Estimating liver perfusion from free-breathing continuously acquired dynamic gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced acquisition with compressed sensing reconstruction

Invest Radiol. 2015 Feb;50(2):88-94. doi: 10.1097/RLI.0000000000000105.


Objective: The purpose of this study was to estimate perfusion metrics in healthy and cirrhotic liver with pharmacokinetic modeling of high-temporal resolution reconstruction of continuously acquired free-breathing gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced acquisition in patients undergoing clinically indicated liver magnetic resonance imaging.

Subjects and methods: In this Health Insurance Portability and Accountability Act-compliant prospective study, 9 cirrhotic and 10 noncirrhotic patients underwent clinical magnetic resonance imaging, which included continuously acquired radial stack-of-stars 3-dimensional gradient recalled echo sequence with golden-angle ordering scheme in free breathing during contrast injection. A total of 1904 radial spokes were acquired continuously in 318 to 340 seconds. High-temporal resolution data sets were formed by grouping 13 spokes per frame for temporal resolution of 2.2 to 2.4 seconds, which were reconstructed using the golden-angle radial sparse parallel technique that combines compressed sensing and parallel imaging. High-temporal resolution reconstructions were evaluated by a board-certified radiologist to generate gadolinium concentration-time curves in the aorta (arterial input function), portal vein (venous input function), and liver, which were fitted to dual-input dual-compartment model to estimate liver perfusion metrics that were compared between cirrhotic and noncirrhotic livers.

Results: The cirrhotic livers had significantly lower total plasma flow (70.1 ± 10.1 versus 103.1 ± 24.3 mL/min per 100 mL; P < 0.05), lower portal venous flow (33.4 ± 17.7 versus 89.9 ± 20.8 mL/min per 100 mL; P < 0.05), and higher arterial perfusion fraction (52.0% ± 23.4% versus 12.4% ± 7.1%; P < 0.05). The mean transit time was higher in the cirrhotic livers (24.4 ± 4.7 versus 15.7 ± 3.4 seconds; P < 0.05), and the hepatocellular uptake rate was lower (3.03 ± 2.1 versus 6.53 ± 2.4 100/min; P < 0.05).

Conclusions: Liver perfusion metrics can be estimated from free-breathing dynamic acquisition performed for every clinical examination without additional contrast injection or time. This is a novel paradigm for dynamic liver imaging.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Flow Velocity
  • Computer Simulation
  • Contrast Media / pharmacokinetics
  • Female
  • Gadolinium DTPA / pharmacology*
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Liver / pathology
  • Liver / physiopathology*
  • Liver Circulation*
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / physiopathology*
  • Liver Function Tests / methods
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Models, Biological
  • Reproducibility of Results
  • Sensitivity and Specificity


  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA