Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

DOI： 10.2463/mrms.mp.2021-0103

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications  

Background

The effectiveness of four-dimensional (4D) flow magnetic resonance imaging (MRI) for assessing hemodynamic changes before and after balloon-occluded retrograde transvenous obliteration (BRTO) remains unclear.

Purpose

To evaluate the feasibility of 4D flow MRI for assessing hemodynamic changes in the portal venous system before and after BRTO.

Material and Methods

We included 10 patients (7 men, 3 women; mean age = 67 years) with liver cirrhosis who had a high risk of gastric variceal bleeding or hepatic encephalopathy. Non-contrast 4D flow MRI of the upper abdomen was performed before and after BRTO. In addition, we compared the blood flow rates in the portal vein (PV), superior mesenteric vein (SMV), splenic vein (SV), left renal vein, and inferior vena cava before and after BRTO. Moreover, the flow directions of the SMV and SV before and after BRTO were assessed using both portography and 4D flow MRI.

Results

There was a significant post-BRTO increase in the blood flow rate in the PV and SV ( P < 0.05). There was no significant post-BRTO change in the blood flow rates in the SMV, inferior vena cava, and left renal vein. In four patients, portography confirmed that hepatofugal flow in the SV and SMV changed to hepatopetal flow after BRTO. Moreover, 4D flow MRI correctly assessed the flow directions in the SMV and SV in 70%–100% of the patients.

Conclusion

4D flow MRI can be used to detect hemodynamic changes in the portal venous system before and after BRTO.

DOI： 10.1177/02841851221133487

Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/02841851221133487

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1177/08465371221085516

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2463/mrms.mp.2021-0143

Language：English   Publishing type：Research paper (scientific journal)  

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：インナービジョン  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Circulation Society  

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is widely used as a first-line procedure for the definitive diagnosis of pancreatic solid tumor. Adverse events associated with the EUS-FNA procedure include acute pancreatitis, bleeding, infection, and duodenal perforation. Rarely, pancreatic tumors disseminate in the peritoneal cavity or seed in the gastric wall via the biopsy needle tract after EUS-FNA. Such seeding has been noted primarily in cases of adenocarcinomas and has not been associated with solid pseudopapillary neoplasm (SPN), a rare and potentially malignant tumor of the pancreas. This is the first report of a case of tumor seeding in the gastric wall after EUS-FNA of pancreatic SPN.

DOI： 10.2169/internalmedicine.3244-19

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

The inferior mesenteric artery arising from the superior mesenteric artery is an extremely rare anatomic variation. We report a case with this variation demonstrated with 3-dimensional contrast-enhanced computed tomography, which later was confirmed at surgery. The ordinary inferior mesenteric artery arising from the aorta was absent. Previously reported cases with this variation are reviewed. 3-dimensional contrast-enhanced computed tomography is useful for in vivo visualization of aberrant arterial anatomy.

DOI： 10.1016/j.radcr.2019.10.024

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To determine the optimal combination of gadoxetate disodium-enhanced magnetic resonance imaging (MRI) findings for the diagnosis of hepatocellular carcinoma (HCC) and to compare its diagnostic ability to that of dynamic computed tomography (CT) in patients with chronic liver disease. METHODS: This multi-institutional study consisted of two parts: Study 1, a retrospective study to determine the optimal combination of gadoxetate disodium-enhanced MRI findings (decision tree and logistic model) to distinguish HCC (n = 199) from benign (n = 81) or other malignant lesions (n = 95) (375 nodules in 269 patients) and Study 2, a prospective study to compare the diagnostic ability of gadoxetate disodium-enhanced MRI to distinguish HCC (n = 73) from benign (n = 15) or other malignant lesions (n = 12) with that of dynamic CT (100 nodules in 83 patients). Two radiologists independently evaluated the imaging findings (Study 1 and 2) and made a practical diagnosis (Study 2). RESULTS: In Study 1, rim or whole enhancement on arterial phase images, signal intensities on T2-weighted/diffusion-weighted/portal venous/transitional/hepatobiliary phase images, and signal drop on opposed-phase images were independently useful for differential diagnosis. In Study 2, the accuracy, sensitivity, negative predictive value, and negative likelihood ratio of the CT decision tree (reader 2) were higher than those of MRI Model 2 (P = 0.015-0.033). There were no other significant differences in diagnostic ability (P = 0.059-1.000) and radiologist-made practical diagnosis (P = 0.059-1.000) between gadoxetate disodium-enhanced MRI and CT. CONCLUSION: We identified the optimal combination of gadoxetate disodium-enhanced MRI findings for HCC diagnosis. However, its diagnostic ability was not superior to that of dynamic CT.

DOI： 10.2463/mrms.mp.2019-0193

PubMed

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Ovid Technologies (Wolters Kluwer Health)  

DOI： 10.1097/rct.0000000000000963

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Liver MR elastography (MRE) is available for the noninvasive assessment of liver fibrosis; however, no previous studies have compared the diagnostic ability of MRE with that of liver biopsy. PURPOSE: To compare the diagnostic accuracy of liver fibrosis staging between MRE-based methods and liver biopsy using the resected liver specimens as the reference standard. STUDY TYPE: A retrospective study at a single institution. POPULATION: In all, 200 patients who underwent preoperative MRE and subsequent surgical liver resection were included in this study. Data from 80 patients were used to estimate cutoff and distributions of liver stiffness values measured by MRE for each liver fibrosis stage (F0-F4, METAVIR system). In the remaining 120 patients, liver biopsy specimens were obtained from the resected liver tissues using a standard biopsy needle. FIELD STRENGTH/SEQUENCE: 2D liver MRE with gradient-echo based sequence on a 1.5 or 3T scanner was used. ASSESSMENT: Two radiologists independently measured the liver stiffness value on MRE and two types of MRE-based methods (threshold and Bayesian prediction method) were applied. Two pathologists evaluated all biopsy samples independently to stage liver fibrosis. Surgically resected whole tissue specimens were used as the reference standard. STATISTICAL TESTS: The accuracy for liver fibrosis staging was compared between liver biopsy and MRE-based methods with a modified McNemar's test. RESULTS: Accurate fibrosis staging was achieved in 53.3% (64/120) and 59.1% (71/120) of patients using MRE with threshold and Bayesian methods, respectively, and in 51.6% (62/120) with liver biopsy. Accuracies of MRE-based methods for diagnoses of ≥F2 (90-91% [108-9/120]), ≥F3 (79-81% [95-97/120]), and F4 (82-85% [98-102/120]) were statistically equivalent to those of liver biopsy (≥F2, 79% [95/120], P ≤ 0.01; ≥F3, 88% [105/120], P ≤ 0.006; and F4, 82% [99/120], P ≤ 0.017). DATA CONCLUSION: MRE can be an alternative to liver biopsy for fibrosis staging. LEVEL OF EVIDENCE: 3. Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1268-1275.

