Real-time MRI monitoring of transcatheter hepatic artery contrast agent delivery in rabbits

Kent T. Sato, Andrew C. Larson, Thomas K. Rhee, Riad A. Salem, Albert A. Nemcek, Taofic Mounajjed, Tatjana Paunesku, Gayle Woloschak, Paul Nikolaides, Reed A. Omary

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Rationale and Objectives. We sought to test the hypothesis that transcatheter hepatic artery delivery of dilute gadolinium (Gd) in rabbits can be monitored in real-time using magnetic resonance imaging (MRI). Materials and Methods. Catheters (2F) were inserted via a femoral access into the hepatic arteries of six New Zealand White rabbits under radiographic guidance. After transfer to a 1.5-T MRI scanner, 26 separate hepatic artery injections of 2 mL of 4% Gd and 14 sham injections were performed. Real-time imaging of all injections was acquired using two-dimensional projection inversion recovery-gradient echo. Films of these 40 injections, as well as 10 random repeats, were independently reviewed in a randomized, blinded fashion by two Certificate of Added Qualification-certified interventional radiologists. Observers reported (i) if Gd injection occurred and (ii) if so, the location of delivery. For each observer, we compared sensitivity/specificity for real-time visualization of contrast injection and accuracy of injection localization. Interobserver and intraobserver variability was assessed using the κ statistic. X-ray digital subtraction angiography was the gold standard for all MRI studies. Results. Both observers had a sensitivity of 100% and a specificity of 93%. Accuracy for intrahepatic contrast delivery was 77% for both observers. Accuracy for extrahepatic delivery was 92% and 96%, respectively. Both interobserver and intraobserver agreement was outstanding. Conclusions. In rabbits, MRI allows for accurate real-time monitoring of transcatheter hepatic artery delivery of contrast agent. Localization accuracy is higher outside the liver than within the liver. These results can be used as a baseline reference for comparing the accuracy of delivery of Gd-tagged therapies in the future.

Original languageEnglish (US)
Pages (from-to)1342-1350
Number of pages9
JournalAcademic Radiology
Volume12
Issue number10
DOIs
StatePublished - Oct 2005
Externally publishedYes

Fingerprint

Hepatic Artery
Contrast Media
Magnetic Resonance Imaging
Rabbits
Gadolinium
Injections
Digital Subtraction Angiography
Observer Variation
Liver
Thigh
Catheters
X-Rays
Sensitivity and Specificity

Keywords

  • HCC
  • Interventional MRI
  • MRA
  • VXZ

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Sato, K. T., Larson, A. C., Rhee, T. K., Salem, R. A., Nemcek, A. A., Mounajjed, T., ... Omary, R. A. (2005). Real-time MRI monitoring of transcatheter hepatic artery contrast agent delivery in rabbits. Academic Radiology, 12(10), 1342-1350. https://doi.org/10.1016/j.acra.2005.06.019

Real-time MRI monitoring of transcatheter hepatic artery contrast agent delivery in rabbits. / Sato, Kent T.; Larson, Andrew C.; Rhee, Thomas K.; Salem, Riad A.; Nemcek, Albert A.; Mounajjed, Taofic; Paunesku, Tatjana; Woloschak, Gayle; Nikolaides, Paul; Omary, Reed A.

In: Academic Radiology, Vol. 12, No. 10, 10.2005, p. 1342-1350.

Research output: Contribution to journalArticle

Sato, KT, Larson, AC, Rhee, TK, Salem, RA, Nemcek, AA, Mounajjed, T, Paunesku, T, Woloschak, G, Nikolaides, P & Omary, RA 2005, 'Real-time MRI monitoring of transcatheter hepatic artery contrast agent delivery in rabbits', Academic Radiology, vol. 12, no. 10, pp. 1342-1350. https://doi.org/10.1016/j.acra.2005.06.019
Sato, Kent T. ; Larson, Andrew C. ; Rhee, Thomas K. ; Salem, Riad A. ; Nemcek, Albert A. ; Mounajjed, Taofic ; Paunesku, Tatjana ; Woloschak, Gayle ; Nikolaides, Paul ; Omary, Reed A. / Real-time MRI monitoring of transcatheter hepatic artery contrast agent delivery in rabbits. In: Academic Radiology. 2005 ; Vol. 12, No. 10. pp. 1342-1350.
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abstract = "Rationale and Objectives. We sought to test the hypothesis that transcatheter hepatic artery delivery of dilute gadolinium (Gd) in rabbits can be monitored in real-time using magnetic resonance imaging (MRI). Materials and Methods. Catheters (2F) were inserted via a femoral access into the hepatic arteries of six New Zealand White rabbits under radiographic guidance. After transfer to a 1.5-T MRI scanner, 26 separate hepatic artery injections of 2 mL of 4{\%} Gd and 14 sham injections were performed. Real-time imaging of all injections was acquired using two-dimensional projection inversion recovery-gradient echo. Films of these 40 injections, as well as 10 random repeats, were independently reviewed in a randomized, blinded fashion by two Certificate of Added Qualification-certified interventional radiologists. Observers reported (i) if Gd injection occurred and (ii) if so, the location of delivery. For each observer, we compared sensitivity/specificity for real-time visualization of contrast injection and accuracy of injection localization. Interobserver and intraobserver variability was assessed using the κ statistic. X-ray digital subtraction angiography was the gold standard for all MRI studies. Results. Both observers had a sensitivity of 100{\%} and a specificity of 93{\%}. Accuracy for intrahepatic contrast delivery was 77{\%} for both observers. Accuracy for extrahepatic delivery was 92{\%} and 96{\%}, respectively. Both interobserver and intraobserver agreement was outstanding. Conclusions. In rabbits, MRI allows for accurate real-time monitoring of transcatheter hepatic artery delivery of contrast agent. Localization accuracy is higher outside the liver than within the liver. These results can be used as a baseline reference for comparing the accuracy of delivery of Gd-tagged therapies in the future.",
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AU - Larson, Andrew C.

