title: Arterial Phase with CAIPIRINHA-Dixon-TWIST (CDT)-Volume-Interpolated Breath-Hold Examination (VIBE) in Detecting Hepatic Metastases.
abstract: OBJECTIVE
  To evaluate lesion enhancement performance of Multi-Arterial CAIPIRINHA-Dixon-TWIST-Volume-Interpolated Breath-Hold Examination (MA-CDT-VIBE) for the detection of hepatic metastases.
  
  
  METHODS
  Thirty-one patients with suspicious hepatic metastases were enrolled in this retrospective study. Two independent radiologists scored visualization of each lesion on a scale of 1 (poor visualization) to 11 (excellent visualization) on 11 sets of images. These included 6 hepatic arterial sub-phases acquired in one breath-hold, 1 series of the mean of 6 hepatic arterial sub-phases, 3 subtracted arterial sub-phases, and 1 portal venous phase. The phases with good (score 8-10) and excellent (score 11) lesion visualization were identified, and the number of lesions seen on each of these phases was compared to the number of lesions that was seen best on the equivalent-to-conventional single arterial phase as well as to those that were see best on the mean of 6 hepatic arterial sub-phases. Inter-reader agreement was also calculated.
  
  
  RESULTS
  The MA-CDT-VIBE was successfully acquired in 25 patients with hypervascular metastases (96 lesions) and 6 patients with hypovascular metastases (13 lesions). In case of hypervascular metastases, the 6th/6 arterial sub-phase had excellent lesion visualization (sore of 11) in 56 and 44 lesions for the 2 readers, respectively. Good lesion visualization (score of 8-10) was recorded in 5th/6 arterial subphases, in 81 and 67 lesions for the 2 readers, respectively. In case of hypovascular metastases, the portal venous phase had excellent lesion visualization (sore of 11) in all 13 lesions for the 2 readers. Good lesion visualization (score of 8-10) was recorded in 12 and 13 lesions on the 5th/6 and 6th/6 arterial subphases, respectively. More hypervascular lesions scored good (score of 8-10) and excellent (score of 11) on the 5th/6 and 6th/6 phases of MA-CDT-VIBE compared with the equivalent-to-conventional single arterial phase (3rd/6) and the set with mean of 6 hepatic arterial sub-phases. The results were statistically significant (t test, P<.0001). Inter-reader agreement was good for hypervascular lesions (kappa=0.627, P<.0001) and excellent for hypovascular lesions (kappa=1.0, P<.0001), respectively.
  
  
  CONCLUSIONS
  The MA-CDT-VIBE improves lesion conspicuity by providing a wide observation window for hypervascular lesions. For hypovascular lesions, the advantage of multiple arterial sub-phases over the portal venous phase is not apparent.
authors.affiliation: Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008. Electronic address: qjryq@126.com.
authors.forename: Jinrong
authors.initials: J
authors.lastname: Qu
authors.affiliation: Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
authors.forename: Shuai
authors.initials: S
authors.lastname: Han
authors.affiliation: Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
authors.forename: Hongkai
authors.initials: H
authors.lastname: Zhang
authors.affiliation: MR Collaboration, Siemens Healthcare, Shanghai, China, 201318.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
authors.forename: Zhaoqi
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA, 21205-2196.
authors.forename: Ihab R
authors.initials: IR
authors.lastname: Kamel
authors.affiliation: MR Pre-development, Siemens Healthcare, Erlangen, Germany, 91052.
authors.forename: Kiefer
authors.initials: K
authors.lastname: Berthold
authors.affiliation: MR Pre-development, Siemens Healthcare, Erlangen, Germany, 91052.
authors.forename: Nickel Marcel
authors.initials: NM
authors.lastname: Dominik
authors.affiliation: Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
authors.forename: Shouning
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
authors.forename: Yafeng
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
authors.forename: Lina
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
authors.forename: Cuicui
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008. Electronic address: doctorhnchr@126.com.
authors.forename: Hailiang
authors.initials: H
authors.lastname: Li