Abstract
Purpose: To evaluate the influence of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) on proton density fat fraction (PDFF) using multiple vendors’ DIXON methods in a multicenter, multivendor phantom study. Materials and Methods: Pairs of phantoms with varying fat volume percentages (0, 5, 10, 15, 20, 30, 40, and 50) and Gd-EOB-DTPA concentrations (0 and 0.4 mM) were constructed. The phantom without Gd-EOB-DTPA in each pair was defined as the precontrast phantom, and the corresponding phantom with Gd-EOB-DTPA in each pair was defined as the postcontrast phantom. The phantoms were scanned via three vendors’ DIXON techniques to determine PDFFs. Agreement between PDFFs determined in precontrast and postcontrast phantoms was evaluated via Bland–Altman analysis. Results: Mean differences (precontrast PDFF - postcontrast PDFF) and limits of agreement were Philips 5.1% (−0.8% to 11.0%), Siemens 6.1% (−0.9% to 13.1%), and GE 1.3% (−1.2% to 3.9%). Conclusions: PDFFs measured using the three vendors’ DIXON techniques were smaller in the postcontrast phantoms than in the corresponding precontrast phantoms regardless of different scanning parameters, because T1 bias was improved by Gd-EOB-DTPA.
Highlights
Nonalcoholic fatty liver disease is a common cause of chronic liver disease worldwide [1]
The phantom without Gd-EOB-DTPA in each pair was defined as the precontrast phantom, and the corresponding phantom with Gd-EOB-DTPA in each pair was defined as the postcontrast phantom
Nonalcoholic fatty liver entails a small risk of associated cirrhosis, whereas nonalcoholic steatohepatitis (NASH) entails a much greater risk of cirrhosis, which can progress to hepatocellular carcinoma [2] [3]
Summary
Nonalcoholic fatty liver disease is a common cause of chronic liver disease worldwide [1]. It includes nonalcoholic fatty liver and nonalcoholic steatohepatitis (NASH). Several factors can confound the accurate determination of PDFF, including T1 bias (which refers to the longer T1 of water compared to fat), T2* decay, the multipeak spectral complexity of fat, and others [5]. To minimize the influence of these factors, a low flip angle to minimize T1 bias, multi-echo techniques to correct T2* decay, and a multipeak fat model are used in the latest DIXON methods [5] [6] [7] [8]. The influence of Gd-EOB-DTPA on PDFF has not been evaluated in a multivendor study in various clinical settings
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