DOI： 10.1002/jmri.25868

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To compare the abilities of three intravoxel incoherent motion (IVIM) imaging approximation methods to discriminate the histological grade of hepatocellular carcinomas (HCCs). METHODS: Fifty-eight patients (60 HCCs) underwent IVIM imaging with 11 b-values (0-1000 s/mm2). Slow (D) and fast diffusion coefficients (D*) and the perfusion fraction (f) were calculated for the HCCs using the mean signal intensities in regions of interest drawn by two radiologists. Three approximation methods were used. First, all three parameters were obtained simultaneously using non-linear fitting (method A). Second, D was obtained using linear fitting (b = 500 and 1000), followed by non-linear fitting for D* and f (method B). Third, D was obtained by linear fitting, f was obtained using the regression line intersection and signals at b = 0, and non-linear fitting was used for D* (method C). A receiver operating characteristic analysis was performed to reveal the abilities of these methods to distinguish poorly-differentiated from well-to-moderately-differentiated HCCs. Inter-reader agreements were assessed using intraclass correlation coefficients (ICCs). RESULTS: The measurements of D, D*, and f in methods B and C (Az-value, 0.658-0.881) had better discrimination abilities than did those in method A (Az-value, 0.527-0.607). The ICCs of D and f were good to excellent (0.639-0.835) with all methods. The ICCs of D* were moderate with methods B (0.580) and C (0.463) and good with method A (0.705). CONCLUSION: The IVIM parameters may vary depending on the fitting methods, and therefore, further technical refinement may be needed.

DOI： 10.2463/mrms.mp.2017-0047

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To compare the occurrence of transient respiratory motion (TM) artifacts between 0.05 mmol/kg and 0.025 mmol/kg gadoxetic-acid on arterial phase MRI intra-individually for evaluating dose-dependence of gadoxetic acid. MATERIALS AND METHODS: This retrospective study involved 91 patients who underwent dynamic MRI at 1.5T at different times, one time with 0.05 mmol/kg and the other 0.025 mmol/kg gadoxetic-acid. Examinations with 0.05 mmol/kg totaled 91 scans, and examinations with 0.025 mmol/kg totaled 375 scans (due to multiple exams for several patients). The scan with 0.025 mmol/kg closest in time to the 0.05 mmol/kg scan was selected to minimize temporal effects. Two radiologists graded TM artifacts in the arterial phase images using a four-point scale: no, mild, moderate, and severe artifacts. Results were compared between the two protocols (0.05 mmol/kg versus all 0.025 mmol/kg and 0.05 mmol/kg versus selected 0.025 mmol/kg), and the odds ratio for moderate-to-severe artifacts was calculated. RESULTS: Significantly more TM artifacts were observed in the double dose (16/91 [17%]) scans compared with either all (17/375 [4%]; P < 0.01) or selected (3/91 [3%]; P = 0.01) standard dose scans. The odds ratio of the moderate-to-severe artifacts with the higher dose was 4.99-5.33. CONCLUSION: There appears to be dose-dependence of gadoxetic-acid and the occurrence of TM artifacts. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:433-438.

DOI： 10.1002/jmri.25764

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00330-017-4811-2

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To evaluate the effect of imaging sequence (spin-echo echo-planar imaging [EPI] and gradient-echo [GRE]) and postprocessing method (two-dimensional [2D] and 3D inversion algorithms) on liver MR elastography (MRE) and to validate the diagnostic performance of EPI-MRE3D versus conventional GRE-MRE2D for liver fibrosis staging. MATERIALS AND METHODS: Three MRE methods (EPI-MRE3D , EPI-MRE2D , and GRE-MRE2D ) were performed on soft and mildly stiff phantoms and 58 patients with chronic liver disease using a 3 Tesla clinical MRI scanner, and stiffness values were compared among the three methods. A validation study comprised 73 patients with histological liver fibrosis (F0-4, METAVIR system). Areas under the receiver operating characteristic curves (AUCs) and accuracies for diagnosing significant fibrosis (F3-4) and cirrhosis (F4) were compared between EPI-MRE3D and GRE-MRE2D . RESULTS: Stiffness values of the soft and mildly stiff phantoms were 2.4 kPa and 4.0 kPa by EPI-MRE3D ; 2.6 kPa and 4.2 kPa by EPI-MRE2D ; and 2.7 kPa and 4.2 kPa by GRE-MRE2D . In patients, EPI-MRE3D provided significantly lower stiffness values than other methods (P < 0.001). However, there was no significant difference between GRE-MRE2D and EPI-MRE2D (P = 0.12). The AUCs and accuracies of EPI-MRE3D and GRE-MRE2D were statistically equivalent in the diagnoses of significant fibrosis (F3-4) and cirrhosis (F4) (all P < 0.005). CONCLUSION: EPI-MRE3D showed modestly lower liver stiffness values than conventional GRE-MRE2D . The diagnostic performances of EPI-MRE3D and GRE-MRE2D were equivalent for liver fibrosis staging. LEVEL OF EVIDENCE: 3 J. Magn. Reson. Imaging 2017;45:1163-1170.

DOI： 10.1002/jmri.25425

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: To evaluate the longitudinal risk to patients with cirrhosis of hypervascular hepatocellular carcinoma (HCC) developing from hypovascular hepatic nodules that show positive uptake of gadoxetic acid (hyperintensity) on hepatocyte phase images. METHODS: In 69 patients, we evaluated findings from serial follow-up examinations of 633 hepatic nodules that appeared hypovascular and hyperintense on initial gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) until the nodules demonstrated hypervascularity and were diagnosed as hypervascular HCC. Cox analyses were performed to identify risk factors for the development of hypervascular HCCs from the nodules. RESULTS: The median follow-up was 663 days (range, 110 to 1215 days). Hypervascular HCCs developed in six of the 633 nodules (0.9 %) in five of the 69 patients. The only independent risk factor, the nodule's initial maximum diameter of 10 mm or larger, demonstrated a hazard ratio of 1.25. The one-year risk of hypervascular HCC developing from a nodule was 0.44 %. The risk was significantly higher for nodules of larger diameter (1.31 %) than those smaller than 10 mm (0.10 %, p < 0.01). CONCLUSIONS: Hypervascular HCC rarely develops from hypovascular, hyperintense hepatic nodules. We observed low risk even for nodules of 10 mm and larger diameter at initial examination. KEY POINTS: • Hypervascularization was rare on follow-up examination of hypovascular, hyperintense nodules • The risk of hypervascularization in a nodule increased with large size • Hypovascular, hyperintense nodules require neither treatment nor more intense follow-up.

