Reducing respiratory motion artifacts in gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI): assessing assisted breath-holding effectiveness.

BACKGROUND

Gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) is a critical modality in hepatobiliary diagnostics, providing high-resolution imaging of hepatic lesions and functional assessment of the liver. Despite its clinical benefits, respiratory motion artifacts in the hepatic arterial phase of EOB-MRI remain a major clinical challenge, reducing diagnostic accuracy. This study aimed to evaluate the efficacy of an assisted breath-holding technique in reducing respiratory motion artifacts during the hepatic arterial phase of EOB-MRI and its impact on diagnostic image quality.

METHODS

This prospective study enrolled 617 participants who underwent EOB-MRI at two separate branches in a tertiary care hospital. Participants who met the inclusion criteria were assigned to consecutive groups: a control group (n=309) that underwent standard breath-holding, and an experimental group (n=308) in which assisted breath-holding using manual nose pinching was applied during hepatic arterial-phase acquisition. Respiratory motion artifacts were graded by two independent radiologists blinded to the group assignments, categorizing images into no artifacts, mild artifacts, moderate artifacts, and severe artifacts. Self-reported dyspnea was recorded immediately post-scan to evaluate patient comfort.

RESULTS

There were 617 patients (mean age, 55.4±11.7 years; 415 men, 202 women) analyzed. The respiratory artifacts occurred in 18.8% (58/309) of controls versus 5.2% (16/308) of experimental participants (P<0.01). Moderate artifacts decreased from 10.4% (32/309) in the control group to 3.9% (12/308). Severe artifact rates decreased from 8.4% (26/309) to 1.3% (4/308). Inter-reader agreement was good (Kappa =0.68, P<0.01). No significant differences in dyspnea incidence were observed (1.94% vs. 2.60%, P=0.58).

CONCLUSIONS

The assisted breath-holding technique significantly reduces respiratory motion artifacts in EOB-MRI without significantly increasing self-reported dyspnea, enhancing hepatobiliary imaging quality.