Thin-slice Free-breathing Pseudo-golden-angle Radial Stack-of-stars with Gating and Tracking T1-weighted Acquisition: An Efficient Gadoxetic Acid-enhanced Hepatobiliary-phase Imaging Alternative for Patients with Unstable Breath Holding

Purpose: To compare four free-breathing scan techniques for gadoxetic acid-enhanced hepatobiliary phase imaging with conventional breath-hold scans. Materials and Methods: Gadoxetic acid-enhanced hepatobiliary phase imaging with six image acquisition sets performed in 50 patients. Image acquisition sets included fat-suppressed 3D T-1-weighted turbo field echo with free-breathing pseudo-golden-angle radial stack-of-stars (FBRS) acquisition, FBRS with track (FBRST), FBRS with gate and track (FBRSG&T), thin-slice FBRS with gate and track (thin-slice FBRSG&T), free-breathing Cartesian acquisition (Cartesian(FB)), and breath-hold Cartesian acquisition (Cartesian(BH)). Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and image quality compared to the six-image acquisition sets. Results: Signal-to-noise ratio and CNR were significantly higher in FBRS, FBRST, FBRSG&T, and thin-slice FBRSG&T than in Cartesian(FB) and Cartesian(BH) (P < 0.001). Based on sharpness, motion artifacts, visibility of intrahepatic vessels, and overall image quality, thin-slice FBRSG&T had the highest image quality followed by Cartesian(BH) and FBRSG&T (P < 0.001). Severe motion artifacts were observed in 25 patients in Cartesian(FB) and three patients in Cartesian(BH), whereas image quality remained above the acceptable range in FBRSG&T, FBRST, FBRS, and thin-slice FBRSG&T in all cases. Conclusion: Thin-slice FBRSG&T demonstrated excellent image quality compared with conventional Cartesian(BH) in gadoxetic acid-enhanced hepatobiliary phase imaging. It can be apply to supplemental sequences of patients with unstable breath holding.