The role of gadoxetic acid as a paramagnetic contrast medium in the characterization and detection of focal liver lesions: a review

Abstract

Recent studies have demonstrated that the use of paramagnetic hepatobiliary contrast agents in the acquisition of magnetic resonance images remarkably improves the detection and differentiation of focal liver lesions, as compared with extracellular contrast agents. Paramagnetic hepatobiliary contrast agents initially show the perfusion of the lesions, as do extracellular agents, but delayed contrast-enhanced images can demonstrate contrast uptake by functional hepatocytes, providing further information for a better characterization of the lesions. Additionally, this intrinsic characteristic increases the accuracy in the detection of hepatocellular carcinomas and metastases, particularly the small-sized ones. Recently, a hepatobiliary contrast agent called gadolinium ethoxybenzyl dimeglumine, that is simply known as gadoxetic acid, was approved by the National Health Surveillance Agency for use in humans. The authors present a literature review and a practical approach of magnetic resonance imaging utilizing gadoxetic acid as contrast agent, based on patients' images acquired during their initial experiment.

Karaciğerin HCC Dışındaki Malign Tümörleri

“…MRG, özellikle küçük boyuttaki (≤1 cm) karaciğer metastazlarının saptanmasında ve karakterize edilmesinde sensitivitesi ve spesifitesi en yüksek metod olarak kabul edilmektedir [4,6,7]. Hepatobiliyer kontrast maddeler ve DAG özellikle küçük boyuttaki bu metastazların saptanmasında sensitiviteyi arttırmaktadır [12][13][14][15]. Günümüzde Gadobenat dimeglumin (Gd-BOPTA; Multi-Hance, Bracco Imaging, Milan, Italy) ve Gadoxetik asid (Gd-EOB; Primovist, Bayer Schering Pharma AG, Berlin Germany) olmak üzere iki farklı hepatobiliyer paramagnetik gadolinyum şelatı kontrast madde bulunmaktadır.…”

“…iken Gd-BOPTA'dan sonra 1-2 saat kadardır. Ancak Gd-BOPTA daha yüksek relaksiviteye sahiptir [9][10][11][12][13][14]. Hepatobiliyer fazda sağlıklı karaciğer belirgin kontrast tutarak hiperintens, hem hipovasküler hem de hipervasküler metastazlar ise fonksiyone hepatosit veya safra yolu içermediğinden kontrast tutulumu göstermeyerek hipointens izlenmektedir.…”

“…Kontrast öncesi sekanslardaki spesifik veya yönlendirici olabilecek ip uçlarına ek olarak kontrast sonrası sekanslardaki lezyonun geç arteryel fazdaki morfolojik kontrastlanma paterni ve geç portal venöz fazdaki temporal kontrastlanma paterni ayırıcı tanıda yardımcı olmaktadır. Ayrıca zaman içerisinde geliştirilen karaciğer spesifik kontrast maddeleri [10][11][12][13][14] ve son yıllarda yaygın olarak kullanıma giren difüzyon ağırlıklı görüntüler (DAG) [3,7,15] lezyonların tespiti ve ayrıcı tanısındaki sensitivite ve spesifiteyi arttırmıştır.…”

Quantification of liver function by linearization of a two‐compartment model of gadoxetic acid uptake using dynamic contrast‐enhanced magnetic resonance imaging

“…However, the use of a hepatobiliary contrast agent allows direct assessment of liver function through contrast uptake in liver parenchyma. Gadoxetic acid, marketed in the USA as Eovist, and as Primovist in Europe, is a hepatobiliary MRI contrast agent . It is distinguished from vascular agents in that it is taken up into liver cells, allowing more direct interrogation of liver function.…”

Is computed tomography the ideal method for the identification and management of lung disease in systemic sclerosis?

“…However, the use of MRI is still limited to certain cases in which there is a need to minimize the use of ionizing radiation (9,10) . Allied to this problem, the upcoming addition of new antifibrotic drugs, such as pirfenidone (11) , to the therapeutic arsenal against SSc will further increase the challenges facing radiologists in the search for an ideal method to monitor patients with the disease.…”