Hepatocyte-specific gadolinium based contrast agents (HSCA) can provide substantial information for the classification and differential diagnosis of focal liver lesions¹. In clinical routine, breathing artifacts can impair image quality and thus decrease diagnostic confidence. In a previous study on dynamic arterial phase imaging we found that patients receiving HSCA particularly suffered from breath-holding difficulties, probably due to their overall reduced general condition². In this context, sequences with radial read-out seem to be a possible solution, as the influence of motion (i.e. breathing) on image quality is far less compared to Cartesian approaches³. On the other hand, new techniques in parallel imaging allow highly accelerated acquisition, resulting in shorter breath-hold intervals⁴. The aim of this study was to evaluate these different approaches for the reduction of breathing artifacts in the hepatobiliary phase - a T1-weighted, volumetric-imaging-breath-hold-examination-(VIBE) sequence with radial k-space sampling (radialVIBE) and a highly accelerated Cartesian VIBE with Dixon fat suppression (CD-VIBE).40 min after injection of the HSCA (0,025mmol/kg KG Primovist, Bayer HealthCare, Germany) radialVIBE (TE 1,7 ms; TR 4,2 ms; resolution 0,9x0,9x3 mm³; flip angle 12°; 3 min acquisition in free breathing) and CD-VIBE (TE 2,5 ms; TR 5,5 ms; 0,9x0,9x3 mm³; CAIPIRINHA acceleration with r=2x2, flip angle 30°; breath-hold 10 sec) were acquired in 21 patients (15 male, 68±9 years), who showed breath-holding difficulties during the dynamic arterial sequence. 2 blinded readers assessed image quality (image sharpness, noise, artifacts, homogeneity of fat saturation and overall image quality) as well as conspicuity of focal liver lesions for both radial- and CD-VIBE.Overall image quality was rated good to excellent for both sequences, with CD-VIBE receiving statistically significantly better ratings (p=0,02). While radialVIBE received better results regarding image noise and artifacts (p=0.03), both sequences were rated equally regarding sharpness and homogeneity of fat saturation. Focal liver lesion (n=25) conspicuity was rated significantly better in CD-VIBE (p<0.01). In 3 patients, CD-VIBE was rated as non-diagnostic due to severe breathing artifacts. In contrast, radialVIBE was rated diagnostic in those patients.The majority of patients with breath-holding difficulties in the dynamic arterial phase sequence were able to follow the substantially shorter breath-hold in the accelerated Cartesian sequence used for hepatobiliary phase imaging. The superior lesion conspicuity and overall image quality in the CD-VIBE sequence (likely attributable to the increased flip angle) made the CD-VIBE the preferable technique for most patients. However, some patients showed breath-holding difficulties despite the short breath-hold interval, resulting in non-diagnostic hepatobiliary phase images using CD-VIBE. radialVIBE however was able to generate diagnostic images in those patients, which – despite its inferior overall image quality – allowed a detection and differentiation of lesions that were not visible on CD-VIBE.Both highly accelerated Cartesian as well as radial acquisition techniques provide good to excellent image quality in hepatobiliary phase MRI. In comparison, CD-VIBE offers better overall image quality and focal liver lesion conspicuity. However, radialVIBE is a valuable alternative in patients unable to hold even short breath-hold intervals.