DOI： 10.1007/s00330-016-4423-2

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To evaluate the usefulness of magnetic resonance elastography (MRE) in detecting the clinical progression of cirrhosis from Child-Pugh class A to B in patients with hepatitis C. MATERIALS AND METHODS: We reviewed the data of 101 consecutive patients with type C viral hepatitis and clinically suspected cirrhosis who fulfilled the all following criteria: available MRE at 1.5 Tesla (T) or 3.0T and laboratory tests within a month, Child-Pugh class A, platelet count less than 155 × 10(3) /μL, no clinical history of hepatocellular carcinoma, and ≥6 months of follow-up after MRE. We longitudinally analyzed the incidence of cirrhosis progression as defined by the clinical progression from Child-Pugh class A to B at two subsequent follow-up points. Risk of cirrhosis progression was assessed by Cox analyses and Kaplan-Meyer methods. RESULTS: Cirrhosis progression was noted in 25 patients during the follow-up period. Liver stiffness (hazard ratio [HR] by 1 kPa increase = 1.397; P = 0.0074), Child-Pugh score of 6 versus score 5 (HR of 3.085; P = 0.0276), and treatment responses to anti-viral therapy versus nonresponse (HR of <0.001, P = 0.0006) were independent risk factors of cirrhosis progression. The 1-year risk (0.7%; 95% confidence interval, 0.1-4.2%) of cirrhosis progression was negligible in patients with liver stiffness of <3.3 kPa or response to anti-viral treatment. CONCLUSION: MRE is useful to stratify the risk of cirrhosis progression in patients with hepatitis C. J. Magn. Reson. Imaging 2016;44:715-722.

DOI： 10.1002/jmri.25182

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: We investigated the added value of the hypointensity on hepatocyte-phase (HP) imaging of gadoxetic acid-enhanced MRI (EOB-MRI) in the 2014 version of the Liver Imaging Reporting and Data System (LI-RADS) for distinguishing hepatocellular carcinoma (HCC) from benign hepatic lesions in patients with chronic liver disease. METHODS: We retrospectively evaluated targeted lesions (111 HCCs, 28 benign hepatic lesions) of 139 patients (101 men, 38 women; aged 18 to 89 years, mean age, 68 ± 11 years) with chronic liver disease. EOB-MRI and dynamic contrast-enhanced computed tomography (CECT) were performed within 3 months. Two abdominal radiologists independently reviewed 3 imaging datasets: (1) EOB-MRI without an HP image using the LI-RADS system (MR imaging without HP); (2) EOB-MRI with an HP image using a modified version of the LI-RADS system in which hypointensity on the HP image was used as an additional major criterion of malignancy (MR imaging with HP); and (3) dynamic contrast-enhanced computed tomography (CECT) images using the LI-RADS system. We evaluated intra- and inter-reader agreement with kappa statistics along with 95% confidence intervals and compared diagnostic sensitivity and specificity of the 3 imaging datasets with McNemar's test. RESULTS: The sensitivities of MR imaging were statistically higher with HP (Reader 1, 95% [107/111]; Reader 2, 95% [106/111]) than without HP (Reader 1, 84% [93/111], P = 0.002; Reader 2, 86% [96/111], P = 0.002). Specificity was comparably high between MR imaging with HP (Reader 1, 96% [27/28]; Reader 2, 96% [27/28]) and dynamic CECT (Reader 1, 100% [28/28], P = 0.317; Reader 2, 100% [28/28], P = 0.317) and MR imaging without HP (Reader 1, 96% [27/28], P = 1.00; Reader 2, 100% [28/28], P = 0.317). CONCLUSION: The use of an HP image from EOB-MRI as an additional major criterion improved the sensitivity of LI-RADS to distinguish HCCs from benign hepatic lesions while retaining high specificity.

DOI： 10.2463/mrms.2014-0149

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND & AIMS: Human hepatocarcinogenesis in cirrhosis is thought to be multistep and characterized by a spectrum of nodular lesions, ranging from low to high grade dysplastic nodules (LGDN and HGDN) to early and progressed hepatocellular carcinoma (eHCC and pHCC). The aim of this study was to investigate the morphophenotypical changes of this sequence and their potential translational significance. METHODS: We scored the vascular profile, ductular reaction/stromal invasion and overexpression of five biomarkers (GPC3, HSP70, GS, CHC, and EZH2), in a series of 100 resected nodules (13 LGDN, 16 HGDN, 42 eHCC and 29 small pHCC). RESULTS: The score separated the four groups of nodules as individual entities (p<0.01). In the sequence, biomarker's overexpression progressively increased with parallel decrease of ductular reaction; the vascular remodeling started very early (LGDN) but did not further develop in a proportion of HCC. eHCC was the most heterogeneous entity, with marginal overlap with HGDN and pHCC. Liver environment (fibrosis, etiology) did not impact on the phenotype of the different nodules. A subclass of eHCC (16/42) without evidence of stromal invasion was identified, suggesting a "preinvasive stage" (p<0.05). For diagnosis, the application of four and five biomarkers (rather than the usual three) improved the sensitivity of the assay for the detection of eHCC (76% and 93% vs. 52%); biomarkers in alternative combinations, and also increased the sensitivity of the assay (GS+CHC+EZH2: 76%; GS+CHC+EZH2+HSP70: 90%). CONCLUSIONS: This study supports the multistep nature of human hepatocarcinogenesis, and suggests that eHCC is more heterogeneous than previously thought. This provides further information of the potential translational significance into clinical practice.

DOI： 10.1016/j.jhep.2015.08.031

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: During the follow-up of patients with chronic liver disease, hypervascular hepatocellular carcinomas (HCCs) can develop either from pre-existing high-risk nodules or by de novo hepatocarcinogenesis. The purpose of this study was to evaluate, by retrospective analysis, the detectability and signal intensity on previous hepatocyte-phase gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) of hypervascular HCC initially detected on current EOB-MRIs. METHODS: We examined 50 initially detected hypervascular HCCs that showed typical enhancement features on EOB-MRI in 39 patients whose previous EOB-MRI images obtained 6-19 months earlier were available. The detectability of each hypervascular HCC on the hepatocyte phase images of previous EOB-MRIs was assessed. The imaging features on hepatocyte-phase images of previous EOB-MRIs at the locations where hypervascular HCCs were found on the current EOB-MRI images were classified as detectable or undetectable. The signal intensities of detectable nodules (defined as group A) on hepatocyte-phase images of previous EOB-MRIs were classified as hypo-, iso-, or hyperintensity. Nodules undetectable on the hepatocyte-phase images of previous EOB-MRIs were assigned to group B. RESULTS: Twenty-two (22/50, 44%) hypervascular HCCs were detectable on the earlier hepatocyte phase images (group A). In contrast, 28 (28/50, 56%) hypervascular HCCs were not detectable on the hepatocyte phase of earlier EOB-MRI images (group B). CONCLUSION: When the previous EOB-MRI images were used as the reference, more than half (28/50, 56%) of hypervascular HCCs initially appearing on the current EOB-MRI images were found not to have developed from nodules detectable on the previous MRIs through the traditionally accepted process of multistep carcinogenesis. Instead, they seemed to have developed via an "imaging-occult" process of carcinogenesis in patients with chronic liver diseases.

