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The image quality was evaluated subjectively on a 5-point scale by two radiologists. Interobserver agreement, as well as signal-to-noise ratio for arterial (SNRart) and portal venous (SNRpv) phases, were evaluated separately. Additionally, the image quality of 4D FreeBreathing sequence was compared to a non-dynamic post-contrast radial stack-of-stars free-breathing T1w fast field echo acquisition (3D T1w Vane mDixon). Interobserver agreement of both assessors was calculated using quadratic weighted Cohen\u2019s kappa test (\u03f0), while independent samples Student\u2019s <jats:italic>t<\/jats:italic>-test was employed to compare mean SNR values among the two groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Using 4D FreeBreathing, SNRart and SNRpv were significantly higher from 500\u2009\u00b1\u2009170 and 550\u2009\u00b1\u2009160 to 900\u2009\u00b1\u2009210 and 820\u2009\u00b1\u2009260 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); the diagnostic image quality increased from 77.6 to 89.6%; respiratory artifacts decreased from 22.4 to 10.4%, with an almost perfect interobserver agreement. Compared to 3D T1w Vane mDixon sequence, SNR and image quality were equal.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>4D FreeBreathing pediatric abdominal MRI improves the feasibility and image quality compared to conventional dynamic exams while showing an image quality equivalent to post-contrast 3D T1w Vane mDixon.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key Points<\/jats:title>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Question<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>During dynamic abdominal MRI in young children, it is important to conduct a brief yet robust examination without respiratory artifacts<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Findings<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>4D FreeBreathing MRI technique for pediatric abdominal imaging enhances both image quality and feasibility when compared to conventional dynamic scans that require breath-holding<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Clinical relevance<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Dynamic abdominal MRI using the 4D FreeBreathing sequence provides significant benefits for pediatric patients. The absence of breath-holding requirements improves patient cooperation, reduces the need for general anesthesia, and results in higher-quality diagnostic images<\/jats:italic>.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00330-025-11577-2","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T12:05:18Z","timestamp":1744805118000},"page":"5891-5899","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Innovative 4D FreeBreathing technique in pediatric abdominal MRI improves feasibility and image quality"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8549-8754","authenticated-orcid":false,"given":"Patricia","family":"Tischendorf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Beck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Kr\u00e4hling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan H.","family":"Lange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6562-280X","authenticated-orcid":false,"given":"Walter","family":"Heindel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"key":"11577_CR1","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.adnc.2004.07.006","volume":"5","author":"LA Stokowski","year":"2005","unstructured":"Stokowski LA (2005) Ensuring safety for infants undergoing magnetic resonance imaging. 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Felix Albert, M. Sc. Institute of Biostatistics and Clinical Research, University of M\u00fcnster.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}