Quantitative Evaluation of Liver Function with Use of Gadoxetate Disodium–enhanced MR Imaging

Yamada, Akira; Hara, Takeshi; Li, Feng; Fujinaga, Yasunari; Ueda, Kazuhiko; Kadoya, Masumi; Doi, Kunio

doi:10.1148/radiol.11100586

Cited by 181 publications

(154 citation statements)

References 30 publications

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“…2,[8][9][10][11][12] The use of hepatobiliary-phase images for the evaluation of hepatic function has also been suggested. 13,14 The approved package insert dose of gadoxetic acid, 0.025 mmol/kg, yields a quarter of the dose of gadolinium of traditional formulation agents, including gadopentetate dimeglumine, gadoteridol, gadodiamide, gadoversetamide, and gadobenate dimeglumine. 15 This dose was determined based on preclinical studies 16,17 that demonstrated comparable early enhancement of hypervascular tumors between MRI with a 0.025 mmol/kg dose showed comparable early enhancement of hypervascular tumors to gadopentetate dimeglumine 16 A dose of 0.025 mmol/kg was also found to be the minimum effective dose during the hepatobiliary phase for the detection and characterization of lesions.…”

Section: Introductionmentioning

confidence: 99%

Intraindividual Crossover Comparison of Gadoxetic Acid Dose for Liver MRI in Normal Volunteers

Bannas

Hernando

Rahimi

et al. 2016

MRMS

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Purpose: We performed a quantitative intraindividual comparison of the performance of 0.025-and 0.05-mmol/kg doses for gadoxetic acid-enhanced liver magnetic resonance (MR) imaging.Materials and Methods: Eleven healthy volunteers underwent liver MR imaging twice, once with a 0.025-and once with a 0.05-mmol/kg dose of gadoxetic acid. MR spectroscopy and 3-dimensional gradient-echo T 1 -weighted images (3D-GRE) were obtained before and 3, 10, and 20 min after injection of the contrast medium to measure T 1 and T 2 values and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) performance. During the dynamic phase, highly time-resolved 3D-GRE was used to estimate the relative CNR (CNR rel ) of the hepatic artery and portal vein (PV) to the liver. We used paired t-tests to compare the results of different doses.Results: During the hepatobiliary phase, we observed shorter T 1 values and higher SNRs of the liver (P < 0.001) and higher liver-to-PV and liver-to-muscle CNRs (P < 0.002) using 0.05 mmol/kg compared to 0.025 mmol/kg. Increasing the dose to 0.05 mmol/kg yielded a greater T 1 -shortening effect at 10 min delay even compared with 0.025 mmol/kg at 20 min (P < 0.001). During the dynamic phase, the peak CNR rel for the hepatic artery and portal vein were higher using 0.05 mmol/kg (P = 0.007 to 0.035).Conclusion: Use of gadoxetic acid at a dose of 0.05 mmol/kg leads to significantly higher SNR and CNR performance than with 0.025 mmol/kg. Quantitatively, a 10-min delay may be feasible for hepatobiliary-phase imaging when using 0.05 mmol/kg of gadoxetic acid.

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Section: Introductionmentioning

confidence: 99%

Intraindividual Crossover Comparison of Gadoxetic Acid Dose for Liver MRI in Normal Volunteers

Bannas

Hernando

Rahimi

et al. 2016

MRMS

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“…Nonetheless, the signal intensity of Gd-EOB-enhanced MRI is influenced, for example, by the degree of fibrosis as a result of a changed distribution volume of the T1 contrast agent and changed relaxivity in the extracellular space or by the fat or iron content. However, these seem to be negligible due to fast gradient echo sequences with short echo times and the use of relative enhancement [51].…”

Section: Mri As Imaging-based Liver Function Testmentioning

confidence: 99%

Imaging-Based Liver Function Tests – Past, Present and Future

Geisel

Lüdemann

Hamm

et al. 2015

Fortschr Röntgenstr

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Preoperative assessment of liver function and?prediction of postoperative functional reserve are important in patients scheduled for liver resection. While determination of absolute liver function currently mostly relies on laboratory tests and clinical scores, postoperative remnant liver function is estimated volumetrically using imaging data obtained with computed tomography (CT) or magnetic resonance imaging (MRI). Accurate estimation of hepatic function is also relevant for intensive care patients, oncologic patients, and patients with diffuse liver disease. The indocyanine green (ICG) test is still the only established test for estimating true global liver function. However, more recent tools such as the LiMAx test also allow global assessment of hepatic function. These tests are limited when liver function is inhomogeneously distributed, which is the case in such conditions as unilateral cholestasis or after portal vein embolization. Imaging-based liver function tests were first developed in nuclear medicine and, compared with laboratory tests, have the advantage of displaying the spatial distribution of liver function. Nuclear medicine scans are obtained using tracers such as?99mTc galactosyl and 99mTc mebrofenin. Liver function is typically assessed using planar scintigraphy. However, three-dimensional volumetry is possible with single-photon emission computed tomography (SPECT-CT). Another technique for image-based liver function estimation is Gd-EOB-enhanced MRI. While metabolization of Gd-EOB in the body is similar to that of ICG and mebrofenin, its distribution in the liver can be displayed by MRI with higher temporal and spatial resolution. Moreover, MRI-based determination of liver function can be integrated into routine preoperative imaging. This makes MRI an ideal candidate for preoperative determination of?liver function, though the best pulse sequence and the parameter to be derived from the image information remain to be identified. Another question to be answered is how the results may be affected by renal function and the presence of hyperbilirubinemia. As more results from clinical evaluation including comparison with postoperative liver function data become available, image-based liver function tests, especially with use of Gd-EOB as the contrast medium, have the potential to add another dimension to preoperative imaging. Key Points: ??Liver function consists of a multitude of subfunctions such as biotransformation, excretion and storage. ??Global liver function tests are score-based tests such as Child-Pugh or MELD as well as the ICG- and LiMAx-test. ??Imaging-based liver function tests add spatial information. Current clinical standard is the 99mTc-Mebrofenin-scintigraphy. ??MRI-based function tests with Gd-EOB-DTPA have the potential to integrate seamlessly into clinical workup, feature a higher temporal and spatial resolution and do not rely on ionizing radiation. Citation Format: ??Geisel D, L?demann L, Hamm B et?al. Imaging-Based Liver Function Tests ? Past, Present and F...

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“…In human studies, liver parenchymal enhancement after administration of Gd-EOB-DTPA has been shown to correlate with ICG clearance and with liver cirrhosis as assessed by the CPS [26,27], and subsequent biliary excretion has been shown to be delayed in patients with impaired liver function [28]. In a study of patients with primary biliary cirrhosis, quantitative parameters indicative of liver function derived from DA were shown to correlate with disease severity [29].…”

mentioning

confidence: 99%

Gd-EOB-DTPA-enhanced MRI for the assessment of liver function and volume in liver cirrhosis

Nilsson¹,

Blomqvist²,

Douglas³

et al. 2013

BJR

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Quantitative Evaluation of Liver Function with Use of Gadoxetate Disodium–enhanced MR Imaging

Cited by 181 publications

References 30 publications

Intraindividual Crossover Comparison of Gadoxetic Acid Dose for Liver MRI in Normal Volunteers

Intraindividual Crossover Comparison of Gadoxetic Acid Dose for Liver MRI in Normal Volunteers

Imaging-Based Liver Function Tests – Past, Present and Future

Gd-EOB-DTPA-enhanced MRI for the assessment of liver function and volume in liver cirrhosis

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