European journal of radiology open · 2026
Utility of intracellular enhancement for improving hepatic lesion visibility at gadoxetic acid-enhanced hepatobiliary-phase MRI.
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Maeda Shogo, Nakamura Yuko, Higaki Toru, Nishihara Takashi, Takizawa Masahiro, Bito Yoshitaka, Asaka Hirokazu, Kodakari Kenji, Fonseca Dara, Kondo Shota, Honda Yukiko, Akiyama Yuji, Kawaoka Tomokazu, Tsuge Masataka, Oka Shiro, Awai Kazuo
Аннотация
PURPOSE: To investigate the utility of the intracellular enhancement (ICE) technique that suppresses extracellular signal component for shortening the gadoxetic acid (EOB)-enhanced hepatobiliary-phase (HBP) delay time while maintaining lesion visibility.
METHODS: In this prospective study, patients who underwent EOB-enhanced MRI were screened and those with HBP hypointense hepatic lesions were included. HBP images were acquired at 10 and 20 min post-EOB injection, with and without ICE (i+- and i--10 and 20 min HBP). One representative lesion per patient was evaluated. The lesion-to-liver contrast ratio (CR) was calculated. Two radiologists assessed overall image quality and lesion visibility on a five-point scale. The primary outcome was lesion visibility, which was assessed qualitatively using subjective lesion visibility scores and quantitatively using CR. Differences between paired groups were determined by using a two-sided Wilcoxon signed-rank test.
RESULTS: Eighty-one patients were included. Overall image quality was significantly worse with ICE at both 10- and 20-min HBP (10 min: mean 3.8 vs 3.1; 20 min: 4.0 vs 3.3; both p < 0.01). There was no significant difference in the CR between i+-10 min and i--20 min HBP (median 1.58 vs 1.54; p = 0.48). Furthermore, lesion visibility scores on i+-10 min HBP were significantly higher than those on i--20 min HBP (mean 4.1 vs 3.9; p < 0.01).
CONCLUSION: ICE has the potential to reduce delay time without compromising lesion visualization; however, further studies with larger sample size.
METHODS: In this prospective study, patients who underwent EOB-enhanced MRI were screened and those with HBP hypointense hepatic lesions were included. HBP images were acquired at 10 and 20 min post-EOB injection, with and without ICE (i+- and i--10 and 20 min HBP). One representative lesion per patient was evaluated. The lesion-to-liver contrast ratio (CR) was calculated. Two radiologists assessed overall image quality and lesion visibility on a five-point scale. The primary outcome was lesion visibility, which was assessed qualitatively using subjective lesion visibility scores and quantitatively using CR. Differences between paired groups were determined by using a two-sided Wilcoxon signed-rank test.
RESULTS: Eighty-one patients were included. Overall image quality was significantly worse with ICE at both 10- and 20-min HBP (10 min: mean 3.8 vs 3.1; 20 min: 4.0 vs 3.3; both p < 0.01). There was no significant difference in the CR between i+-10 min and i--20 min HBP (median 1.58 vs 1.54; p = 0.48). Furthermore, lesion visibility scores on i+-10 min HBP were significantly higher than those on i--20 min HBP (mean 4.1 vs 3.9; p < 0.01).
CONCLUSION: ICE has the potential to reduce delay time without compromising lesion visualization; however, further studies with larger sample size.