Hypervascular hepatocellular carcinomas: detection with gadoxetate disodium-enhanced MR imaging and multiphasic multidetector CT

Abstract

Gadoxetate disodium is a new liver-specific MR imaging contrast agent. Gadoxetate disodium-enhanced MRI helps the assessment of patients with liver disease. It showed high diagnostic accuracy for the detection of hepatocellular carcinoma.

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

“…13,17 However, there is little information on the optimal time delay after the arrival of the contrast agent to the aorta. Researchers have used delay times ranging from 7 to 15 s. 17,[20][21][22] If bolus timing cannot be manipulated as described above, timing may instead be adjusted via the test-injection method, in which a small amount (e.g., 0.5 mL) of contrast agent is injected before dynamic study to measure the length of time for the agent to reach the aorta.…”

Ultrasonography Fusion Imaging System Increases the Chance of Radiofrequency Ablation for Hepatocellular Carcinoma with Poor Conspicuity on Conventional Ultrasonography

“…At first, an unenhanced MRI was obtained using a T1-weighted gradient echo sequence (dual echoes; in-phase and out-of-phase). Then, unenhanced, arterial, portal, late and hepatobiliary phase images were acquired just before, 25, 70, 180 s and 20 min, respectively, after injection of the contrast agent [9,10]. …”

“…The diagnosis of hypervascular HCC was established on the basis of the typical imaging features on dynamic CT, CT angiography or Gd-EOB-DTPA-enhanced MRI [10]. Tumor biopsy was conducted for the nodules which were more than 10 mm in diameter and showed hypointensity on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI without early enhancement, on at least two imaging modalities of contrast-enhanced US (CEUS), dynamic CT and Gd-EOB-DTPA-enhanced MRI [9,18].…”

“…Since second-generation contrast medium for ultrasonography (US) including Sonazoid (Daiichi-sankyo, Tokyo, Japan) and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA; Primovist, Bayer Healthcare, Osaka, Japan), a liver-specific magnetic resonance (MR) contrast agent, became available, imaging diagnosis of HCC has dramatically advanced [8,9,10,11,12,13,14]. As a result, the diagnosis of HCC has come to be made at an earlier stage.…”

Role of Gadolinium-Ethoxybenzyl-Diethylenetriamine Pentaacetic Acid-Enhanced Magnetic Resonance Imaging in the Management of Hepatocellular Carcinoma: Consensus at the Symposium of the 48th Annual Meeting of the Liver Cancer Study Group of Japan

“…This contrast agent, consisting of Gd-DTPA conjugated with an ethoxybenzyl (EOB) group, has the characteristics of both an extracellular Gd contrast agent and a hepatocyte-specific contrast agent. Because Gd-EOB-DTPA-enhanced MRI (EOB-MRI) allow for the observation of blood flow in hepatocellular carcinoma (HCC) and the function of hepatocyte, diagnosis made by EOB-MRI is reportedly superior to diagnosis of hepatic blood flow either by dynamic computed tomography (CT) using multi-detector CT, dynamic MRI using an extra-cellular Gd contrast agent, or functional diagnosis of hepatic Kupffer cells by superparamagnetic iron oxide (SPIO)-MRI [6,7,8,9,10,11,12,13]. EOB-MRI is highly capable of detecting not only typical hypervascular HCC but also early-stage hypovascular HCC [11,12,13], greatly influencing early diagnosis and treatment for HCC.…”