title: Reducing Artifacts during Arterial Phase of Gadoxetate Disodium-enhanced MR Imaging: Dilution Method versus Reduced Injection Rate.
abstract: Purpose To compare two contrast material-administration protocols (dilution vs slow injection) in terms of their effectiveness in arterial phase artifact reduction at gadoxetic acid-enhanced magnetic resonance (MR) imaging. Materials and Methods This HIPAA-compliant retrospective case-controlled cohort study was approved by the institutional review board, with a waiver of informed patient consent. A total of 318 consecutive patients undergoing gadoxetic acid-enhanced MR imaging were placed into one of two subcohorts of 159 consecutive patients each: the dilution subcohort (gadoxetic acid was diluted 1:1 with saline and injected at a rate of 2.0 mL/sec) and the slow injection subcohort (gadoxetic acid was not diluted and was injected at a rate of 1.0 mL/sec). Eighty-nine patients in the dilution subcohort also underwent follow-up MR imaging with the slow injection method, and 34 patients in the slow injection subcohort underwent follow-up MR imaging with the dilution method. Both patient- and image-based analyses, as well as intraindividual analysis, were used to compare two parameters-mean artifact score rated by two observers using a five-point scale and frequency of severe artifact-between the dilution and slow injection subcohorts with the Wilcoxon Mann-Whitney test, χ2test, and generalized estimating equation. Results In both patient- and image-based analyses, the mean artifact score and frequency of severe artifact were lower in the dilution subcohort (mean, 1.46% and 3.8% [six of 159]) than in the slow injection subcohort (mean, 1.95% and 15.1% [24 of 159]) (P ≤ .001 and P < .001, respectively). In intraindividual analysis, both variables were also decreased in the dilution subcohort (P = .007 and P = .001, respectively). We found the two variables to be significantly increased in the slow injection subcohort when compared with that in the dilution subcohort for three different MR platforms (P < .05). Conclusion In comparison with slow injection of undiluted contrast material at a rate of 1.0 mL/sec, gadoxetic acid diluted to 50% and injected at a rate of 2 mL/sec had a significantly less severe ghosting artifact in the arterial phase of gadoxetic acid-enhanced MR imaging.©RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Department of Radiological Sciences, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095-1721 (Y.K.K., W.C.L., K.S., S.S.R., D.M., D.L.); and Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (Y.L., S.G.).
authors.forename: Young Kon
authors.initials: YK
authors.lastname: Kim
authors.affiliation: From the Department of Radiological Sciences, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095-1721 (Y.K.K., W.C.L., K.S., S.S.R., D.M., D.L.); and Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (Y.L., S.G.).
authors.forename: Wei-Chan
authors.initials: WC
authors.lastname: Lin
authors.affiliation: From the Department of Radiological Sciences, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095-1721 (Y.K.K., W.C.L., K.S., S.S.R., D.M., D.L.); and Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (Y.L., S.G.).
authors.forename: Kyunghyun
authors.identifier: 0000-0003-4175-5322
authors.initials: K
authors.lastname: Sung
authors.affiliation: From the Department of Radiological Sciences, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095-1721 (Y.K.K., W.C.L., K.S., S.S.R., D.M., D.L.); and Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (Y.L., S.G.).
authors.forename: Steven S
authors.initials: SS
authors.lastname: Raman
authors.affiliation: From the Department of Radiological Sciences, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095-1721 (Y.K.K., W.C.L., K.S., S.S.R., D.M., D.L.); and Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (Y.L., S.G.).
authors.forename: Daniel
authors.initials: D
authors.lastname: Margolis
authors.affiliation: From the Department of Radiological Sciences, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095-1721 (Y.K.K., W.C.L., K.S., S.S.R., D.M., D.L.); and Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (Y.L., S.G.).
authors.forename: Yaeji
authors.initials: Y
authors.lastname: Lim
authors.affiliation: From the Department of Radiological Sciences, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095-1721 (Y.K.K., W.C.L., K.S., S.S.R., D.M., D.L.); and Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (Y.L., S.G.).
authors.forename: Seonhye
authors.initials: S
authors.lastname: Gu
authors.affiliation: From the Department of Radiological Sciences, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095-1721 (Y.K.K., W.C.L., K.S., S.S.R., D.M., D.L.); and Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (Y.L., S.G.).
authors.forename: David
authors.initials: D
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D016477:Artifacts; D003198:Computer Simulation; D003287:Contrast Media / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007201:Indicator Dilution Techniques; D007267:Injections / Q000379:methods; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008954:Models, Biological; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D012965:Sodium Chloride; D019786:Gadolinium DTPA