Transient Severe Motion Artifact on Arterial Phase in Gadoxetic Acid-Enhanced Liver Magnetic Resonance Imaging A Systematic Review and Meta-analysis

Objectives: The aims of this study were to determine the incidence of transient severe motion artifact (TSM) on arterial phase gadoxetic acid-enhanced magnetic resonance imaging of the liver and to investigate the causes of heterogeneity in the published literature. Materials and Methods: Original studies reporting the incidence of TSM were identified in searches of PubMed, Embase, and Cochrane Library databases. The pooled incidence of TSMwas calculated using random-effectsmeta-analysis of single proportions. Subgroup analyses were conducted to explore causes of heterogeneity. Results: A total of 24 studieswere finally included (single arterial phase, 19 studies with 3065 subjects; multiple arterial phases, 8 studies with 2274 subjects). Studies using single arterial phase imaging reported individual TSM rates varying from 4.8% to 26.7% and a pooled incidence of TSM of 13.0% (95% confidence interval, 10.3%-16.2%), which showed substantial study heterogeneity. The pooled incidence of TSMin the studies using multiple arterial phase imaging was 3.2% (95% confidence interval, 1.9%-5.2%), which was significantly less than in those studies using single arterial phase imaging (P < 0.001). In the subgroup analysis, the geographical region of studies and the definition of TSMwere found to be causes of heterogeneity. The incidence of TSMwas higher in studies withWestern populations from Europe or North America than in those with Eastern (Asia/Pacific) populations (16.0% vs 8.8%, P = 0.005). Regarding the definition of TSM, the incidence of TSMwas higher when a 4-point scale was used for its categorization than when a 5-point scale was used (20.0% vs 11.0%, P = 0.008), and a definition considering motion artifact on phases other than arterial phase imaging lowered the incidence of TSM compared with it being defined only on arterial phase imaging (11.3% vs 20.3%, P = 0.018). Conclusions: The incidence of TSM on arterial phase images varied across studies and was associated with the geographical region of studies and the definition of TSM. Careful interpretation of results reporting TSM might therefore be needed.

Automated summary

This study aimed to determine the incidence of transient severe motion artifact (TSM) on arterial phase gadoxetic acid-enhanced magnetic resonance imaging of the liver and investigate the causes of heterogeneity in the published literature. The pooled incidence of TSM varied across studies and was associated with the geographical region of studies and the definition of TSM. Careful interpretation of results reporting TSM might therefore be needed.