DOI： 10.1159/000367736

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To evaluate the use of intravoxel incoherent motion (IVIM) imaging for staging hepatic fibrosis, and compare its staging ability with that of magnetic resonance elastography (MRE). MATERIALS AND METHODS: This study included 129 patients with pathologically staged liver fibrosis, and 53 patients with healthy livers. All patients underwent both MRE and IVIM imaging. Four diffusivity indices were calculated with 11 b-values; slow diffusion coefficient related to molecular diffusion (D), fast diffusion coefficient related to perfusion in micro-vessels (D*), perfusion-related diffusion fraction (f), and apparent diffusion coefficient (ADC). Receiver operating characteristic curve analysis was performed to determine the accuracy of IVIM imaging and MRE for staging hepatic fibrosis. RESULTS: D*, f, and ADC values decreased significantly with fibrosis stage (P < 0.0124), and liver stiffness increased (P < 0.0001). The Az value of MRE was significantly higher than that of D* for all fibrosis stages (D* vs. MRE for ≥ F1, 0.851 vs. 0.992 [P < 0.0001]; ≥ F2, 0.898 vs. 0.998 [P = 0.0003]; ≥ F3, 0.904 vs. 0.995 [P = 0.0004]; F4, 0.885 vs. 0.996 [P < 0.0001]). CONCLUSION: IVIM imaging is a useful technique for evaluating hepatic fibrosis, but MRE is better able to discriminate fibrosis stages than IVIM imaging.

DOI： 10.1002/jmri.24760

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To evaluate the effect of hepatitis activity on liver stiffness measurements and the role of serum alanine aminotransferase (ALT) in liver fibrosis staging by MR elastography (MRE). MATERIALS AND METHODS: We measured liver stiffness (kPa) in 135 patients by MRE and histologically assessed fibrosis and hepatitis activity within 2 months. Stepwise multiple linear regression was performed to determine the maximum adjusted R(2) against liver stiffness, after adjusting for nothing (model 1), ALT/upper limit of normal categories (model 2), and hepatitis activity (A grade) by METAVIR (model 3). Logistic regression was used to identify independent factors associated with pathologically proven cirrhosis. RESULTS: Platelet count and METAVIR F score were strongly associated with liver stiffness. The adjusted R(2) value of model 3 (0.7026) was higher than those of models 1 (0.6472) and 2 (0.6564), showing that hepatitis activity affected liver stiffness measurement. High ALT levels (odds ratio, 0.0066; P = 0.0003) as well as MRE (odds ratio, 9.91; P < 0.0001) were independently associated with cirrhosis. CONCLUSION: Hepatitis activity may be a confounder of liver stiffness measurement during liver fibrosis staging using MRE. MRE can potentially make an overdiagnosis of liver cirrhosis if the patient has high ALT levels.

DOI： 10.1002/jmri.24666

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: We evaluated the validity and reliability of magnetic resonance elastography (MRE) for staging hepatic fibrosis in patients with chronic hepatitis B. METHODS: The study included 73 patients with chronic hepatitis B and confirmed stages of pathological fibrosis. Two radiologists measured liver stiffness using MRE in all cases. We compared the area under the receiver operating characteristic (ROC) curve (Az) for distinguishing stages of fibrosis compared with MRE liver stiffness measurements and serum fibrosis markers. We used intraclass correlation coefficients to analyze interobserver agreement for measurements of liver stiffness and 2 one-sided t-tests to test the equivalence of the measurements by the 2 observers. RESULTS: ROC analyses revealed the significantly superior discrimination abilities of MRE for liver fibrosis staging (Az = 0.945 to 0.978 [Observer 1] and 0.936 to 0.967 [Observer 2]) to those of serum fibrosis markers (0.491 to 0.742) for both observers (P < 0.0004). The intraclass correlation coefficient between the 2 observers was excellent (ρ = 0.971), and the measurements of liver stiffness by the 2 observers were statistically equivalent within a 0.1-kPa difference (P = 0.0157)CONCLUSION: MRE is a valid and reliable technique for discriminating the stage of hepatic fibrosis in patients with chronic hepatitis B.

DOI： 10.2463/mrms.2014-0150

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: To compare the diagnostic accuracies of magnetic resonance elastography (MRE) and transient elastography (TE) for hepatic fibrosis. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board and included 113 patients (mean age, 63.1±12.2years; 84 men and 29 women) with chronic liver disease who underwent liver biopsy or resection, histopathologic assessment (METAVIR scoring system), and TE within 6months of MRE. Diagnostic accuracies of MRE and TE were compared using receiver operating characteristic curve analysis. Appropriate cutoff values of the two methods determined by maximum positive and minimum negative likelihood ratios were used to calculate the positive and negative predictive values for discriminating significant fibrosis (≥F2) from F0-F1 or cirrhosis (F4) from F0-F3. RESULTS: Mean (95% confidence interval) area under the receiver operating characteristic curve values of MRE for cirrhosis (F4) (0.97 [0.93-0.99] vs. 0.93 [0.87-0.96]; P=0.0308), clinically significant fibrosis (≥F2) (0.98 [0.94-0.99] vs. 0.87 [0.79-0.92]; P=0.0003), and any fibrosis (≥F1) (0.97 [0.92-0.99] vs. 0.87 [0.76-0.93]; P=0.0126) were significantly higher than those of TE. By using the cutoff values derived from the maximum positive likelihood ratio, the positive and negative predictive values for≥F2 were 98.8% and 83.9%, respectively, by MRE and 98.2% and 44.8%, respectively, by TE; and for F4, 97.0% and 86.3%, respectively, by MRE and 95.8% and 77.5%, respectively, by TE. CONCLUSION: MRE has better diagnostic accuracy than TE for staging hepatic fibrosis.

DOI： 10.1016/j.mri.2014.10.003

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To identify magnetic resonance imaging (MRI)-based parameters associated with gastroesophageal varices (GEVs) in patients with chronic liver disease. MATERIALS AND METHODS: Ninety-three patients were divided into three groups based on endoscopic findings: group 1 with no GEVs (n = 49), group 2 with mild GEVs (n = 30), and group 3 with severe GEVs (n = 14). We used a multivariate logistic regression analysis to assess liver stiffness, aspartate aminotransferase-to-platelet ratio index, spleen stiffness and volume, portal vein velocity, cross-sectional area, and flow volumes potential independent associators of any (mild and severe) GEVs or severe GEVs. RESULTS: The analysis showed that spleen and liver stiffness and spleen volume were independently associated with any GEVs (spleen stiffness, odds ratio [95% confidence interval], 1.25 [1.04-1.68], P = 0.018; liver stiffness, 1.52 [1.13-2.17], P = 0.006; spleen volume, 1.01 [1.00-1.01], P = 0.016), whereas spleen stiffness was associated with severe GEVs (1.82 [1.25-2.95]; P = 0.005). CONCLUSION: Liver and spleen stiffness and spleen volume are associated with GEVs in patients with chronic liver disease. Compared with liver stiffness and spleen volume, spleen stiffness is more strongly associated with severe GEVs.

