Half-dose gadoxetic acid-enhanced liver magnetic resonance imaging in patients at risk for nephrogenic systemic fibrosis

Highlights: •Half dose of gadoxetic acid achieved more than 75% enhancement degree of a standard dose. •No significant difference was observed in enhancement quality between half-dose and standard-dose MRIs for all upper abdominal organs. •Liver MRI using half-dose gadoxetic acid at 3-T can be a feasible alternative for standard-dose MRI in patients at risk for NSF. -- Abstract: Purpose: To evaluate the feasibility of half-dose gadoxetic acid (0.0125 mmol/kg) for liver MRI at 3-T compared to standard-dose (0.025 mmol/kg) in patients at risk for nephrogenic systemic fibrosis (NSF). Materials and methods: Forty patients who underwent both half-dose and standard-dose gadoxetic acid-enhanced MRIs were included. Contrast enhancement index (CEI) was calculated for liver, aorta, pancreas and kidney. Two observers independently rated and performed a one-to-one direct comparison of enhancement quality for both groups. Results: Liver CEIs were not significantly different on arterial phase between the two groups but CEIs of standard-dose MRIs were greater than half-dose MRIs on other phases (P < 0.001). CEIs were not significantly different on arterial phase for the aorta or on any phases for the pancreas. Kidney CEIs of standard-dose MRIs were greater than half-dose MRIs on all phases (P < 0.05). Enhancement quality of both groups was diagnostic and did not significantly differ for any organs. In one-to-one direct comparisons of enhancement quality, equal ratings were given in 87.5% (35/40) of cases by observer 1 and 85.0% (34/40) by observer 2. Conclusion: Liver MRI using half-dose gadoxetic acid at 3-T can be a feasible alternative for standard-dose MRI in patients at risk for NSF