title: Effect of Gadoxetate Disodium on Arterial Phase Respiratory Waveforms Using a Quantitative Fast Fourier Transformation-Based Analysis.
abstract: OBJECTIVE
  The purpose of this study is to investigate the effect of gadoxetate disodium administration on arterial phase respiratory waveforms.
  
  
  METHODS
  From 2013 to 2015, 107 subjects undergoing liver MRI with either gadoxetate disodium (10 mL diluted 1:1 with saline; injection rate, 2 mL/s; n = 40) or gadobenate dimeglumine (0.2 mL/kg; maximum, 20 mL; injection rate, 2 mL/s; n = 67) were enrolled. Respiratory waveforms obtained during unenhanced and dynamic contrast-enhanced phases were filtered by a physicist, who was blinded to contrast agent and imaging phase, to eliminate electronic and cardiac noise using fast Fourier transformation. The average root-mean-square difference of two intrasubject control phases (unenhanced and late dynamic) was termed D1, and the root-mean-square deviation of the arterial phase referent to the control record mean was termed D2. D1, D2, and their difference were compared across agents with the Mann-Whitney U test. Bland-Altman plots were generated for D1 and D2 values.
  
  
  RESULTS
  D1 values were similar for both agents (mean [± SD], 232 ± 203 for gadoxetate vs 201 ± 230 for gadobenate; p = 0.48), indicating similar intercohort baseline breath-holding capability. D2 was greater and more variable for the gadoxetate cohort (438 ± 381) than for the gadobenate cohort (167 ± 167; p < 0.001), indicating larger and more unpredictable respiratory waveform deviations isolated to the arterial phase (subject-level rate, 48% [19/40] for gadoxetate vs 1% [1/67] for gadobenate; p < 0.001). Aberrant respiratory waveform peaks in the arterial phase were usually associated with transient tachypnea (mean maximum arterial phase respiratory rate for the gadoxetate cohort, 27 breaths/min; range, 11-40 breaths/min).
  
  
  CONCLUSIONS
  Fixed-dose gadoxetate disodium (10 mL; 1:1 dilution with 10 mL of saline; injection rate, 2 mL/s) transiently reduces breath-holding capacity during the arterial phase and is accompanied by brief transient tachypnea.
authors.affiliation: 1 Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, B2-A209P, Ann Arbor MI 48109.|2 Department of Urology, University of Michigan Health System, Ann Arbor, MI.|3 Michigan Radiology Quality Collaborative, Ann Arbor, MI.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Davenport
authors.affiliation: 1 Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, B2-A209P, Ann Arbor MI 48109.
authors.forename: Dariya I
authors.initials: DI
authors.lastname: Malyarenko
authors.affiliation: 1 Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, B2-A209P, Ann Arbor MI 48109.
authors.forename: Yuxi
authors.initials: Y
authors.lastname: Pang
authors.affiliation: 1 Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, B2-A209P, Ann Arbor MI 48109.
authors.forename: Hero K
authors.initials: HK
authors.lastname: Hussain
authors.affiliation: 1 Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, B2-A209P, Ann Arbor MI 48109.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Chenevert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D062485:Breath Holding / Q000187:drug effects*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005583:Fourier Analysis; D019786:Gadolinium DTPA / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D015656:Respiratory Mechanics / Q000187:drug effects*; D012680:Sensitivity and Specificity; D059246:Tachypnea / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D055815:Young Adult
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: arterial phase; gadoxetate disodium; respiratory; transient dyspnea; transient severe motion