DOI： 10.1002/jmri.24505

PubMed

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1097/rct.0000000000000114

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: After much debate, the International Consensus Group for Hepatocellular Neoplasia (ICGHN) has recently arrived at a conclusion regarding the pathological criteria for early hepatocellular carcinoma (HCC). They have stated that stromal invasion should be recognized as the most important pathological finding for precisely diagnosing and differentiating early HCC from dysplastic nodules (DN). METHODS: We conducted a review of the imaging findings from multi-imaging modalities of early HCC cases diagnosed according to the pathological criteria of the ICGHN. The multi-imaging modalities included gadoxetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI), abbreviated as EOB-MRI, contrast-enhanced CT (CE-CT), CT during arterioportography (CTAP), and CT during hepatic arteriography (CTHA). It has been shown that EOB-MRI is the only imaging modality that has sufficient resolution for the detection and classification of early HCC. RESULTS: The most significant imaging feature for diagnosing early HCC was hypointensity on hepatobiliary-phase (HP) images of EOB-MRI; all of the cases of early HCC that were detected on HP images of EOB-MRI showed hypointensity, while all of the images of DN showed isointensity or hyperintensity compared with the liver parenchyma. The results of the diagnostic performance analysis showed that EOB-MRI had excellent sensitivity (97%) for detecting early HCC and outstanding specificity (100%) for distinguishing early HCC from DN. CONCLUSIONS: Considering the results from imaging-pathologic correlations and follow-up studies indicating that many early-stage hepatocellular nodules showing hypointensity on HP images of EOB-MRI tend to develop hypervascularization during a relatively short follow-up period, it is beginning to be accepted that such nodules may be treated as early HCC. However, hepatologists and radiologists should also recognize that some cases of early HCC may show isointensity or hyperintensity on HP images of EOB-MRI, making it impossible to differentiate early HCC from DN, although the low prevalence of such nodules may be unlikely to affect the generally accepted follow-up protocols for cirrhotic patients. Our results and other recent reports have indicated that signal-intensity patterns on HP images of EOB-MRI for DN and early HCC directly correlate with the degree of expression of the organic anion transporting polypeptide (OATP) 1B3 in the nodules. Thus, the diagnostic performance of pathological analyses for early HCC cases may be dramatically improved, nearly up to that of EOB-MRI, by incorporating an OATP1B3 staining method.

DOI： 10.1159/000343865

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To determine whether the presence of a hypovascular nodule in the liver showing hypointensity on hepatocyte-phase of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) is a risk factor for hypervascular hepatocellular carcinoma (HCC) in patients with chronic liver disease. MATERIALS AND METHODS: Forty-one patients with pathologically confirmed hypervascular HCC and 41 age- and gender-matched controls were retrospectively selected. These patients had undergone EOB-MRI at least twice: the latest EOB-MRI and EOB-MRI performed more than 6 months earlier. History of hypervascular HCC, presence of a hypointense hypovascular nodule in previous hepatocyte-phase MR images, percent prothrombin time, platelet count, serum levels of albumin, total bilirubin, aspartate aminotransferase, alanine aminotransferase, α-fetoprotein, and protein induced by vitamin K absence-II (PIVKA-II) were variables evaluated by multivariate logistic regression analysis. RESULTS: Multivariate analysis revealed that serum albumin level (odds ratio [95% confidence interval], 0.19 [0.06-0.57]; P = 0.0024), history of hypervascular HCC (8.62 [2.71-32.8]; P = 0.0001), and presence of a hypointense hypovascular nodule (4.18 [1.18-17.2]; P = 0.0256) were significant risk factors for hypervascular HCC. CONCLUSION: Patients with chronic liver disease showing a hypointense hypovascular nodule in the liver on hepatocyte-phase EOB-MRI have a high risk of HCC development.

DOI： 10.1002/jmri.24164

PubMed

Language：Japanese  

Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To investigate the relationship between estimated glomerular filtration rate (eGFR) and parameters calculated using intravoxel incoherent motion (IVIM) imaging of the kidneys. MATERIALS AND METHODS: We studied 365 patients, divided into 4 groups based on eGFR levels (mL/min/1.73m(2)): group 1, eGFR≥80(n=80); group 2, eGFR 60-80 (n=156); group 3, eGFR 30-60 (n=114); and group 4 ,eGFR<30 (n=15). IVIM imaging was used to acquire diffusion-weighted images at 12 b values. The diffusion coefficient of pure molecular diffusion (D), the diffusion coefficient of microcirculation or perfusion (D*), and perfusion fraction (f) were compared among the groups using group 1 as control. RESULTS: In the renal cortex, D* values were significantly lower in groups 2, 3, and 4 than in group 1. The D value of renal cortex was significantly low in only group 3. In the renal medulla, the D* and D values were significantly lower only in groups 2 and 3, respectively. CONCLUSION: As renal dysfunction progresses, renal perfusion might be reduced earlier and affected more than molecular diffusion in the renal cortex. These changes are effectively detected by IVIM MR imaging.

DOI： 10.1016/j.mri.2012.08.004

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: To assess the value of hepatic arterial-phase (HAP) imaging with a low tube voltage (80 kVp), using non-helical, volumetric acquisition with a 320-detector-rows area-detector CT (ADCT) scanner for evaluating hypervascular hepatocellular carcinoma (HCC) compared with routine 120-kVp HAP imaging. METHODS: This study enrolled 128 patients with 148 HCCs. Seventy-six patients with 79 HCCs underwent HAP imaging with 80 kVp obtained using a 320-detector-rows ADCT scanner. The remaining 52 patients with 69 HCCs underwent routine HAP imaging with 120 kVp obtained by 64-slice helical acquisition. Image noise and tumor to liver contrast-to-noise ratio (CNR) of the two sets of images were compared. Three radiologists evaluated both sets of images using receiver operating characteristic analyses. RESULTS: Although there was a two-fold increase in the mean image noise with 80 kVp over that with 120 kVp (p < 0.001), no significant differences were observed in CNR among the two sets. The mean area under the curve (Az value) and the sensitivity for detecting HCC with 80 kVp (0.980, 78/79, respectively) were higher than that of 120 kVp (0.892, 55/69, respectively). CONCLUSIONS: HAP imaging with 80 kVp obtained by an ADCT scanner significantly improves the diagnostic performance for evaluating hypervascular HCC.

