Imaging characteristics of hepatocellular carcinoma using the hepatobiliary contrast agent GD-EOB-DTPA

Jung, Gregor; Breuer, Josy; Poll, L. W.; Koch, Jens‐Albrecht; Balzer, Thomas; Chang, Sun O; Mödder, Ulrich

doi:10.1080/02841850500406795

Cited by 69 publications

(63 citation statements)

References 17 publications

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“…However, it is unknown whether this limitation has a clinical impact on the selection of recipients and their prognosis. According to previous reports, 9% to 27% of HCC can be isointense or hyperintense on gadoxetic acid-enhanced hepatobiliary phase images (18,(33)(34)(35). The reason why no early HCC showed hyperintensity on gadoxetic acid-enhanced hepatobiliary phase images in the present study is unknown.…”

Section: Discussioncontrasting

confidence: 44%

Gadoxetic acid‐enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria

Rhee

Kim

Park

et al. 2011

Magnetic Resonance Imaging

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Purpose: To describe the imaging features of early hepatocellular carcinoma (HCC) on gadoxetic acid-enhanced MRI (Gd-EOB-MRI) in comparison with multidetector computed tomography (MDCT) examinations. Materials and Methods:We analyzed imaging findings of 19 pathologically proven early HCC lesions in 15 patients who underwent both MDCT and Gd-EOB-MRI at 3.0 Tesla (T) units before surgery. MRI included in-phase and outof-phase T1-weighted dual-echo gradient-recalled-echo sequences, dynamic T1-weighted images before and after bolus injection of gadoxetic acid disodium, fat-saturated T2-weighted fast spin-echo sequences, and T1-weighted hepatobiliary phase images 20 min after contrast injection. Two radiologists retrospectively evaluated the signal intensities and enhancement features on MRI and MDCT.Results: None of the lesions displayed arterial enhancement and washout on MDCT. On Gd-EOB-MRI, six (32%) lesions showed T2-hyperintensity, five (26%) lesions showed signal drop on opposed-phase. Three lesions (16%) showed arterial enhancement and washout. Twelve (63%), 13 (68%), and 15 (79%) lesions were hypointense on hepatic venous, equilibrium, and hepatobiliary phase, respectively. Conclusion:Most early HCCs did not show arterial enhancement and washout pattern on both MDCT and Gd-EOB-MRI. Gd-EOB-MRI may provide several ancillary findings for diagnosis of early HCC such as decreased hepatobiliary uptake, T2 hyperintensity and signal drop in opposed phase.

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Section: Discussioncontrasting

confidence: 44%

Gadoxetic acid‐enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria

Rhee

Kim

Park

et al. 2011

Magnetic Resonance Imaging

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“…Gadoxetic acid can effectively be used in dynamic and liver-specific static MRI with accurate delineation, classification, and characterization of liver tumors, in which excellent sensitivity and characterization for hepatocellular lesions are provided (10,12,14,(16)(17)(18)(19). The diagnosis of early HCC is one of the potential indication (20,21).…”

Section: Discussionmentioning

confidence: 99%

Outcome of hypovascular hepatic nodules revealing no gadoxetic acid uptake in patients with chronic liver disease

Motosugi

Ichikawa

Sano

et al. 2011

Magnetic Resonance Imaging

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Purpose: To elucidate the natural history of hypovascular nodules that appear hypointense on hepatocyte-phase gadoxetic acid-enhanced MR images by focusing on hypervascularization over time. Materials and Methods:In this study, 135 hypovascular nodules revealing no gadoxetic acid uptake in 53 patients were examined. All nodules were retrospectively examined using serial follow-up computed tomography (CT) and MRI examinations until hypervascularity was observed on arterial-phase dynamic CT or gadoxetic acid-enhanced MR images, or on CT during hepatic arteriography. Logistic regression analysis was used to investigate the association between hypervascularization and MR findings including a presence of fat assessed by a signal drop on opposed-phase T1-weighted images.Results: Of the 135 nodules, 16 underwent hypervascularization. The size of the nodules and the presence of fat in the nodules were independent indicators of hypervascularization. The 1-year cumulative risk of hypervascularization was 15.6%. This risk was significantly increased in the case of nodules >10 mm (37.6%, P < 0.01) and fatcontaining nodules (26.5%, P < 0.01).Conclusion: Hypovascular nodules that appear hypointense on hepatocyte-phase gadoxetic acid-enhanced MR images may progress to conventional hypervascular hepatocellular carcinoma. Nodules more than 10 mm in diameter and containing fat are at high risk for developing hypervascularization.

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“…[1][2][3][4][5] Uptake by hepatocytes of approximately half the injected dose of gadoxetic acid improves detection of liver malignancies on hepatocyte-phase imaging. [6][7][8] When gadoxetic acid is used, hepatocyte-phase imaging can be acquired 10 to 20 min after injection of the contrast material.…”

Section: Introductionmentioning

confidence: 99%

Diffusion- and T2-weighted MR Imaging of the Liver: Effect of Intravenous Administration of Gadoxetic Acid Disodium

Muhi

Ichikawa

Sou

et al. 2012

MRMS

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Purpose: We evaluated the eŠect of intravenous administration of gadoxetic acid disodium to hepatic lesions and liver parenchyma on T 2 -weighted (T 2 WI) and diŠusion-weighted imaging (DWI).Materials and Methods: One hundred and one consecutive patients with 259 hepatic lesions underwent T 2 WI and DWI (b-values of 500 and 1000 s/mm 2 ) before and after gadoxetic acid administration. We compared the ratio of signal intensity (SIR) of the liver parenchyma and hepatic lesions, the ratio of contrast intensity of the lesion to the liver (CIR), the apparent diŠusion coe‹cients (ADCs) of the liver and lesions, and lesion detectability between pre-and post-contrast images.Results: SIRs, CIRs, and ADC of focal hepatic lesions were comparable on pre-and post-contrast images, and lesion detectability did not diŠer signiˆcantly between pre-and post-contrast T 2 WI and DWI. The SIRs of the liver parenchyma were signiˆcantly lower on post-contrast DWI (1.4±0.68 [b＝500 s/mm 2 ] and 1.71±0.67 [b＝1000 s/mm 2 ]) than pre-contrast images (1.89±0.68 [b＝500 s/mm 2 ] and 2.26±0.78 [b＝1000 s/mm 2 ]) ( Pº 0.001). ADCs of the liver parenchyma were also signiˆcantly decreased on post-contrast DWI (0.77±0.32 mm 2 /s) than pre-contrast images (0.64±0.33 mm 2 /s) ( P＝0.001).Conclusion: T 2 WI and DWI after administration of gadoxetic acid are feasible and do not compromise the SIR, CIR, and ADC of focal hepatic lesions. However, the signal intensity of DWI and ADC value of the liver parenchyma were decreased on gadoxetic acidenhanced hepatocyte phase images.

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Imaging characteristics of hepatocellular carcinoma using the hepatobiliary contrast agent GD-EOB-DTPA

Cited by 69 publications

References 17 publications

Gadoxetic acid‐enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria

Gadoxetic acid‐enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria

Outcome of hypovascular hepatic nodules revealing no gadoxetic acid uptake in patients with chronic liver disease

Diffusion- and T2-weighted MR Imaging of the Liver: Effect of Intravenous Administration of Gadoxetic Acid Disodium

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