AU - Rhee, Thomas K.

AU - Salem, Riad A.

AU - Nemcek, Albert A.

AU - Mounajjed, Taofic

AU - Paunesku, Tatjana

AU - Woloschak, Gayle

AU - Nikolaides, Paul

AU - Omary, Reed A.

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N2 - Rationale and Objectives. We sought to test the hypothesis that transcatheter hepatic artery delivery of dilute gadolinium (Gd) in rabbits can be monitored in real-time using magnetic resonance imaging (MRI). Materials and Methods. Catheters (2F) were inserted via a femoral access into the hepatic arteries of six New Zealand White rabbits under radiographic guidance. After transfer to a 1.5-T MRI scanner, 26 separate hepatic artery injections of 2 mL of 4% Gd and 14 sham injections were performed. Real-time imaging of all injections was acquired using two-dimensional projection inversion recovery-gradient echo. Films of these 40 injections, as well as 10 random repeats, were independently reviewed in a randomized, blinded fashion by two Certificate of Added Qualification-certified interventional radiologists. Observers reported (i) if Gd injection occurred and (ii) if so, the location of delivery. For each observer, we compared sensitivity/specificity for real-time visualization of contrast injection and accuracy of injection localization. Interobserver and intraobserver variability was assessed using the κ statistic. X-ray digital subtraction angiography was the gold standard for all MRI studies. Results. Both observers had a sensitivity of 100% and a specificity of 93%. Accuracy for intrahepatic contrast delivery was 77% for both observers. Accuracy for extrahepatic delivery was 92% and 96%, respectively. Both interobserver and intraobserver agreement was outstanding. Conclusions. In rabbits, MRI allows for accurate real-time monitoring of transcatheter hepatic artery delivery of contrast agent. Localization accuracy is higher outside the liver than within the liver. These results can be used as a baseline reference for comparing the accuracy of delivery of Gd-tagged therapies in the future.

AB - Rationale and Objectives. We sought to test the hypothesis that transcatheter hepatic artery delivery of dilute gadolinium (Gd) in rabbits can be monitored in real-time using magnetic resonance imaging (MRI). Materials and Methods. Catheters (2F) were inserted via a femoral access into the hepatic arteries of six New Zealand White rabbits under radiographic guidance. After transfer to a 1.5-T MRI scanner, 26 separate hepatic artery injections of 2 mL of 4% Gd and 14 sham injections were performed. Real-time imaging of all injections was acquired using two-dimensional projection inversion recovery-gradient echo. Films of these 40 injections, as well as 10 random repeats, were independently reviewed in a randomized, blinded fashion by two Certificate of Added Qualification-certified interventional radiologists. Observers reported (i) if Gd injection occurred and (ii) if so, the location of delivery. For each observer, we compared sensitivity/specificity for real-time visualization of contrast injection and accuracy of injection localization. Interobserver and intraobserver variability was assessed using the κ statistic. X-ray digital subtraction angiography was the gold standard for all MRI studies. Results. Both observers had a sensitivity of 100% and a specificity of 93%. Accuracy for intrahepatic contrast delivery was 77% for both observers. Accuracy for extrahepatic delivery was 92% and 96%, respectively. Both interobserver and intraobserver agreement was outstanding. Conclusions. In rabbits, MRI allows for accurate real-time monitoring of transcatheter hepatic artery delivery of contrast agent. Localization accuracy is higher outside the liver than within the liver. These results can be used as a baseline reference for comparing the accuracy of delivery of Gd-tagged therapies in the future.

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