Antonio Luna MD, Presenter: Nothing to Disclose

Teodoro Martin MD, Abstract Co-Author: Nothing to Disclose

Lidia Alcala Mata MD, Abstract Co-Author: Nothing to Disclose

Jordi Broncano MD, Abstract Co-Author: Nothing to Disclose

Javier Sanchez MD, PhD, Abstract Co-Author: Research Consultant, Koninklijke Philips NV

Jorge A. Soto MD, Abstract Co-Author: Nothing to Disclose

Analyze if FAIR-ASL is feasible in the liver Check if FAIR-ASL is able to differentiate cystic and solid liver lesions in comparison to DCE-MRI

20 patients with 28 focal liver lesions (n=18 solid and n=10 of cystic nature) were submitted to our 3T magnet for further characterization. Solid lesions included 6 metastasis, 4 hepatocellular carcinoma, 6 hemangioma, 1 dysplastic nodule and 1 FNH and cystic lesions correspond to 7 simple cysts, 1 hydatid cyst, 1 postsurgical collection and 1 treated HCC.  ASL-FAIR sequence was performed as part of the MRI protocol, which also include chemical-shift imaging, axial TSE T2-weighted sequence and DCE-MRI. Two radiologist independtly reviewed all MRI studies in 2 different session blinded to any clinical information. In the first session, they read all the unenhanced series and the ASL sequence. In the second session, they read all MR sequences including the DCE-MRI, except the ASL. They classified all focal liver lesion over 8 mm as solid or cystic. Criteria for solid lesions were presence of internal flow in ASL sequence or enhancement in the DCE-MRI sequence. DCE-MRI was considered as the gold-standard. The ASL-FAIR is a breath-hold balanced TFE sequence: flip angle: 35, TR: 3,6 ms, TE: 1,7 ms, SENSE factor: 2, Tag delay: 1500 ms, image resolution: 4x4x10 mm3, acquisition time: 14s.  

Interreader agreement for both ASL and DCE-MRI was excellent (κ=1; p<0,001). A statistically significant correlation was demonstrated between DCE-MRI and ASL (r=0,85;p<0,001). Sensitivity, specificity, and posittive and negative predictive values were of 100%. 80%, 90% and 100%, respectively for both readers. The two false positive in ASL reading corresponded to a postsurgical collection and a simple cyst.

FAIR-ASL was feasible in all patients, and as part of a liver MRI protocol. ASL can show accurately the presence or absence of flow in solid and cystic liver lesions, respectively.

ASL is feasible in the liver. ASL can be used as an alternative non-contrast technique to DCE-MRI in the differentiation between benign and malignant focal liver lesion.

Luna, A, Martin, T, Alcala Mata, L, Broncano, J, Sanchez, J, Soto, J, Feasibility of Arterial Spin Label to Differentiate Solid and Cystic Focal Liver Lesions.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017044.html