Real-time MRI monitoring of transcatheter hepatic artery contrast agent delivery in rabbits

Kent T. Sato*, Andrew C. Larson, Thomas K. Rhee, Riad A. Salem, Albert A. Nemcek, Taofic Mounajjed, Tatjana Paunesku, Gayle Woloschak, Paul Nikolaides, Reed A. Omary

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Rationale and Objectives. We sought to test the hypothesis that transcatheter hepatic artery delivery of dilute gadolinium (Gd) in rabbits can be monitored in real-time using magnetic resonance imaging (MRI). Materials and Methods. Catheters (2F) were inserted via a femoral access into the hepatic arteries of six New Zealand White rabbits under radiographic guidance. After transfer to a 1.5-T MRI scanner, 26 separate hepatic artery injections of 2 mL of 4% Gd and 14 sham injections were performed. Real-time imaging of all injections was acquired using two-dimensional projection inversion recovery-gradient echo. Films of these 40 injections, as well as 10 random repeats, were independently reviewed in a randomized, blinded fashion by two Certificate of Added Qualification-certified interventional radiologists. Observers reported (i) if Gd injection occurred and (ii) if so, the location of delivery. For each observer, we compared sensitivity/specificity for real-time visualization of contrast injection and accuracy of injection localization. Interobserver and intraobserver variability was assessed using the κ statistic. X-ray digital subtraction angiography was the gold standard for all MRI studies. Results. Both observers had a sensitivity of 100% and a specificity of 93%. Accuracy for intrahepatic contrast delivery was 77% for both observers. Accuracy for extrahepatic delivery was 92% and 96%, respectively. Both interobserver and intraobserver agreement was outstanding. Conclusions. In rabbits, MRI allows for accurate real-time monitoring of transcatheter hepatic artery delivery of contrast agent. Localization accuracy is higher outside the liver than within the liver. These results can be used as a baseline reference for comparing the accuracy of delivery of Gd-tagged therapies in the future.

Original languageEnglish (US)
Pages (from-to)1342-1350
Number of pages9
JournalAcademic radiology
Volume12
Issue number10
DOIs
StatePublished - Oct 2005

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Keywords

  • HCC
  • Interventional MRI
  • MRA
  • VXZ

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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