Effect of flip angle for optimization of image quality of gadoxetate disodium-enhanced biliary imaging at 1.5 T.

AJR. American journal of roentgenology

PubMedID: 23255746

Kim S, Mussi TC, Lee LJ, Mausner EV, Cho KC, Rosenkrantz AB. Effect of flip angle for optimization of image quality of gadoxetate disodium-enhanced biliary imaging at 1.5 T. AJR Am J Roentgenol. 2013;200(1):90-6.
OBJECTIVE
The purpose of this study was to perform a qualitative and quantitative comparison of image quality of gadoxetate disodium-enhanced imaging of the biliary system acquired using different flip angles (FAs).

MATERIALS AND METHODS
Thirty-two patients (21 men and 11 women; mean [± SD] age, 51 ± 16 years) who underwent gadoxetate disodium-enhanced 1.5-T MRI were included. A 3D fat-suppressed T1-weighted gradient-echo sequence was acquired during the hepatobiliary phase using FAs of 12°, 25°, and 40°. One radiologist, who was blinded to FA, measured signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) of the biliary tree. Two other blinded radiologists assessed subjective biliary duct clarity, overall image quality, background signal suppression, and ghosting artifact from the biliary tree using a scale of 1 to 4.

RESULTS
SNRs and CNRs of the common bile duct were significantly higher for FAs of 25° (227.5 ± 113.2 and 191.0 ± 102.2, respectively) and 40° (239.6 ± 118.7 and 201.7 ± 107.7, respectively) than for 12° (168.9 ± 73.9 and 126.7 ± 59.7, respectively; all p < 0.001). There were no significant differences in SNR or CNR between FAs of 25° and 40° (p = 0.360). Clarity of first-, second-, and third-order intrahepatic ducts, background signal suppression, and overall image quality were significantly higher for both readers for FAs of 25° and 40° than for 12° (all p = 0.031). None of these comparisons was significantly different for either reader between FAs 25° and 40° (all p = 0.091), aside from improved depiction of third-order ducts at 40° for one reader (p = 0.030). Biliary ghosting artifact was significantly worse at 40° than at 12° for both readers (p = 0.016).

CONCLUSION
The use of an FA larger than the clinical standard of approximately 12° has the potential to improve the image quality of gadoxetate disodium-enhanced biliary imaging.