Quantitative evaluation of focal liver lesions with T1 mapping using a phase-sensitive inversion recovery sequence on gadoxetic acid-enhanced MRI

Motohira Mio; Yasuhiro Fujiwara; Kazuki Tani; Tatsuo Toyofuku; Toshihiro Maeda; Toshiro Inoue

doi:10.1016/j.ejro.2020.100312

Quantitative evaluation of focal liver lesions with T1 mapping using a phase-sensitive inversion recovery sequence on gadoxetic acid-enhanced MRI

Eur J Radiol Open. 2020 Dec 24:8:100312. doi: 10.1016/j.ejro.2020.100312. eCollection 2021.

Authors

Motohira Mio¹, Yasuhiro Fujiwara², Kazuki Tani¹, Tatsuo Toyofuku¹, Toshihiro Maeda¹, Toshiro Inoue¹

Affiliations

¹ Department of Radiology, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, 818-8502, Japan.
² Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, 4-24-1, Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan.

Abstract

Purpose: To determine the usefulness of T1 values measured using a phase-sensitive inversion recovery (PSIR) sequence for the diagnosis of focal liver lesions.

Method: The study enrolled 87 patients who underwent gadoxetic acid-enhanced magnetic resonance imaging (MRI) for assessment of 38 hepatocellular carcinomas, 33 hepatic hemangiomas, 30 metastatic liver tumors, and 14 hepatic cysts. PSIR was performed before and 15 min after contrast agent administration, and then the respective T1 values were measured and the T1 reduction rate was calculated. Wilcoxon matched-pairs signed-rank test was used to compare T1 values pre- and post-contrast administration in each tumor. The Kruskal-Wallis test and Dunn's post-hoc test were used to compare T1 values among all tumors pre- and post-contrast administration and the T1 reduction rate among all tumors.

Results: The T1 values measured before and after contrast enhancement were 1056 ± 292 ms and 724 ± 199 ms for hepatocellular carcinoma, 1757 ± 723 ms and 1033 ± 406 ms for metastatic liver tumor, 2524 ± 908 ms and 1071 ± 390 ms for hepatic hemangioma, and 3793 ± 207 ms and 3671 ± 241 ms for liver cysts, respectively. The T1 values obtained before and after contrast administration showed significant differences for all tumors except liver cysts (P < 0.0001). T1 reduction rate was not significantly different between hepatocellular carcinoma and metastatic liver tumor, but was significantly different among other tumors (P < 0.05).

Conclusions: T1 mapping using the PSIR sequence is useful to differentiate focal liver lesions.

Keywords: AUC, area under the ROC curve; CT, computed tomography; Gadoxetic acid-enhanced MRI; HBP, hepatobiliary phase; HCC, hepatocellular carcinoma; Liver; MRI, magnetic resonance imaging; Magnetic resonance imaging (MRI); PSIR, phase-sensitive inversion recovery; Phase-sensitive inversion recovery (PSIR); ROC, receiver operating characteristic; ROI, region of interest; SI, signal intensity; T1 mapping.