Sevgi Gokce Kafali, Bradley D Bolster, Shu-Fu Shih, Timoteo I Delgado, Vibhas Deshpande, Xiaodong Zhong, Timothy R Adamos, Shahnaz Ghahremani, Kara L Calkins, Holden H Wu
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Abstract
Background: Conventional liver magnetic resonance elastography (MRE) requires breath-holding (BH) to avoid motion artifacts, which is challenging for children. While radial free-breathing (FB)-MRE is an alternative for quantifying liver stiffness (LS), previous methods had limitations of long scan times, acquiring two slices in 5 minutes, and not resolving motion during reconstruction.
Purpose: To reduce FB-MRE scan time to 4 minutes for four slices and to investigate the impact of self-gated (SG) motion compensation on FB-MRE LS quantification in terms of agreement, intrasession repeatability, and technical quality compared to conventional BH-MRE.
Study type: Prospective.
Population: Twenty-six children without fibrosis (median age: 12.9 years, 15 females).
Field strength/sequence: 3 T; Cartesian gradient-echo (GRE) BH-MRE, research application radial GRE FB-MRE.
Assessment: Participants were scanned twice to measure repeatability, without moving the table or changing the participants' position. LS was measured in areas of the liver with numerical confidence ≥90%. Technical quality was examined using measurable liver area (%).
Statistical tests: Agreement of LS between BH-MRE and FB-MRE was evaluated using Bland-Altman analysis for SG acceptance rates of 40%, 60%, 80%, and 100%. LS repeatability was assessed using within-subject coefficient of variation (wCV). The differences in LS and measurable liver area were examined using Kruskal-Wallis and Wilcoxon signed-rank tests. P < 0.05 was considered significant.
Results: FB-MRE with 60% SG achieved the closest agreement with BH-MRE (mean difference 0.00 kPa). The LS ranged from 1.70 to 1.83 kPa with no significant differences between BH-MRE and FB-MRE with varying SG rates (P = 0.52). All tested methods produced repeatable LS with wCV from 4.4% to 6.5%. The median measurable liver area was smaller for FB-MRE (32%-45%) than that for BH-MRE (91%-93%) (P < 0.05).
Data conclusion: FB-MRE with 60% SG can quantify LS with close agreement and comparable repeatability with respect to BH-MRE in children.
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