Evaluation of arterial phase sequences acquired with and without CARE-BOLUS for the optimization of liver MRI studies

Accurate timing of contrast-enhanced phases in liver magnetic resonance imaging (MRI) is critical for identifying and characterizing focal liver lesions (FLL), aiding in the diagnosis and characterization of various liver pathologies. In this study, we evaluated the accuracy of the manual and the CARE bolus tracking methods during the arterial phase of contrast enhancement, in which the contrast agent reaches peak concentration in the hepatic arteries. Images have been collected from 31 patients suffering from liver disease, who underwent two liver MRI scans using each of the tracking methods within a time period of six months. The images were then evaluated by two independent readers in order to establish inter-reader agreement rates regarding image quality. Image quality was determined by six parameters, the most significant of which is the RI-QUAL. Our study found that both tracking methods showed comparable performance in image quality assessment, reaffirming the use of both methods in clinical practice. The manual method showed a slight tendency to reduce artifacts, while the CARE method appeared to enhance fat saturation and lesion detectability. Liver Edge Sharpness (LES) has been found to be the strongest predictor of overall image quality. We recommend conducting future studies with a larger sample population, in order to discover potential differences between the tracking methods in specific patient subgroups.

Evaluation of arterial phase sequences acquired with and without CARE-BOLUS for the optimization of liver MRI studies