and PC-MRE LSM (R2=0.98, p<0.001) with no significant differences. The interobserver agreement was also excellent (ICC, 0.94-0.99). There were no significant differences in the cut-off LSM value/accuracy/sensitivity/specificity for detection of significant liver fibrosis with NC-MRE and PC-MRE (2.98kPa/98.5%/100%/88%, p<0.001 and 3.1kPa/98.2%/98%/88%, p<0.001 respectively). Conclusion: Intravenous Gd-DTPA had no significant influence on LSM with MRE and does not significantly affect the diagnostic performance of MRE for fibrosis detection.

KW - Intravenous Gd-DTPA

KW - Liver fibrosis

KW - Liver stiffness

KW - Magnetic resonance elastography

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