Jesse L. Wei MD, Presenter: Nothing to Disclose

Dennis Kiranpal S. Boparai MD, Abstract Co-Author: Nothing to Disclose

Faisal Khosa MBBS, Abstract Co-Author: Nothing to Disclose

Jacob Richard Wouden MD, Abstract Co-Author: Nothing to Disclose

Ivan Pedrosa MD, Abstract Co-Author: Nothing to Disclose

Neil Mitchell Rofsky MD, Abstract Co-Author: Research grant, General Electric Company Research grant, Bayer AG Consultant, EPIX Pharmaceuticals, Inc Advisory Board, Bayer AG Advisory Board, General Electric Company

The hepatobiliary phase is achieved at least 15 minutes after administration of Gd-EOB-DTPA. In order to determine the feasibility of performing T2W imaging during the delay between contrast administration and hepatobiliary imaging, and thus streamlining the protocol, we assessed the conspicuity of liver lesions and visibility of the biliary tree on T2-weighted (T2W) imaging before and after Gd-EOB-DTPA administration.

35 patients with known or suspected liver lesions were evaluated at 1.5T or 3.0T before and after administration of 0.025 mmol/kg of Gd-EOB-DTPA. The scan protocol included three forms of 2D T2W imaging (single-shot fast spin echo [SSFSE], T2 fast spin echo with fat suppression [T2FS], and long-TE slab SSFSE [MRCP]) acquired prior to and after Gd-EOB-DTPA administration. The conspicuity of liver lesions as well as the biliary tree were then subjectively assessed. Region of interest [ROI] measurements of the liver, spleen, liver lesions, and common bile duct were measured on both pre- and post-contrast imaging.

43 measurable lesions were identified, composed of 8 cysts, 8 hemangiomas, 2 abscesses, 10 FNHs, 1 adenoma, 3 HCCs, 6 diffuse liver disease (fibrosis, fatty liver, hepatitis), and 5 other lesions (4 indeterminate, 1 RFA burn zone). Visual assessment of 38 lesions scanned on SSFSE with short post-contrast delay (2-7 minutes) showed 31 lesions to be equally conspicuous, 3 less, and 4 more. Of 35 lesions scanned on SSFSE with longer post-contrast delay (7-17 minutes), 30 lesions were equally conspicuous, 2 were less, and 3 were more. Of 45 lesions seen on T2FS with intermediate delay, 30 were equally conspicuous, 6 were less, and 9 were more. No lesion identified prior to contrast was obscured after contrast on T2W imaging. On slab MRCP images with intermediate delay, only 12 of 32 examinations had acceptable biliary tree contrast, whereas early post-contrast SSFSE imaging sustained adequate biliary tree visualization. Quantitative ROI assessment support these subjective findings.

GD-EOB-DTPA protocols can be streamlined by obtaining SSFSE and T2FS imaging in the first 10 minutes after contrast administration. Long TE MRCP slabs should be performed prior to contrast administration.

A streamlined Gd-EOB-DTPA protocol can be achieved by obtaining some types of T2-weighted imaging post-contrast while retaining diagnostic efficacy.

Wei, J, Boparai, D, Khosa, F, Wouden, J, Pedrosa, I, Rofsky, N, Streamlining Hepatobiliary MR Contrast Protocols: Feasibility of T2-weighted Imaging after the Administration of Gd-EOB-DTPA.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8008240.html