DOI： 10.1007/s11604-013-0217-5

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To compare diffusivity values between malignant and benign focal hepatic lesions using the intravoxel incoherent motion model. MATERIALS AND METHODS: This study included 84 focal hepatic lesions in 84 patients. Final diagnoses were as follows: hepatocellular carcinoma (n = 45), cholangiocarcinoma (n = 6), metastatic liver tumor (n = 3), cyst (n = 20), hemangioma (n = 5), inflammatory pseudotumor (n = 2), abscess (n = 2), and focal nodular hyperplasia (n = 1). Diffusion-weighted images at 12 b-values were used to obtain the diffusion coefficient of pure molecular diffusion (D), diffusion coefficient of microcirculation or perfusion-related diffusion (D*), and perfusion-related diffusion fraction (f). Parameters of malignant and benign focal hepatic lesions were compared using the Wilcoxon test. The diagnostic performance for distinguishing between malignant and benign hepatic lesions was also analyzed. RESULTS: Both the D value (1.15 ± 0.21 × 10(-3) mm(2) /s [mean ± standard deviation]) and D* value (62.7 ± 12.7 × 10(-3) mm(2) /s) in malignant lesions was significantly lower than that in benign lesions (D value [2.46 ± 0.45× 10(-3) mm(2) /s], P < 0.0001; D* value [87.6 ± 35.3 × 10(-3) mm(2) /s], P = 0.0008). The f value did not differ significantly between malignant (25.0 15.1 ± 15.1%) and benign lesions (30.1 ± 16.3%). CONCLUSION: D* and D values were suppressed in malignant lesions. However, the D value was more reliable for distinguishing between malignant and benign focal hepatic lesions.

DOI： 10.1002/jmri.23930

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Ovid Technologies (Wolters Kluwer Health)  

DOI： 10.1097/RCT.0b013e3182873799

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: We evaluated flow parameters measured by phase-contrast magnetic resonance (MR) imaging (PC-MRI) of the portal venous system and liver stiffness measured by MR elastography (MRE) to determine the usefulness of these methods in predicting gastroesophageal varices (GEV) in patients with chronic liver disease (CLD). METHODS: In patients with CLD and controls, we performed PC-MRI on the portal (PV) and superior mesenteric veins; calculated mean velocity (V, cm/s), cross-sectional area (S, mm²), and flow volume (Q, mL/min); and determined markers of liver fibrosis (liver stiffness [kPa]) and aspartate aminotransferase (AST) platelet ratio index [APRI]). We visually assessed GEV and development of collateral pathways of the PV on routine contrast-enhanced dynamic MR imaging and compared patient characteristics, flow parameters, liver stiffness markers, and visual analysis among 3GEV groups, those with mild, severe, or no GEV with reference to endoscopic findings. RESULTS: Child-Pugh grade, VPV, SPV, liver stiffness, APRI, and visually identified GEV (visible GEV) differed significantly among the 3 groups (P<0.05). We investigated VPV, SPV, liver stiffness, and visible GEV as independent markers to distinguish patients with and without GEV and examined VPV and visible GEV to predict severe GEV. Visible GEV showed low sensitivity (14 to 30%) and high specificity (98%) for predicting GEV in patients with CLD. A subgroup analysis that excluded cases with collateral pathway demonstrated slightly improved diagnostic performance of VPV and liver stiffness. CONCLUSIONS: Portal vein flow parameters and liver stiffness can be useful markers for predicting GEV in patients with CLD.

DOI： 10.2463/mrms.2012-0052

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: To examine if liver stiffness measured by magnetic resonance elastography (MRE) is a risk factor for hepatocellular carcinoma (HCC) in patients with chronic liver disease. METHODS: By reviewing the records of magnetic resonance (MR) examinations performed at our institution, we selected 301 patients with chronic liver disease who did not have a previous medical history of HCC. All patients underwent MRE and gadoxetic acid-enhanced MR imaging. HCC was identified on MR images in 66 of the 301 patients, who were matched to controls from the remaining patients without HCC according to age. MRE images were obtained by visualising elastic waves generated in the liver by pneumatic vibration transferred via a cylindrical passive driver. Risk factors of HCC development were determined by the odds ratio with logistic regression analysis; gender and liver stiffness by MRE and serum levels of aspartate transferase, alanine transferase, alpha-fetoprotein, and protein induced by vitamin K absence-II. RESULTS: Multivariate analysis revealed that only liver stiffness by MRE was a significant risk factor for HCC with an odds ratio (95 % confidence interval) of 1.38 (1.05-1.84). CONCLUSION: Liver stiffness measured by MRE is an independent risk factor for HCC in patients with chronic liver disease.

DOI： 10.1007/s00330-012-2571-6

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: We evaluated the use of magnetic resonance (MR) elastography (MRE) for staging liver fibrosis in patients with chronic hepatitis C and compared the ability of MRE and serum fibrosis markers for discriminating each stage of fibrosis. METHODS: We evaluated 114 patients with chronic hepatitis C in whom the pathological fibrosis stage was determined (fibrosis stage 0 [F0], 3; F1, 15; F2, 28; F3, 25; and F4, 43). All patients underwent MRE using a 1.5-tesla MR system and pneumatic driver system. We measured stiffness values (kPa) of the liver in a circular region of interest placed on elastograms. We determined the optimal cutoff value and diagnostic ability for discriminating each stage of fibrosis using receiver operating characteristic (ROC) curve analysis and compared the discriminative ability of MRE with that of serum fibrosis markers. RESULTS: The mean stiffness values of the liver increased with stage of fibrosis: F0, 2.10±0.10 kPa; F1, 2.42±0.29 kPa; F2, 3.16±0.32 kPa; F3, 4.21±0.78 kPa; and F4, 6.20±1.08 kPa. The mean area under the ROC curve (Az) values for discriminating liver fibrosis stages were: ≥F1, 0.984 (95% confidence interval, 0.933-0.996); ≥F2, 0.986 (0.956-0.996); ≥F3, 0.973 (0.935-0.989); and ≥F4, 0.976 (0.945-0.990). The Az values for discriminating fibrosis stages were significantly higher for MRE than serum fibrosis markers. CONCLUSION: MRE is a reliable technique for staging liver fibrosis and discriminating liver fibrosis stages in patients with chronic hepatitis C.

DOI： 10.2463/mrms.11.291

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: The aim of this study was to examine liver stiffness value measured by magnetic resonance elastography (MRE) and laboratory test results to find the best method for predicting insufficient liver enhancement on gadoxetic acid-enhanced hepatocyte-phase images. MATERIALS AND METHODS: The institutional ethics committee approved this retrospective study with waiver of informed consent. In total, 118 patients with Child-Pugh class A disease and type C hepatitis underwent MRE and gadoxetic acid-enhanced magnetic resonance imaging. During MRE examination, a pneumatic passive driver was used to obtain liver stiffness in kPa. Liver enhancement was assessed using liver-to-spleen contrast ratio (LSR), calculated using signal intensities of the liver and spleen on hepatocyte-phase magnetic resonance images obtained 20 minutes after contrast administration of gadoxetic acid. Insufficient liver enhancement was defined as an LSR lower than 1.5. The following laboratory test results were used as possible predictors of insufficient liver enhancement as well as liver stiffness measured by MRE: albumin, total bilirubin, aspartate aminotransferase, percentage prothrombin time, and platelet count. Correlation coefficients were calculated between LSR and these variables. Logistic analysis was performed to determine independent predictors of insufficient liver enhancement. RESULTS: All possible predictors investigated were significantly correlated with LSR. Logistic regression analysis revealed that MRE was the only variable to predict insufficient liver enhancement, with an odds ratio (95% confidence interval) of 2.03 (1.22-3.85) (P = 0.0138). A cutoff value of greater than 6.4 kPa yielded 95% specificity for predicting insufficient liver enhancement. CONCLUSION: Gadoxetic acid is not recommended in patients with liver stiffness greater than 6.4 kPa (consistent with severe fibrosis) because of insufficient liver enhancement on hepatocyte-phase images.

