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Hepatocellular carcinoma on Achieva 1.5T with/without dStream

Case Study
Punjabi, Gopal, M.D. Hennepin County Medical Center • USA
Truwit, Chip, MD, FACR Hennepin County Medical Center • USA

Patient history

A 70-year-old male diagnosed with hepatocellular carcinoma underwent MRI before and after chemoembolization at Hennepin County Medical Center.

MR examination

The first exam was performed on an Achieva 1.5T.
The second exam was performed in the same after the SmartPath to dStream upgrade.


Left column:    Achieva 1.5T                 before embolization
Right column:  Achieva 1.5T dStream     after embolization

Click on an image to enlarge
Achieva 1.5T T2 SPAIR, slices 8.5 mm, gap 1.5 mm <br>Achieva 1.5T dStream After chemoembolization<br>
T2 SPAIR, slices 6.6 mm, gap 0.6 mm<br>
Achieva 1.5T
Achieva 1.5T dStream
T2 SPAIR, slices 8.5 mm, gap 1.5 mm
After chemoembolization
T2 SPAIR, slices 6.6 mm, gap 0.6 mm
Achieva 1.5T Thick slab MRCP <br>Achieva 1.5T dStream <br> After chemoembolization<br>
Thick slab MRCP <br>
Achieva 1.5T
Achieva 1.5T dStream
Thick slab MRCP
After chemoembolization
Thick slab MRCP
Achieva 1.5T In phase<br> <br>Achieva 1.5T dStream After chemoembolization<br>
In phase <br>
Achieva 1.5T
Achieva 1.5T dStream
In phase

After chemoembolization
In phase
Achieva 1.5T Out of phase<br>Achieva 1.5T dStream After chemoembolization<br>
Out of phase<br>
Achieva 1.5T
Achieva 1.5T dStream
Out of phase
After chemoembolization
Out of phase
Achieva 1.5T Post-contrast THRIVE, 3 mm slicesAchieva 1.5T dStream After chemoembolization<br>
Post-contrast THRIVE, 2 mm slices<br>
Achieva 1.5T
Achieva 1.5T dStream
Post-contrast THRIVE, 3 mm slices
After chemoembolization
Post-contrast THRIVE, 2 mm slices


The images on the left originate from Achieva 1.5T, the images on the right were prepared after the SmartPath to dStream update. 

The comparison shows that imaging with dStream affords improved fat saturation, faster scan times and higher resolution post-contrast images in liver MR. The dStream images show better fat saturation and better liver signal on T2 SPAIR, better MRCP background suppression, less inhomogeneities on in-phase and out-of-phase images.

In particular on the THRIVE sequence, we have better resolution as the slice thickness decreased from 3 mm to 2 mm, while maintaining a similar matrix and FOV. On the T2 SPAIR sequence, we have reduced the slice thickness from 8.5 mm with a 1.5 mm gap to 6.6 mm with a 0.6 mm gap.

Clinical impact

Combining SENSE and dStream results in improved SNR, which we are able to use either for a shorter scan time or to obtain improved spatial resolution, or both. We are seeing higher resolution while maintaining breath-hold times under 15 seconds.

Related reading:

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Jul 25, 2014

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Case Study
Achieva 1.5T
Body, dStream, Liver, SmartPath to dStream, THRIVE

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