title: 3D T1 relaxometry pre and post gadoxetic acid injection for the assessment of liver cirrhosis and liver function.
abstract: OBJECTIVE
  To assess the diagnostic value of a 3D dual-flip-angle (DFA) T1 mapping technique with whole liver coverage before and after gadoxetic acid injection for assessment of cirrhosis and liver function, compared to blood tests (APRI: aspartate aminotransferase-to-platelet ratio index).
  
  
  METHODS
  A total of 133 patients who underwent gadoxetic acid-enhanced liver MRI including a 3D FLASH DFA-T1 mapping sequence before and 20min post-contrast (hepatobiliary phase, HBP) were included in this retrospective IRB approved study. T1 values (msec) were measured on pre-contrast and during HBP in liver parenchyma, ΔT1 (%) was calculated as [(T1 pre-T1 post)/T1 pre]×100. T1 and ΔT1 values were compared between cirrhotic and non-cirrhotic patients and between patients stratified using Child-Pugh and Model for End-Stage Liver Disease (MELD) scores using Mann-Whitney U test. Diagnostic performance of T1 mapping parameters vs. APRI for diagnosing cirrhosis and for assessing degree of liver dysfunction was evaluated using ROC analysis.
  
  
  RESULTS
  Fifty non-cirrhotic and 83 cirrhotic patients [Child-Pugh A (n=41), B (n=31) and C (n=11)] were included. There was no significant difference in pre-contrast T1 values between cirrhotic and non-cirrhotic patients. T1-HBP and ΔT1 values were significantly different in patients with cirrhosis (p<0.0001) and higher MELD scores (>17) (p=0.003). ΔT1 showed significant strong correlations with Child-Pugh and MELD scores (r=-0.7, p<0.0001; r=-0.56, p<0.001 respectively). Similar AUCs (p=0.9) for detection of liver cirrhosis were observed for T1 HBP (0.83), ΔT1 (0.86) and APRI (0.85); however APRI showed limited sensitivity (≤55%) in comparison with ΔT1 (74.7%) and T1 HBP (80.7%).
  
  
  CONCLUSIONS
  3D DFA-T1 mapping sequence used before and after gadoxetic acid injection is useful for the diagnosis of cirrhosis and for the assessment of liver function.
authors.affiliation: Department of Radiology, Body MRI, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029; Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029. Electronic address: cecilia.besacorrea@mountsinai.org.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Besa
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029.
authors.forename: Octavia
authors.initials: O
authors.lastname: Bane
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029.
authors.forename: Guido
authors.initials: G
authors.lastname: Jajamovich
authors.affiliation: Department of Radiology, Body MRI, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029.
authors.forename: Joseph
authors.initials: J
authors.lastname: Marchione
authors.affiliation: Department of Radiology, Body MRI, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029; Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029.
authors.forename: Bachir
authors.initials: B
authors.lastname: Taouli
mesh_terms: D019540:Area Under Curve; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008099:Liver / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Cirrhosis; Gadoxetic acid; Liver function; T1 mapping