DOI： 10.1097/RLI.0b013e318260ac9e

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To utilize 320-detector row CT in perfusion CT of multiple abdominal organs and to compare the tissue perfusion between patients with and without liver cirrhosis. MATERIALS AND METHODS: This study included 21 patients with cirrhosis and 20 without cirrhosis. The 320-detector row CT scanner enabled multi-organ perfusion CT without requiring the scanner table to be moved. Perfusion was calculated using the maximum slope model for the aorta, the portal vein, the right and left lobes of the liver, the head and body of the pancreas, the spleen, and the corpus and antrum of the stomach. Perfusion in each organ of patients with and without cirrhosis was compared. RESULTS: Portal venous perfusion of the right and left lobes of the liver in patients with cirrhosis (117 and 100 mL min(-1)100mL(-1), respectively) was significantly less than that in patients without cirrhosis (213 and 174 mL min(-1)100mL(-1), respectively; p=0.0081 and 0.0294, respectively). Arterial perfusion of the spleen (111 mL min(-1)100mL(-1)) and the body of the pancreas (112 mL min(-1)100mL(-1)) in patients with cirrhosis was also significantly decreased compared with that in patients without cirrhosis (spleen, 162 mL min(-1)100mL(-1), p=0.0020; body of pancreas, 133 mL min(-1)100mL(-1), p=0.0405). CONCLUSION: The results of the perfusion CT suggest that arterial perfusion of the spleen and the body of the pancreas, as well as portal perfusion of the liver, in cirrhotic patients was decreased compared with that in non-cirrhotic patients.

DOI： 10.1016/j.ejrad.2011.11.054

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To clarify the optimal iodine dose of contrast material for 3-dimensional multidetector-row CT angiography (3D-MDCTA) of the venous vasculature of the liver using volume rendering technique. MATERIALS AND METHODS: This study included 103 patients who were randomly assigned to 5 contrast-enhanced MDCT protocol groups with different body-weight-tailored doses of contrast material: 500, 600, 630, 650, and 700 mgI/kg body weight. The arterial, portal, and hepatic parenchymal phases were obtained to evaluate enhancement values of the aorta, portal vein, and hepatic vein. Visualization of the portal and hepatic veins on the volume-rendering images of 3D-MDCTA was evaluated using a 5-point grade. Dunnett's test was used to compare the mean enhancement value and mean grades of image quality (700 mgI/kg dose group was control). RESULTS: The mean enhancement values of portal and hepatic vein in the group with 500 and 600 mgI/kg were significantly lower than those of the control group. During visual assessment, a significantly lower mean grades were observed in 500 mgI/kg groups for the portal vein, and 500 and 600 mgI/kg groups for hepatic vein. There were no significant intergroup differences in mean enhancement values and visual assessment among the groups using 630 mgI/kg or more. CONCLUSION: Iodine doses of 630 mgI/kg was recommended for 3D-MDCTA.

DOI： 10.1016/j.ejrad.2011.06.022

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To intraindividually compare gadoxetic acid-enhanced magnetic resonance (MR) imaging with contrast material-enhanced multi-detector row computed tomography (CT) in detection of pancreatic carcinoma and liver metastases. MATERIALS AND METHODS: The ethics committee approved this retrospective study with waiver of informed consent. This study included 100 patients (53 men, 47 women; mean age, 67.8 years) consisting of 54 patients with pathologically confirmed pancreatic carcinoma (mean size, 33 mm) and 46 without a pancreatic lesion. Sixty-two liver metastases (mean size, 10 mm) in 15 patients with pancreatic carcinoma were diagnosed at pathologic examination or multimodality assessment. Three readers blinded to the final diagnosis interpreted all MR (precontrast T1- and T2-weighted and gadoxetic acid-enhanced dynamic and hepatocyte phase MR images) and tetraphasic dynamic contrast-enhanced CT images and graded the presence (or absence) of pancreatic carcinoma and liver metastasis on patient-by-patient and lesion-by-lesion bases. Receiver operating characteristic analysis, McNemar test, and Fisher test were performed to compare the diagnostic performance of CT and MR imaging. RESULTS: No significant differences were observed between CT and MR images in depiction of pancreatic carcinoma. However, MR imaging had greater sensitivity in depicting liver metastasis than did CT for two of the three readers in the MR imaging-versus-CT analysis (85% vs 69%, P = .046) and for all three readers in the lesion-by-lesion analysis (92%-94% vs 74%-76%, P = .030-.044). CONCLUSION: Gadoxetic acid-enhanced MR imaging was equivalent to dynamic contrast-enhanced CT in depicting pancreatic carcinoma and had better sensitivity for depicting liver metastases, suggesting the usefulness of gadoxetic acid-enhanced MR imaging for evaluation of patients with pancreatic carcinoma.

DOI： 10.1148/radiol.11103548

PubMed

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Event date： 2023.12

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：ZoomによるWeb開催   Country：Japan  

Event date： 2023.12

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：有明セントラルタワーホール＆カンファレンス   Country：Japan  

Event date： 2023.9

Language：Japanese   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：軽井沢プリンスホテル ウェスト   Country：Japan  

Event date： 2023.9

Language：Japanese   Presentation type：Poster presentation  

Venue：軽井沢プリンスホテルウェスト   Country：Japan  

Event date： 2023.9

Language：English   Presentation type：Oral presentation(invited, special)  

Country：Thailand  

Event date： 2023.8

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：第24回群馬県CT・MRI研究会   Country：Japan  

Event date： 2023.7

Language：Japanese   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：神戸ポートピアホテル＋オンラインライブ配信.   Country：Japan  

Event date： 2023.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：仙台国際センター   Country：Japan  

Event date： 2023.6

Language：Japanese   Presentation type：Poster presentation  

Venue：仙台国際センター  

Event date： 2023.4

Language：Japanese   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：パシフィコ横浜   Country：Japan  

Event date： 2023.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：パシフィコ横浜   Country：Japan  

Event date： 2022.12

Language：Japanese   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：Web開催  

Language：Japanese   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：Web開催  

Event date： 2022.10

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web講演  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web講演  

Event date： 2022.9

Language：English   Presentation type：Oral presentation(general)  

Language：English   Presentation type：Oral presentation(general)  

Venue：名古屋国際会議場/ライブ配信（ハイブリッド開催）  

Event date： 2022.7

Language：Japanese   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：Web配信  

Language：Japanese   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：Web配信  

Event date： 2022.5

Language：English   Presentation type：Poster presentation  

Venue：ExCel London   Country：United Kingdom  

Event date： 2021.9

Language：English   Presentation type：Poster presentation  

Event date： 2021.9

Language：English   Presentation type：Oral presentation(general)  

