Gd-EOB-DTPA Enhanced MRI for Hepatocellular Carcinoma: Quantitative Evaluation of Tumor Enhancement in Hepatobiliary Phase

Abstract

Objective: The purpose of this study was to evaluate the utility of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for the quantitative evaluation of hepatocellular carcinoma (HCC) and dysplastic nodules in the hepatobiliary phase.Material and Methods: The subjects comprised 12 patients with 27 lesions (22 HCCs and 5 dysplastic nodules). Chemical-shift-selective fat-suppressed T 1 -weighted sequences were obtained before and 10, 20, and 40 min after the injection of Gd-EOB-DTPA. Quantitative analyses were performed with the enhancement ratio of the lesion and the contrast-to-noise (C W N) ratio.Results: The enhancement ratios of the HCCs were 44.0±36.5, 44.7±46.8, and 47.7±52.8 (z) at 10, 20, and 40 min, respectively, after the injection of Gd-EOB-DTPA. The enhancement ratios of the dysplastic nodules were 36.2±34.3, 44.3±37.3, and 40.1± 46.8 (z). The C W N ratios of the HCCs were 0.2±6.6 for the precontrast image, and -9.2 ±12.6, -9.9±14.8, and -12.7±15.7 at 10, 20, and 40 min, respectively, after the injection of Gd-EOB-DTPA. The C W N ratios of the dysplastic nodules were 1.4±8.0, -13.7±11.1, -13.3±7.6, and -13.1±10.4. No signiˆcant diŠerences were found between the HCCs and the dysplastic nodules in the enhancement ratio and the C W N ratio. Only two HCCs showed a positive C W N ratio value, and these HCCs were pathologically conˆrmed to be a well diŠerentiated and a moderately diŠerentiated carcinoma, respectively.Conclusion: HCCs and some of the dysplastic nodules showed hypointensity in the hepatobiliary phase in Gd-EOB-DTPA-enhanced MRI. No speciˆc enhancement was observed, regardless of tumor diŠerentiation.

Rules, Roles, and Room for Discussion in Gadoxetic Acid-enhanced Magnetic Resonance Liver Imaging: Current Knowledge and Future Challenges

“…Approximately 10 to 20z of conventional HCCs can show high intensity or take up gadoxetic acid during hepatocyte phase imaging. 89 There have been reports that OATP-8, an anion transporter on the hepatocyte surface, is overexpressed in these lesions. 90,91 One study suggested that none of these lesions was poorly diŠerentiated HCC.…”

MR Imaging of Carcinosarcoma of the Liver using Gd-EOB-DTPA

“…Hepatocellular carcinomas usually do not take up Gd-EOB-DTPA and appear as hypointense lesions in the hepatobiliary phase, as do other tumors without normal hepatocyte function. 11,12 However, some hepatocellular carcinomas can show hyperintense lesions in the hepatobiliary phase, as in the present case. 3 The mechanism of the uptake of Gd-EOB-DTPA is currently being researched.…”

Gd-EOB-DTPA-enhanced MR Imaging Findings of Hepatocellular Adenoma: Correlation with Pathological Findings

“…Although Gd-EOB-DTPA generally accumulates in benign hepatocellular lesions, its accumulation has been reported in a part of hepatocellular carcinomas in the hepatobiliary phase. 1 The teams of Kitao 9 and Narita 10 reported that expression of OATP1B3 determines the uptake of Gd-EOB-DTPA in the hepatobiliary phase in hepatocellular carcinomas, and Kitao's group reported that the expression of MRP3 determines the excretion of Gd-EOB-DTPA in the hepatobiliary phase in hepatocellular carcinomas. 9 To the best of our knowledge, the expression of transporters in benign hepatocellular nodules is not reported.…”

“…Use of a recently available liverspeciˆc contrast medium for magnetic resonance (MR) imaging, gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA), has become common in the evaluation of hepatocellular lesions. [1][2][3][4][5] The medium accumulates in partially benign hepatocellular nodules. 5 However, few reports describe theˆndings of Gd-EOB-DTPA-enhanced MR imaging for hepatocellular adenoma, 2 and to the best of our knowledge, no reports detail their correlation with pathologicalˆndings.…”