Evaluation of incidence of acute transient dyspnea and related artifacts after administration of gadoxetate disodium: a prospective observational study

To evaluate motion artifacts, breath-hold failure, acute transient dyspnea, and clinical parameters during hepatic arterial phase of gadoxetate disodium-enhanced magnetic resonance (MR) imaging. This was an institutional review board-approved observational prospective study (written informed consent acquired) performed in 250 consecutive patients, who underwent liver MR with a multiarterial phase technique. Oxygen saturation (SatO(2)) and heart rate (HR) were monitored, while patients reported subjective symptoms. Breath-holds were assessed using prospective acquisition correction technique (PACE) monitors. Three readers independently analyzed all images to establish the presence of motion artifacts. Nonparametric statistical testing and Fleiss' kappa were used. No statistical differences in SatO(2) and HR values were observed during the entire length of MR examination. The PACE graphs showed an altered breath-hold in 16/250 patients (6.4%), however only 6 patients self-reported symptoms during the procedure, and among these 6 subjects, only 2 suffered from acute transient dyspnea (0.8%). Motion-related artifacts increased mostly in the third arterial phase of gadoxetate disodium acquisition (p < 0.0001): The artifacts incidence was 2.9% in the first phase; 4.0% in the second; and 19.5% in the third. This increase was mainly due to patients' inability to hold their breath for the entire duration of the examination. However, at least one gadoxetate disodium arterial phase without motion artifacts and adequate for acquisition timing, was acquired in all MR examinations. The incidence of breath-hold failure and acute transient dyspnea after gadoxetate disodium administration increased during the third arterial phase only. Our protocol allowed the acquisition of at least one arterial phase not compromised by motion artifacts and adequate for acquisition timing, in all patients.