Language：English   Presentation type：Poster presentation  

Venue：パシフィコ横浜  

Language：English   Presentation type：Oral presentation(general)  

Venue：パシフィコ横浜  

Event date： 2021.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：福岡大学病院　福大メディカルホール  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：福岡大学病院 福大メディカルホール  

Event date： 2020.12

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Event date： 2020.10

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Event date： 2020.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Event date： 2020.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Event date： 2020.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Event date： 2020.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Event date： 2020.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Event date： 2020.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Event date： 2020.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Event date： 2020.8

Language：English   Presentation type：Oral presentation(general)  

Venue：Web  

Language：English   Presentation type：Oral presentation(general)  

Venue：Web  

Event date： 2019.7

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：東京  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：東京  

Event date： 2016.11

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Event date： 2016.9

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大宮  

Event date： 2016.6

Language：Japanese   Presentation type：Poster presentation  

Venue：金沢  

Language：Japanese   Presentation type：Poster presentation  

Venue：金沢  

Event date： 2016.6

Language：English   Presentation type：Oral presentation(general)  

Venue：Prague, Czech Republic  

Language：English   Presentation type：Oral presentation(general)  

Venue：Prague, Czech Republic  

Event date： 2016.4

Language：English   Presentation type：Poster presentation  

Venue：Tokyo  

Language：English   Presentation type：Poster presentation  

Venue：Tokyo  

Event date： 2015.12

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2015.12

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2015.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2015.11

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Event date： 2015.11

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Event date： 2015.11

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Event date： 2015.11

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Event date： 2015.9

Language：Japanese   Presentation type：Poster presentation  

Venue：東京  

Event date： 2015.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：東京  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：東京  

Language：Japanese   Presentation type：Poster presentation  

Venue：東京  

Event date： 2015.7

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：神戸  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：神戸  

Event date： 2015.7

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：神戸  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：神戸  

Event date： 2015.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：浜松  

Event date： 2015.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：浜松  

Event date： 2015.6

Language：Japanese   Presentation type：Poster presentation  

Venue：浜松  

Event date： 2015.6

Language：Japanese   Presentation type：Poster presentation  

Venue：浜松  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：浜松  

Language：Japanese   Presentation type：Poster presentation  

Venue：浜松  

Language：Japanese   Presentation type：Poster presentation  

Venue：浜松  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：浜松  

Event date： 2015.6

Language：English   Presentation type：Poster presentation  

Venue：Paris, France  

Language：English   Presentation type：Poster presentation  

Venue：Paris, France  

Event date： 2015.6

Language：English   Presentation type：Oral presentation(general)  

Venue：Toronto, Canada  

Language：English   Presentation type：Oral presentation(general)  

Venue：Toronto, Canada  

Event date： 2015.5

Language：English   Presentation type：Poster presentation  

Venue：Toronto, Canada  

Language：English   Presentation type：Poster presentation  

Venue：Toronto, Canada  

Event date： 2015.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2015.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2015.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2015.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2014.12

Language：English   Presentation type：Oral presentation(general)  

Event date： 2014.11

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：秋葉原  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：秋葉原  

Event date： 2014.10

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：東京  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：東京  

Event date： 2014.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Event date： 2014.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Event date： 2014.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Event date： 2014.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：秋田  

Event date： 2014.6

Language：Japanese   Presentation type：Poster presentation  

Venue：秋田  

Event date： 2014.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：秋田  

Language：Japanese   Presentation type：Poster presentation  

Venue：秋田  

Event date： 2014.6

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：軽井沢  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：軽井沢  

Event date： 2014.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Event date： 2014.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Event date： 2014.5

Language：English   Presentation type：Oral presentation(general)  

Event date： 2014.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2014.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2014.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2014.3

Language：English   Presentation type：Oral presentation(general)  

Event date： 2014.3

Language：English   Presentation type：Oral presentation(general)  

Event date： 2014.2

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大阪  

Event date： 2013.12

Language：English   Presentation type：Oral presentation(general)  

Event date： 2013.12

Language：English   Presentation type：Oral presentation(general)  

Event date： 2013.12

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2013.12

Language：English   Presentation type：Oral presentation(general)  

Event date： 2013.12

Language：English   Presentation type：Oral presentation(general)  

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2013.11

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：甲府  

Event date： 2013.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：徳島  

Event date： 2013.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：徳島  

Event date： 2013.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：徳島  

Event date： 2013.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：徳島  

Event date： 2013.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：徳島  

Event date： 2013.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：徳島  

Event date： 2013.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：徳島  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：徳島  

Event date： 2013.7

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：新宿  

Event date： 2013.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Event date： 2013.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Event date： 2013.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Event date： 2013.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Event date： 2013.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Event date： 2013.4

Language：English   Presentation type：Poster presentation  

Venue：Salt Lake City, USA  

Language：English   Presentation type：Poster presentation  

Venue：Salt Lake City, USA  

Event date： 2013.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2013.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2013.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2013.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2013.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2013.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2013.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2013.3

Language：English   Presentation type：Oral presentation(general)  

Event date： 2013.3

Language：English   Presentation type：Oral presentation(general)  

Event date： 2013.2

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：甲府  

Event date： 2013.1

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：有明  

Event date： 2012.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2012.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2012.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2012.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2012.10

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：熊本  

Event date： 2012.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：長崎  

Event date： 2012.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Event date： 2012.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Event date： 2012.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Event date： 2012.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Event date： 2012.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：京都  

Event date： 2012.7

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：金沢  

Event date： 2012.7

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：金沢  

Event date： 2012.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大阪  

Event date： 2012.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大阪  

Event date： 2012.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大阪  

Event date： 2012.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大阪  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大阪  

Event date： 2012.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2012.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2012.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2012.1

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：神戸  

Event date： 2011.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago USA  

Event date： 2011.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago USA  

Event date： 2011.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago USA  

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago USA  

Event date： 2011.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago USA  

Event date： 2011.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：小倉  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：小倉  

Event date： 2011.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：小倉  

Event date： 2011.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大阪  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大阪  

Event date： 2011.5

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：Web開催  

Event date： 2011.3

Language：English   Presentation type：Oral presentation(general)  

Venue：Vienna, Austria  

Language：English   Presentation type：Oral presentation(general)  

Venue：Vienna, Austria  

Event date： 2010.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：つくば  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：つくば  

Event date： 2010.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：軽井沢  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：軽井沢  

Event date： 2010.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2009.10

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2009.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：岡山  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：岡山  

Event date： 2009.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2008.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：つくば  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：つくば  

Event date： 2008.3

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：東京  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：東京  

Event date： 2008.2

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：甲府  

Event date： 2007.10

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：蓼科  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：蓼科  

Event date： 2007.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：神戸  

Event date： 2007.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：神戸  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：神戸  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：神戸