University of Twente Student Theses
NCE-MRI as Preoperative Imaging Technique for Hepatoblastoma Surgery : A Pilot Study to Relaxation-Enhanced Angiography without Contrast and Triggering
Nieuwenhof, H.B. van den (2021) NCE-MRI as Preoperative Imaging Technique for Hepatoblastoma Surgery : A Pilot Study to Relaxation-Enhanced Angiography without Contrast and Triggering.
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| Full Text Status: | Access to this publication is restricted |
| Embargo date: | 1 January 2036 |
| Abstract: | Hepatoblastoma is a malignant embryonal liver tumour. Triphasic CT (3PCT) is the currently used preoperative imaging method to assess the hepatoblastoma tumour and adjacent vital structures. However, the success rate of the 3PCT of children is low and 3PCT uses ionizing radiation. Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) is a novel NCE-MR technique developed to clearly visualise vasculature. In this study, the applicability of REACT in the preoperative planning of the liver vasculature in children with a hepatoblastoma tumour is investigated. Three healthy adults were scanned with REACT for the optimisation of the sequence for liver vasculature imaging. Subsequently, REACT was added to the paediatric liver tumour MRI protocol. Image quality parameters were assessed including the portal vein, portal vein branches, inferior vena cava, hepatic veins, and hepatic artery using a 5-point Likert scale, where a lower score indicated poorer image quality. The result of the optimisation study was a REACT scan with a transversal slice orientation, voxel size of 1.2 x 1.2 x 2.5 mm3, and scan time of 03:25 min. Moreover, excellent vessel-to-liver contrast, and vessel and liver edge sharpness were observed. Two children underwent both the REACT and 3PCT examination intended for preoperative planning. Both scans had median scores of ‘good’ for the portal vein, portal vein branches, inferior vena cava, and total image quality (p>.05). For the hepatic veins and preoperative planning, the median score for REACT was ‘good’ and for 3PCT was ‘poor’ (p=.002). The hepatic artery proper had a median score of ‘good’ for REACT and ‘moderate-good’ for 3PCT (p>.05). We succeeded to clearly visualise the hepatic vascular structures and tumour thrombus in children, and showed that assessment of the relation between these vital structures is possible. The results were encouraging, yet were limited by the small study population. A large-scale comparative study is required to investigate whether REACT is superior to the 3PCT for visualising liver vasculature in children with a hepatoblastoma tumour. |
| Item Type: | Essay (Master) |
| Clients: | Prinses Máxima Centrum voor kinderoncologie, Utrecht, Nederland |
| Faculty: | TNW: Science and Technology |
| Subject: | 33 physics, 44 medicine |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/88034 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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