Qualitative assessment of EOB-GD-DTPA and Gd-BT-DO3A MR contrast studies in HCC patients and colorectal liver metastases

Abstract

AimTo compare liver-specific EOB-GD-DTPA and liver-non-specific Gd-BT-DO3A MR, in hepatocellular carcinoma (HCC) and liver colorectal metastases.Material and methodsSeventy HCC patients with 158 nodules and 90 colorectal liver metastases (mCRC) with 370 lesions were included in the retrospective analysis. HCC patients underwent MR at 0 time (MR0), after 3 (MR3) and 6 months (MR6) using two different CM; 69 mCRC patients underwent MR with Gd-EOB-BTPA and 21 mCRC patients with Gd-BT-DO3A. We evaluated arterial phase hyperenhancement, lesion-to-liver contrast during portal phase, hepatobiliary phase parenchymal hyperenhancement.ResultsIn HCC patients arterial phase hyperenhancement degree was statistically higher (p = 0.03) with Gd-BT-DO3A (mean 4) than GD-EOB-DTPA (mean 2.6), while we found no significant statistical differences among mean (2.6) values at MR0 and MR6 using GD-EOB-DTPA. For all 209 patients underwent Gd-EOB-DTPA, we found that lesion-to-liver contrast during portal phase mean value was 4 while for patients underwent MR with Gd-BT-DO3A was 3 (p = 0.04). For HCC hepatobiliary phase parenchymal hyperenhancement mean value was 2.4. For mCRC patients: among 63 patients underwent previous chemotherapy hepatobiliary phase parenchymal hyperenhancement mean value was 3.1 while for 6 patients no underwent previous chemotherapy was 4 (p = 0.05).ConclusionsGd-EOB-DTPA should be chosen in pre surgical setting in patients with colorectal liver metastases.

Abbreviated MRI protocol for colorectal liver metastases: How the radiologist could work in pre surgical setting

“…Imaging is an important tool in the management of patients with liver metastases by helping enumerate the number and sites of lesions, assessing the resectability, evaluating the response to treatment (systemic or ablative therapies), and detecting drug toxicities [1][2][3][4]. Although multidetector computed tomography (MDCT) is routinely used for primary staging and disease surveillance, Magnetic Resonance imaging (MRI) is a valuable diagnostic technique in oncologic setting, since this tool provides morphological and functional data [5][6][7][8]. Functional data, extracted by diffusion weighted imaging (DWI) and dynamic contrast-enhanced (DCE)-MRI, allow a proper detection and characterization of focal liver lesions [5][6][7][8].…”

“…Although multidetector computed tomography (MDCT) is routinely used for primary staging and disease surveillance, Magnetic Resonance imaging (MRI) is a valuable diagnostic technique in oncologic setting, since this tool provides morphological and functional data [5][6][7][8]. Functional data, extracted by diffusion weighted imaging (DWI) and dynamic contrast-enhanced (DCE)-MRI, allow a proper detection and characterization of focal liver lesions [5][6][7][8]. Oncology is a major field of application of DWI, especially in the detection and characterization of liver metastases [9][10][11].…”

Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients

“…In our study, the choice of a dynamic protocol is linked to the criteria that define the effectiveness of a locoregional treatment [ 21 ], so we believe that it is necessary to use the contrast medium and, considering the limits of the EOB, an interstitial type [ 14 ]. To obtain an efficacy treatment is critical the creation of a rim of greater than 5–10 mm around the lesion; thus, an ablation area larger than the original lesion is a needed feature.…”

“…RECIST are unfitting to evaluate locoregional treatment, since the current morphologic response criteria do not offer the sufficient data to define the efficacy of therapy. Hence, response criteria dedicated to ablation therapies are needed in clinical practice, other than in clinical trials [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. According to Lencioni et al, it is mandatory to obtain a dual-phase imaging of the liver, arterial and portal phase, while the equilibrium phase is useful but not necessary [ 11 ].…”

Introduction to Special Issue of Radiology and Imaging of Cancer

“…Medical imaging comprises a huge number of imaging techniques, and multiple biomedical imaging techniques are used in all phases of cancer management because they are able to provide morphological and functional data [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. In addition, image-guided invasive therapy has the promise to improve outcomes and reduce collateral effects compared to systemic or surgical treatment [ 20 , 21 ].…”