title: Quantitative BOLD imaging at 3T: Temporal changes in hepatocellular carcinoma and fibrosis following oxygen challenge.
abstract: To evaluate the utility of oxygen challenge and report on temporal changes in blood oxygenation level-dependent (BOLD) contrast in normal liver, hepatocellular carcinoma (HCC) and background fibrosis.
  
  
  
  Eleven volunteers (nine male and two female, mean age 33.5, range 27-41 years) and 10 patients (nine male and one female, mean age 68.9, range 56-87 years) with hepatocellular carcinoma on a background of diffuse liver disease were recruited. Imaging was performed on a 3T system using a multiphase, multiecho, fast gradient echo sequence. Oxygen was administered via a Hudson mask after 2 minutes of free-breathing. Paired t-tests were performed to determine if the mean pre- and post-O2 differences were statistically significant.
  
  
  
  In patients with liver fibrosis (n = 8) the change in T2* following O2 administration was elevated (0.88 ± 0.582 msec, range 0.03-1.69 msec) and the difference was significant (P = 0.004). The magnitude of the BOLD response in patients with HCC (n = 10) was larger, however the response was more variable (1.07 ± 1.458 msec, range -0.93-3.26 msec), and the difference was borderline significant (P = 0.046). The BOLD response in the volunteer cohort was not significant (P = 0.121, 0.59 ± 1.162 msec, range -0.81-2.44 msec).
  
  
  
  This work demonstrates that the BOLD response following oxygen challenge within cirrhotic liver is consistent with a breakdown in vascular autoregulatory mechanisms. Similarly, the elevated BOLD response within HCC is consistent with the abnormal capillary vasculature within tumors and the arterialization of the blood supply. Our results suggest that oxygen challenge may prove a viable BOLD contrast mechanism in the liver. J. Magn. Reson. Imaging 2016;44:739-744.
authors.affiliation: Department of Radiology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Patterson
authors.affiliation: Department of Radiology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Priest
authors.affiliation: Department of Radiology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Bowden
authors.affiliation: Department of Radiology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
authors.forename: Tess E
authors.initials: TE
authors.lastname: Wallace
authors.affiliation: Department of Radiology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
authors.forename: Ilse
authors.initials: I
authors.lastname: Patterson
authors.affiliation: Department of Radiology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Graves
authors.affiliation: Department of Radiology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lomas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000378:metabolism*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D010101:Oxygen Consumption; D012079:Renal Circulation; D013997:Time Factors; D000072258:Tumor Hypoxia; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: BOLD; fibrosis; hepatocellular carcinoma; liver