Does gadoxetate disodium affect MRE measurements in the delayed hepatobiliary phase?

Abstract

Objectives To assess if the administration of gadoxetate disodium (Gd-EOB-DTPA) significantly affects hepatic magnetic resonance elastography (MRE) measurements in the delayed hepatobiliary phase (DHBP). Methods A total of 47 patients (15 females, 32 males; age range 23-78 years, mean 54.28 years) were assigned to standard hepatic magnetic resonance imaging (MRI) with application of Gd-EOB-DTPA and hepatic MRE. MRE was performed before injection of Gd-EOB-DTPA and after 40-50 min in the DHBP. Liver stiffness values were obtained before and after contrast media application and differences between pre-and post-Gd-EOB-DTPA values were evaluated using a Bland-Altman plot and the Mann-Whitney-Wilcoxon test. In addition, the data were compared with regard to the resulting fibrosis classification. Results Mean hepatic stiffness for pre-Gd-EOB-DTPA measurements was 4.01 kPa and post-Gd-EOB-DTPA measurements yielded 3.95 kPa. We found a highly significant individual correlation between pre-and post-Gd-EOB-DTPA stiffness values (Pearson correlation coefficient of r = 0.95 (p < 0.001) with no significant difference between the two measurements (p =0.49)). Bland-Altman plot did not show a systematic effect for the difference between pre-and post-stiffness measurements (mean difference: 0.06 kPa, SD 0.81). Regarding the classification of fibrosis stages, the overall agreement was 87.23% and the intraclass correlation coefficient was 96.4%, indicating excellent agreement. Conclusions Administration of Gd-EOB-DTPA does not significantly influence MRE stiffness measurements of the liver in the DHBP. Therefore, MRE can be performed in the DHBP. Key Points • MRE of the liver can reliably be performed in the delayed hepatobiliary phase.• Gd-EOB-DTPA does not significantly influence MRE stiffness measurements of the liver.• MRE performed in the delayed hepatobiliary-phase is reasonable in patients with reduced liver function.

Liver Magnetic Resonance Elastography: Focus on Methodology, Technique, and Feasibility

“…It is important in this step that the radiographer is well trained to guide the patients through the breathing cycle and also that the radiographer checks the respiratory patients' movement from the internal camera before the start of the acquisition. In our experience, we did not perform MRE after the administration of contrast medium, as different study results have shown no significant differences in stiffness values when performing MRE before and after contrast medium administration [5,33].…”

Assessment of an MR Elastography‐Based Nomogram as a Potential Imaging Biomarker for Predicting Microvascular Invasion of Hepatocellular Carcinoma

“…Finally, MRE scanning was conducted before contrast enhancement in our study. According to prior researches, 27,28 contrast administration did not significantly influence MRE stiffness measurements of liver, but its potential influence for tumor assessment has not been well understood, and might be an interesting avenue for future work. Furthermore, the application of threedimensional MRE, especially in smaller lesions, needs to be investigated.…”

Liver MR Elastography Technique and Image Interpretation: Pearls and Pitfalls

“…Study results (42,43) have shown that the administration of gadolinium-based contrast material has no effect on liver stiffness, and thus there is no substantial difference between the liver stiffness measured before and that measured after intravenous injection of a gadolinium-based contrast agent. Finally, the liver fat and iron quantification usually performed with MR elastography still should be performed before contrast agent administration to avoid the effects of gadolinium on these measurements (Fig 6).…”