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Article

Does Hepatic Steatosis Influence the Detection Rate of Metastases in the Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI?

by
Ingo G. Steffen
1,
Thomas Weissmann
1,
Jan Holger Rothe
1,
Dominik Geisel
1,
Sascha S. Chopra
2,
Johannes Kahn
1,
Bernd Hamm
1 and
Timm Denecke
3,*
1
Klinik für Radiologie, Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, 13353 Berlin, Germany
2
Klinik für Allgemein-Viszeral-und Transplantationschirurgie, Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, 13353 Berlin, Germany
3
Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig, 04103 Leipzig, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(1), 98; https://doi.org/10.3390/jcm10010098
Submission received: 25 November 2020 / Revised: 18 December 2020 / Accepted: 26 December 2020 / Published: 30 December 2020
(This article belongs to the Special Issue Application of Radiological Imaging: Diagnosis, Therapy Monitoring and Pathophysiology in Oncology)
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Abstract

The aim of this exploratory study was to evaluate the influence of hepatic steatosis on the detection rate of metastases in gadoxetic acid-enhanced liver magnetic resonance imaging (MRI). A total of 50 patients who underwent gadoxetic acid-enhanced MRI (unenhanced T1w in- and opposed-phase, T2w fat sat, unenhanced 3D-T1w fat sat and 3-phase dynamic contrast-enhanced (uDP), 3D-T1w fat sat hepatobiliary phase (HP)) were retrospectively included. Two blinded observers (O1/O2) independently assessed the images to determine the detection rate in uDP and HP. The hepatic signal fat fraction (HSFF) was determined as the relative signal intensity reduction in liver parenchyma from in- to opposed-phase images. A total of 451 liver metastases were detected (O1/O2, n = 447/411). O1/O2 detected 10.9%/9.3% of lesions exclusively in uDP and 20.2%/15.5% exclusively in HP. Lesions detected exclusively in uDP were significantly associated with a larger HSFF (area under curve (AUC) of receiver operating characteristic (ROC) analysis, 0.93; p < 0.001; cutoff, 41.5%). The exclusively HP-positive lesions were significantly associated with a smaller diameter (ROC-AUC, 0.82; p < 0.001; cutoff, 5 mm) and a smaller HSFF (ROC-AUC, 0.61; p < 0.001; cutoff, 13.3%). Gadoxetic acid imaging has the advantage of detecting small occult metastatic liver lesions in the HP. However, using non-optimized standard fat-saturated 3D-T1w protocols, severe steatosis (HSFF > 30%) is a potential pitfall for the detection of metastases in HP.
Keywords: magnetic resonance imaging; MRI; gadolinium; gadoxetic acid; hepatic signal fat fraction; liver steatosis magnetic resonance imaging; MRI; gadolinium; gadoxetic acid; hepatic signal fat fraction; liver steatosis

Share and Cite

MDPI and ACS Style

Steffen, I.G.; Weissmann, T.; Rothe, J.H.; Geisel, D.; Chopra, S.S.; Kahn, J.; Hamm, B.; Denecke, T. Does Hepatic Steatosis Influence the Detection Rate of Metastases in the Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI? J. Clin. Med. 2021, 10, 98. https://doi.org/10.3390/jcm10010098

AMA Style

Steffen IG, Weissmann T, Rothe JH, Geisel D, Chopra SS, Kahn J, Hamm B, Denecke T. Does Hepatic Steatosis Influence the Detection Rate of Metastases in the Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI? Journal of Clinical Medicine. 2021; 10(1):98. https://doi.org/10.3390/jcm10010098

Chicago/Turabian Style

Steffen, Ingo G., Thomas Weissmann, Jan Holger Rothe, Dominik Geisel, Sascha S. Chopra, Johannes Kahn, Bernd Hamm, and Timm Denecke. 2021. "Does Hepatic Steatosis Influence the Detection Rate of Metastases in the Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI?" Journal of Clinical Medicine 10, no. 1: 98. https://doi.org/10.3390/jcm10010098

APA Style

Steffen, I. G., Weissmann, T., Rothe, J. H., Geisel, D., Chopra, S. S., Kahn, J., Hamm, B., & Denecke, T. (2021). Does Hepatic Steatosis Influence the Detection Rate of Metastases in the Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI? Journal of Clinical Medicine, 10(1), 98. https://doi.org/10.3390/jcm10010098

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