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Liver MRI with amide proton transfer imaging: feasibility and accuracy for the characterization of focal liver lesions

 Nieun Seo  ;  Ha-Kyu Jeong  ;  Jin-Young Choi  ;  Mi-Suk Park  ;  Myeong-Jin Kim  ;  Yong Eun Chung 
 EUROPEAN RADIOLOGY, Vol.31(1) : 222-231, 2021-01 
Journal Title
Issue Date
Amides ; Carcinoma, Hepatocellular* / diagnostic imaging ; Feasibility Studies ; Humans ; Liver Neoplasms* / diagnostic imaging ; Magnetic Resonance Imaging ; Protons
Amides ; Feasibility studies ; Hepatocellular carcinoma ; Liver ; Magnetic resonance imaging
Objective: To investigate the feasibility of using amide proton transfer (APT) magnetic resonance imaging (MRI) in the liver and to evaluate its ability to characterize focal liver lesions (FLLs).

Methods: A total of 203 patients with suspected FLLs who underwent APT imaging at 3T were included. APT imaging was obtained using a single-slice turbo spin-echo sequence to include FLLs through five breath-holds, and its acquisition time was approximately 1 min. APT signals in the background liver and FLL were measured with magnetization transfer ratio asymmetry (MTRasym) at 3.5 ppm. The technical success rate of APT imaging and the reasons for failure to obtain meaningful MTRasym values were assessed. The Mann Whitney U test was used to compare MTRasym values between different FLLs.

Results: The technical success rate of APT imaging in the liver was 62.1% (126/203). The reasons for failure were a too large B0 inhomogeneity (n = 43), significant respiratory motion (n = 12), and these two factors together (n = 22), respectively. Among 59 FLLs with analyzable APT images, MTRasym values were compared between 27 patients with liver metastases and 23 patients with hepatocellular carcinomas (HCCs). The MTRasym values of metastases were significantly higher than those of HCC (0.13 ± 2.15% vs. - 1.41 ± 3.68%, p = 0.027).

Conclusions: APT imaging could be an imaging biomarker for the differentiation of FLLs. However, further technical improvement is required before APT imaging can be clinically applied to liver MRI.

Key points: • Liver APT imaging was technically feasible, but with a relatively low success rate (62.1%). • Liver metastases showed higher APT values than hepatocellular carcinomas.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Seo, Nieun(서니은) ORCID logo https://orcid.org/0000-0001-8745-6454
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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