Abdominal Radiology

, Volume 44, Issue 12, pp 4037–4047 | Cite as

Effects of gadoxetic acid on image quality of arterial multiphase magnetic resonance imaging of liver: comparison study with gadoteric acid-enhanced MRI

  • Ki Choon Sim
  • Beom Jin ParkEmail author
  • Na Yeon Han
  • Deuk Jae Sung
  • Min Ju Kim
  • Yeo Eun Han



To compare the effects of gadoxetic acid and gadoteric acid on the image quality of single-breath-hold, triple (first, second, and third) arterial hepatic magnetic resonance imaging (MRI).


Two hundred and eleven patients were divided into two groups according to the contrast materials used (gadoxetic acid, 108 patients and gadoteric acid, 103 patients). All 3.0-T MR examinations included triple arterial phase acquisition using the 4D enhanced T1-weighted high-resolution isotropic volume examination (eTHRIVE) keyhole technique. The image qualities of the pre-contrast and triple arterial phases were assessed in terms of image artifacts, sharpness of the intrahepatic vessel and liver edge, and overall image quality with a 5-point scale for qualitative analysis.


The image quality of gadoxetic acid-enhanced liver MRI in the triple arterial phases was significantly degraded compared with that of gadoteric acid-enhanced liver MRI, although better image scores were observed in the pre-contrast images in the gadoxetic acid group (P < 0.001). The overall image quality gradually improved from the first to the third arterial phases in both groups (P < 0.003).


Intravenous gadoxetic acid could have a detrimental effect on image quality of triple arterial phase MRI with the 4D eTHRIVE Keyhole technique. The third arterial phase images had the best image qualities; thus, they could be used as key scans.


Gd-EOB-DTPA Liver Magnetic resonance imaging Artifacts Image quality Contrast media 



No funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The Institutional Review Board waived the requirement for informed consent for this retrospective study.


  1. 1.
    Yoshioka H, Takahashi N, Yamaguchi M, Lou D, Saida Y, Itai Y (2002) Double arterial phase dynamic MRI with sensitivity encoding (SENSE) for hypervascular hepatocellular carcinomas. J Magn Reson Imaging 16:259-266. CrossRefPubMedGoogle Scholar
  2. 2.
    Taouli B, Martin AJ, Qayyum A, Merriman RB, Vigneron D, Yeh BM, Coakley FV (2004) Parallel imaging and diffusion tensor imaging for diffusion-weighted MRI of the liver: preliminary experience in healthy volunteers. AJR Am J Roentgenol 183:677-680. CrossRefPubMedGoogle Scholar
  3. 3.
    Ito K, Fujita T, Shimizu A, Koike S, Sasaki K, Matsunaga N, Hibino S, Yuhara M (2004) Multiarterial phase dynamic MRI of small early enhancing hepatic lesions in cirrhosis or chronic hepatitis: differentiating between hypervascular hepatocellular carcinomas and pseudolesions. AJR Am J Roentgenol 183:699-705. CrossRefPubMedGoogle Scholar
  4. 4.
    Beck GM, De Becker J, Jones AC, von Falkenhausen M, Willinek WA, Gieseke J (2008) Contrast-enhanced timing robust acquisition order with a preparation of the longitudinal signal component (CENTRA plus) for 3D contrast-enhanced abdominal imaging. J Magn Reson Imaging 27:1461-1467. CrossRefPubMedGoogle Scholar
  5. 5.
    Kanematsu M, Goshima S, Kondo H, Yokoyama R, Kajita K, Hoshi H, Onozuka M, Nozaki A, Hirano M, Shiratori Y, Moriyama N (2006) Double hepatic arterial phase MRI of the liver with switching of reversed centric and centric K-space reordering. AJR Am J Roentgenol 187:464-472. CrossRefPubMedGoogle Scholar
  6. 6.
    Low RN, Bayram E, Panchal NJ, Estkowski L (2010) High-resolution double arterial phase hepatic MRI using adaptive 2D centric view ordering: initial clinical experience. AJR Am J Roentgenol 194:947-956. CrossRefPubMedGoogle Scholar
  7. 7.
    McKenzie CA, Lim D, Ransil BJ, Morrin M, Pedrosa I, Yeh EN, Sodickson DK, Rofsky NM (2004) Shortening MR image acquisition time for volumetric interpolated breath-hold examination with a recently developed parallel imaging reconstruction technique: clinical feasibility. Radiology 230:589-594. CrossRefPubMedGoogle Scholar
  8. 8.
    Rofsky NM, Lee VS, Laub G, Pollack MA, Krinsky GA, Thomasson D, Ambrosino MM, Weinreb JC (1999) Abdominal MR imaging with a volumetric interpolated breath-hold examination. Radiology 212:876-884. CrossRefPubMedGoogle Scholar
  9. 9.
    Hong HS, Kim HS, Kim MJ, De Becker J, Mitchell DG, Kanematsu M (2008) Single breath-hold multiarterial dynamic MRI of the liver at 3T using a 3D fat-suppressed keyhole technique. J Magn Reson Imaging 28:396-402. CrossRefPubMedGoogle Scholar
  10. 10.
    Tanimoto A, Lee JM, Murakami T, Huppertz A, Kudo M, Grazioli L (2009) Consensus report of the 2nd International Forum for Liver MRI. Eur Radiol 19 Suppl 5:S975-S989. CrossRefPubMedGoogle Scholar
  11. 11.
    Davenport MS, Viglianti BL, Al-Hawary MM, Caoili EM, Kaza RK, Liu PS, Maturen KE, Chenevert TL, Hussain HK (2013) Comparison of acute transient dyspnea after intravenous administration of gadoxetate disodium and gadobenate dimeglumine: effect on arterial phase image quality. Radiology 266:452-461. CrossRefPubMedGoogle Scholar
  12. 12.
    Bayer Inc. (2017) PRIMOVIST product Monograph: part III Consumer information. Accessed on March 28 2019.
  13. 13.
    Haradome H, Grazioli L, Tsunoo M, Tinti R, Frittoli B, Gambarini S, Morone M, Motosugi U, Colagrande S (2010) Can MR fluoroscopic triggering technique and slow rate injection provide appropriate arterial phase images with reducing artifacts on gadoxetic acid-DTPA (Gd-EOB-DTPA)-enhanced hepatic MR imaging? J Magn Reson Imaging 32:334-340. CrossRefPubMedGoogle Scholar
  14. 14.
    Feuerlein S, Boll DT, Gupta RT, Ringe KI, Marin D, Merkle EM (2011) Gadoxetate disodium-enhanced hepatic MRI: dose-dependent contrast dynamics of hepatic parenchyma and portal vein. AJR Am J Roentgenol 196:W18-W24. CrossRefPubMedGoogle Scholar
  15. 15.
    Motosugi U, Ichikawa T, Sou H, Sano K, Ichikawa S, Tominaga L, Araki T (2009) Dilution method of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). J Magn Reson Imaging 30:849-854. CrossRefPubMedGoogle Scholar
  16. 16.
    Tanimoto A, Higuchi N, Ueno A (2012) Reduction of ringing artifacts in the arterial phase of gadoxetic acid-enhanced dynamic MR imaging. Magn Reson Med Sci 11:91-97. CrossRefPubMedGoogle Scholar
  17. 17.
    Ringe KI, Husarik DB, Sirlin CB, Merkle EM (2010) Gadoxetate disodium-enhanced MRI of the liver: part 1, protocol optimization and lesion appearance in the noncirrhotic liver. AJR Am J Roentgenol 195:13-28. CrossRefPubMedGoogle Scholar
  18. 18.
    Zech CJ, Vos B, Nordell A, Urich M, Blomqvist L, Breuer J, Reiser MF, Weinmann HJ (2009) Vascular enhancement in early dynamic liver MR imaging in an animal model: comparison of two injection regimen and two different doses Gd-EOB-DTPA (gadoxetic acid) with standard Gd-DTPA. Invest Radiol 44:305-310. CrossRefPubMedGoogle Scholar
  19. 19.
    Kim YK, Lin WC, Sung K, Raman SS, Margolis D, Lim Y, Gu S, Lu D (2016) Reducing Artifacts during Arterial Phase of Gadoxetate Disodium-enhanced MR Imaging: Dilution Method versus Reduced Injection Rate. Radiology 283:429-437. CrossRefPubMedGoogle Scholar
  20. 20.
    Moore KP, Wong F, Gines P, Bernardi M, Ochs A, Salerno F, Angeli P, Porayko M, Moreau R, Garcia-Tsao G, Jimenez W, Planas R, Arroyo V (2003) The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club. Hepatology 38:258-266. CrossRefPubMedGoogle Scholar
  21. 21.
    Cruite I, Schroeder M, Merkle EM, Sirlin CB (2010) Gadoxetate disodium-enhanced MRI of the liver: part 2, protocol optimization and lesion appearance in the cirrhotic liver. AJR Am J Roentgenol 195:29-41. CrossRefPubMedGoogle Scholar
  22. 22.
    Tamada T, Ito K, Sone T, Yamamoto A, Yoshida K, Kakuba K, Tanimoto D, Higashi H, Yamashita T (2009) Dynamic contrast-enhanced magnetic resonance imaging of abdominal solid organ and major vessel: comparison of enhancement effect between Gd-EOB-DTPA and Gd-DTPA. J Magn Reson Imaging 29:636-640. CrossRefPubMedGoogle Scholar
  23. 23.
    Pietryga JA, Burke LM, Marin D, Jaffe TA, Bashir MR (2014) Respiratory motion artifact affecting hepatic arterial phase imaging with gadoxetate disodium: examination recovery with a multiple arterial phase acquisition. Radiology 271:426-434. CrossRefPubMedGoogle Scholar
  24. 24.
    Motosugi U, Bannas P, Bookwalter CA, Sano K, Reeder SB (2016) An investigation of transient severe motion related to gadoxetic acid-enhanced MR imaging. Radiology 279:93-102. CrossRefPubMedGoogle Scholar
  25. 25.
    Kim SY, Park SH, Wu EH, Wang ZJ, Hope TA, Chang WC, Yeh BM (2015) Transient respiratory motion artifact during arterial phase MRI with gadoxetate disodium: risk factor analyses. AJR Am J Roentgenol 204:1220-1227. CrossRefPubMedGoogle Scholar
  26. 26.
    Hirokawa Y, Isoda H, Maetani YS, Arizono S, Shimada K, Togashi K (2008) MRI artifact reduction and quality improvement in the upper abdomen with PROPELLER and prospective acquisition correction (PACE) technique. AJR Am J Roentgenol 191:1154-1158. CrossRefPubMedGoogle Scholar
  27. 27.
    Vu KN, Haldipur AG, Roh AT, Lindholm P, Loening AM (2019) Comparison of End-Expiration Versus End-Inspiration Breath-Holds With Respect to Respiratory Motion Artifacts on T1-Weighted Abdominal MRI. AJR Am J Roentgenol 212:1024-1029. CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiology, Korea University Anam HospitalKorea University College of MedicineSeoulKorea

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