Related Experiment Video
Updated: Aug 13, 2026
Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Procedure
Published on: August 14, 2017
Leo J. Rigler lecture. MR imaging of the liver
Abstract:
Recent technical and clinical advances in MR of the liver are reviewed with special reference to the role of MR as a primary screening technique for detection of space-occupying lesions, especially metastases. The major current problem in upper abdominal MR imaging is physiologic motions, and this appears to have been effectively solved by newly introduced pulse-sequence and timing-parameter strategies. Short-TR/TE spin-echo sequences with extensive signal averaging and heavy T1-weighting produce images with exceptional anatomic detail and liver-cancer contrast differences. With this sequence superior sensitivity for liver-cancer detection has been shown in quantitative signal-difference to noise comparisons with other pulse sequences and in clinical comparisons with CT. MR discovered 14% more individual metastases and 3% more patients with liver cancer than CT in a blinded comparative study of 142 patients undergoing both exams. MR also showed greater specificity (98%) than CT (91%) in distinguishing patients without liver metastases. Differentiation of hemangioma from metastases was possible with greater than 90% specificity by using heavily T2-weighted sequences. Use of a fast-scan, gradient-recalled echo technique can also produce good-quality, multislice, T1-weighted studies of the liver in 20 sec--a breath-hold. MR contrast agents (such as gadolinium-DTPA and reticuloendothelial-system-specific, superparamagnetic ferrite-iron-oxide particles) offer further promise for enhanced sensitivity for liver-cancer detection. When optimal pulse sequences are employed, MR can now be appropriate as a primary screening method for detecting liver neoplasms.
Insights
Magnetic resonance (MR) imaging advancements now enable effective liver cancer screening. New techniques improve lesion detection and differentiation, making MR a primary tool for identifying liver neoplasms.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Physiologic motion artifacts have historically challenged upper abdominal MR imaging.
- Recent advancements in pulse sequences and timing strategies have addressed motion-related issues.
Purpose of the Study:
- To review technical and clinical advances in liver MR imaging.
- To evaluate MR's role as a primary screening technique for detecting liver space-occupying lesions, particularly metastases.
Main Methods:
- Utilized short-TR/TE spin-echo sequences with signal averaging and T1-weighting for detailed imaging.
- Employed heavily T2-weighted sequences for differentiating hemangiomas from metastases.
- Assessed fast-scan, gradient-recalled echo techniques for rapid T1-weighted liver studies.
- Compared MR performance against CT in a blinded study of 142 patients.
Main Results:
- MR demonstrated superior sensitivity and specificity in detecting liver metastases compared to CT.
- MR identified 14% more individual metastases and 3% more patients with liver cancer than CT.
- MR achieved 98% specificity in distinguishing patients without metastases, versus 91% for CT.
- Differentiation of hemangioma from metastases exceeded 90% specificity using T2-weighted sequences.
Conclusions:
- Optimal MR pulse sequences and contrast agents enhance liver cancer detection sensitivity.
- MR imaging is now suitable as a primary screening method for liver neoplasms.
- Advancements have significantly improved MR's capability in diagnosing liver space-occupying lesions.
