title: Contrast-enhanced free-breathing 3D T1-weighted gradient-echo sequence for hepatobiliary MRI in patients with breath-holding difficulties.
abstract: OBJECTIVE
  Evaluate the image quality and diagnostic performance of a free-breathing 3D-gradient-echo sequence with radial acquisition (rGRE) compared with a Cartesian breath-hold 3D-GRE (cGRE) sequence on hepatobiliary phase MRI in patients with breath-holding difficulties.
  
  
  METHODS
  Twenty-eight consecutive patients (15 males; mean age 61 ± 11.9 years) were analysed in this retrospective IRB-approved study. Breath-holding difficulties during gadoxetate-disodium-enhanced liver MRI manifested as breathing artefacts during dynamic-phase imaging. MRI included axial and coronal cGRE and a radially sampled rGRE sequence during the hepatobiliary phase. Two radiologists independently evaluated cGRE and rGRE images for image quality, liver lesion detection and conspicuity, and bile duct conspicuity on a four-point scale.
  
  
  RESULTS
  Liver edge sharpness was significantly higher on rGRE images (P < 0.001). Overall image quality was slightly but significantly higher for rGRE than for cGRE (P < 0.001 and P = 0.039). Bile duct conspicuity scores of rGRE and cGRE were not significantly different. Sensitivity for detection of the 26 liver lesions was similar for rGRE and cGRE (81-77 % and 73-77 %, P = 0.5 and 1.0). Lesion conspicuity scores were significantly higher for rGRE for one reader (P = 0.012).
  
  
  CONCLUSIONS
  In patients with breath-holding difficulties, overall image quality and liver lesion conspicuity on hepatobiliary phase MRI can be improved using the rGRE sequence.
  
  
  CONCLUSIONS
  • Patients with diminished breath-holding capacities present a major challenge in abdominal MRI. • A free-breathing sequence for hepatobiliary-phase MRI can improve image quality. • Further advances are needed to reduce acquisition time of the free-breathing gradient-echo sequence.
authors.affiliation: Department of Radiology, Duke University Medical Center, Duke North - Room 1417, Erwin Road, Durham, NC, 27710, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Reiner
authors.forename: A M
authors.initials: AM
authors.lastname: Neville
authors.forename: H K
authors.initials: HK
authors.lastname: Nazeer
authors.forename: S
authors.initials: S
authors.lastname: Breault
authors.forename: B M
authors.initials: BM
authors.lastname: Dale
authors.forename: E M
authors.initials: EM
authors.lastname: Merkle
authors.forename: M R
authors.initials: MR
authors.lastname: Bashir
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D001660:Biliary Tract Diseases / Q000175:diagnosis*; D062485:Breath Holding; D003287:Contrast Media; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional; D008107:Liver Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA