Does injection flow rate have an impact on arterial phase image degradation in liver MRI? A comparison of gadoxetic acid versus gadobutrol

Abstract

To evaluate retrospectively the impact of injection flow rate on arterial phase image degradation in liver magnetic resonance imaging (MRI) with gadoxetic acid (Gd-EOB-DTPA) compared to gadobutrol. Two hundred consecutive patients who had undergone liver MRI were enrolled in this Health Insurance Portability and Accountability Act (HIPAA)-compliant institutional review board (IRB)-approved study and were divided into three groups. Group 1 (50 patients) and 2 (50 patients) had undergone MRI performed with gadoxetic acid (fixed 10ml) at flow rate of 1 and 2ml/s, respectively. Group 3 (100 patients) had undergone MRI performed with gadobutrol (0.1mmol/kg) at 1ml/s. Precontrast and post-contrast (arterial, portal venous, and hepatic venous phases) image degradation was assessed by two blinded independent readers using a four-point rating scale. The numbers of patients with arterial phase image degradation were compared using the Fisher exact test among the three groups. The incidence of arterial phase image degradation was 12% (6/50) in group 1 and 16% (8/50) in group 2 for both readers, 6% (6/100) for reader 1 and 5% (5/100) for reader 2 in group 3. Group 2 had a higher incidence of arterial phase image degradation when compared with group 3 for reader 2 (p=0.032). Severe arterial phase image degradation, resulting in non-diagnostic image quality, occurred in 4% (2/50) of patients when performed with gadoxetic acid administration at 2ml/s and 2% (1/50) at 1ml/s. A slower injection flow rate has a trend to reduce the incidence and severity of arterial phase image degradation during liver MRI with gadoxetic acid when compared to gadobutrol.