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The goal of this interventional study (clinical trial) is to learn if different breath-holding techniques, with and without extra oxygen, can improve the quality of abdominal Magnetic Resonance Imaging (MRI) images in healthy adults, ages 18-75.
The main questions it aims to answer are:
Researchers will compare breath-holding with and without oxygen to see if using oxygen improves image quality during MRI scans.
Participants will:
This is a within-subject, randomized crossover interventional study conducted at UCSF China Basin Imaging Center using a 3 Tesla Magnetic Resonance Imaging (3T MRI scanner). The study aims to optimize abdominal MRI protocols by evaluating the impact of breath-holding techniques, with and without oxygen supplementation, on motion artifacts and overall image quality.
Each participant will undergo non-contrast abdominal MRI scans using two breath-hold conditions: (1) Functional Residual Capacity (FRC)/end-expiration without oxygen and (2) FRC/end-expiration with preoxygenation. The order of these conditions will be randomized to control for potential order effects, and each participant will serve as their own control to reduce inter-individual variability.
T2-weighted and Magnetic Resonance Cholangiopancreatography (MRCP) sequences will be acquired during each breath-hold trial. MRI-compatible pulse oximetry will be used to monitor oxygen saturation and pulse rate throughout scanning. A radiology research nurse will be present if additional monitoring is needed based on the participant's pre-screening or intra-scan findings. Participants will receive training on breath-hold procedures prior to imaging to improve consistency and comfort during scanning.
Two board-certified radiologists, blinded to the breath-hold condition, will independently assess each image set for motion artifacts and overall image quality using a standardized 5-point grading system. The grading will range from very poor (1) to very good (5) based on sharpness, visibility of anatomical details, and presence of blurring or signal loss.
Inter-rater reliability will be evaluated using the Intraclass Correlation Coefficient (ICC). Statistical analyses will include repeated measures ANOVA to compare image quality scores across breath-holding conditions. Descriptive analyses will assess breath-hold durations and participant characteristics (e.g., age, gender) in relation to image quality and safety outcomes, including oxygen saturation and self-reported comfort.
This study involves minimal risk, does not utilize contrast agents, and is intended to support the development of motion-reduced, efficient liver MRI protocols, particularly for living liver donor evaluation. Data collected during the study will not be used for clinical decision-making.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Functional Residual Capacity/End-Expiration Without Oxygen | Experimental | Participants will undergo abdominal MRI scans while performing breath-holding at end-expiration without oxygen supplementation. T2-weighted and MRCP sequences will be acquired during breath-hold trials. |
|
| Functional Residual Capacity/End-Expiration With Oxygen | Experimental | Participants will undergo abdominal MRI scans while performing breath-holding at end-expiration with oxygen supplementation administered prior to. T2-weighted and MRCP sequences will be acquired during breath-hold trials. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Breath-hold conditions | Other | Functional Residual Capacity/End-Expiration (breath-hold technique) with/without oxygen to optimize MRI image quality. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Liver MRI Image Quality (Motion Artifacts) | Image quality of liver MRI scans will be assessed by quantifying the degree of respiratory motion artifacts under two breath-holding conditions: Functional Residual Capacity (FRC) alone and FRC with oxygen supplementation. Reduced artifacts indicate improved image clarity and feasibility of the technique. Unit of Measure: Motion artifact score (ordinal scale, e.g., 1-5). | During the single MRI session (approximately 1 hour) |
| Measure | Description | Time Frame |
|---|---|---|
| Breath-Holding Duration | The duration (in seconds) that participants can comfortably sustain a breath-hold under each condition (FRC alone and FRC with oxygen supplementation). Unit of Measure: Seconds. | During the MRI session (approximately 1 hour) |
| Oxygen Saturation During Breath-Holding |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| John P Roberts, MD | Contact | 415-353-3677 | John.Roberts@ucsf.edu |
| Name | Affiliation | Role |
|---|---|---|
| John P Roberts, MD | University of California, San Francisco | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California, San Francisco | Recruiting | San Francisco | California | 94143 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26807896 | Background | Yoo JL, Lee CH, Park YS, Kim JW, Lee J, Kim KA, Seol HY, Park CM. The Short Breath-Hold Technique, Controlled Aliasing in Parallel Imaging Results in Higher Acceleration, Can Be the First Step to Overcoming a Degraded Hepatic Arterial Phase in Liver Magnetic Resonance Imaging: A Prospective Randomized Control Study. Invest Radiol. 2016 Jul;51(7):440-6. doi: 10.1097/RLI.0000000000000249. | |
| 30835515 |
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| ID | Term |
|---|---|
| D006985 | Hyperventilation |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
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Peripheral oxygen saturation will be monitored during each breath-hold condition to assess physiologic tolerance and safety. Unit of Measure: Percent oxygen saturation (%). |
| During the MRI session (approximately 1 hour) |
| Adverse Events and Participant-Reported Discomfort | Number and type of adverse events, as well as participant-reported discomfort, occurring during or immediately after each breath-hold condition. Unit of Measure: Number of events. | During and immediately after the MRI session (up to 1 hour) |
| Background |
| Vu KN, Haldipur AG, Roh AT, Lindholm P, Loening AM. Comparison of End-Expiration Versus End-Inspiration Breath-Holds With Respect to Respiratory Motion Artifacts on T1-Weighted Abdominal MRI. AJR Am J Roentgenol. 2019 May;212(5):1024-1029. doi: 10.2214/AJR.18.20239. Epub 2019 Mar 5. |
| 37207259 | Background | Towell V, Gysen KV, Cross S, Kk Low G. Efficacy of preoxygenation administration in volunteers, in extending the end-expiration breath-hold duration for application to abdominal radiotherapy. Tech Innov Patient Support Radiat Oncol. 2023 May 4;26:100208. doi: 10.1016/j.tipsro.2023.100208. eCollection 2023 Jun. |
| 27168468 | Background | Parkes MJ, Green S, Stevens AM, Parveen S, Stephens R, Clutton-Brock TH. Safely prolonging single breath-holds to >5 min in patients with cancer; feasibility and applications for radiotherapy. Br J Radiol. 2016 Jul;89(1063):20160194. doi: 10.1259/bjr.20160194. |
| 31778311 | Background | Khot R, McGettigan M, Patrie JT, Feuerlein S. Quantification of gas exchange-related upward motion of the liver during prolonged breathholding-potential reduction of motion artifacts in abdominal MRI. Br J Radiol. 2020 Feb 1;93(1106):20190549. doi: 10.1259/bjr.20190549. Epub 2019 Dec 10. |
| 25555833 | Background | Funk E, Anderzen-Carlsson A, Ingverud P, Leander A, Thunberg P. Patient-initiated breath-holds in MRI: an alternative for reducing respiratory artifacts and improving image quality. Clin Imaging. 2015 Jul-Aug;39(4):619-22. doi: 10.1016/j.clinimag.2014.12.007. Epub 2014 Dec 13. |
| 26146869 | Background | Chandarana H, Feng L, Ream J, Wang A, Babb JS, Block KT, Sodickson DK, Otazo R. Respiratory Motion-Resolved Compressed Sensing Reconstruction of Free-Breathing Radial Acquisition for Dynamic Liver Magnetic Resonance Imaging. Invest Radiol. 2015 Nov;50(11):749-56. doi: 10.1097/RLI.0000000000000179. |
| D013568 | Pathological Conditions, Signs and Symptoms |