Added Value of Gadoxetic Acid–enhanced Hepatobiliary Phase MR Imaging in the Diagnosis of Hepatocellular Carcinoma

Ahn, Sung Soo; Kim, Do Young; Lim, Joon Seok; Hong, Hye Suk; Chung, Yong Eun; Choi, Jin Young

doi:10.1148/radiol.10091388

Cited by 308 publications

(250 citation statements)

References 30 publications

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“…In addition to providing the dynamic enhancement data, Gd-EOB-DTPA has an added value of hepatobiliary phase, which has been shown to be an important adjunct to the detection and characterization of hepatic masses in both patients with normal and cirrhotic livers (1)(2)(3)(4). In patients with hepatic cirrhosis as well as in those without it, lesion detection and characterization heavily rely on comparison of the lesion's signal intensity to that of the background hepatic parenchyma (3,4).…”

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confidence: 99%

Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors

Chernyak

Kim

Rozenblit

et al. 2011

Magnetic Resonance Imaging

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Purpose: To identify factors influencing hepatobiliary phase (HBP) hepatic enhancement on gadoxetate disodium-enhanced MRI in patients with chronic liver disease (CLD). Materials and Methods:We retrospectively reviewed abdominal gadoxetate disodium-enhanced MRIs and medical records of patients with (n ¼ 97) and without (n ¼ 48) CLD. CLD subgroups were formed based on normal/ abnormal components of liver function tests (LFTs). Hepatic enhancement coefficients (HEKs) were calculated on MRI, and compared with LFTs and Model for Endstage Liver Disease (MELD) scores.Results: The mean HEK was significantly lower (P < 0.0008) in the CLD than control group. The mean HEK was similar to controls in the subgroup with all normal LFTs (P ¼ 0.09) and subgroup with normal direct bilirubin (DB) (p ¼ 0.09), while it was significantly reduced (P < 0.0001) in the subgroup with elevated DB. For all other LFT components, regardless of normal or abnormal values, there was a significant reduction in the mean HEKs versus controls (all P values <0.01). There was a highly negative correlation between the mean HEKs in CLD subgroups and number of abnormal LFTs (r ¼ À0.93) and MELD scores (r ¼ À0.89).Conclusion: HBP hepatic enhancement in CLD patients is similar to those with no CLD as long as direct bilirubin remains normal. Higher MELD scores and higher number of abnormal LFT components are associated with reduced hepatic enhancement.

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confidence: 99%

Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors

Chernyak

Kim

Rozenblit

et al. 2011

Magnetic Resonance Imaging

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“…22 A higher lesion-to-liver contrast in the hepatocyte phase may improve the sensitivity of the detection of hepatocellular lesions, [14][15][16]23 especially early HCC. 24 In our study, we observed hypovascular nodules that were hypointense in the hepatocytephase images in 27.2z (82/302) of the patients who underwent gadoxetic acid-enhanced MR imaging for suspected or conˆrmed HCC.…”

Section: Discussionmentioning

confidence: 99%

Natural Course of Hypovascular Nodules Detected on Gadoxetic Acid-enhanced MR Imaging: Presence of Fat is a Risk Factor for Hypervascularization

et al. 2013

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Purpose: Hypovascular nodules that exhibit hypointensity in hepatocyte-phase images of gadoxetic acid-enhanced magnetic resonance (MR) imaging are frequently encountered in clinical practice. We investigated risk factors for the development of these nodules into hypervascular hepatocellular carcinoma (HCC).Methods: We retrospectively reviewed our institutional database and identiˆed 302 patients who underwent gadoxetic acid-enhanced MR imaging for suspected or conˆrmed HCC from February 1, 2008 to January 30, 2011. We excluded patients who were examined for metastasis of other malignancies or for other hepatic tumors, such as focal nodular hyperplasia. We identiˆed hypovascular nodules that were hypointense in hepatocytephase images, recorded their characteristics, and calculated the cumulative hypervascularization rate for nodules that were followed up.Results: Of the 302 patients, 82 had hypovascular nodules (178 nodules; mean size, 9.3 mm). Sixty nodules were followed up for over 6 months, and eight progressed to hypervascular HCC. Hypervascularization occurred more frequently in nodules with fat than those without (Pº0.01). The cumulative hypervascularization rate was 5.1z over a year.Conclusion: The presence of intralesional fat was found to be a risk factor for hypervascularization of hypovascular nodules that exhibited hypointensity in the hepatocyte-phase images of gadoxetic acid-enhanced MR imaging.

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“…One report showed that 95.4% of HCCs have low signals in Gd-EOB-DTPA-enhanced hepatobiliary-phase MRI images [28]. Using Gd-EOB-DTPA-enhanced hepatobiliary-phase M-RI images, the detection rates of well-differentiated early HCCs, HCCs with less-abundant blood supplies, and HCCs with diameters ≤1 cm are higher than those using multi-slice spiral CT, CTAP, CTHA, and conventional three-phase dynamic contrast-enhanced MR [29][30][31].…”

Section: Application Of Targeted Contrast Agents For Mrimentioning

confidence: 99%

“…Pathological examination revealed that those cancer cells were well-differentiated and had strong bile secretion function [32], DNs often show an isosignal or high signal during the hepatobiliary phase. Gd-EOB-DTPA, therefore, is of great significance for the differentiation of DNs and early HCCs [27][28][29][30][31] …”

Section: Application Of Targeted Contrast Agents For Mrimentioning

confidence: 99%

The Role of Multimodality Imaging Techniques on Differential Diagnosis of Precancerous Nodules and Hepatocellular Carcinoma

Jiang¹,

Li²

2012

IJMPCERO

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In recent years, the incidence of hepatocellular carcinoma (HCC) has been increasing worldwide, and its high mortality seriously threatens public health. Early detection and treatment are crucial to improving the survival rate. Imaging examination widely used for the diagnosis of HCC and provides a non-invasive means of tumor visualization. The rapid development of medical imaging technology is expected to improve early-stage diagnosis rates for HCC. This article summarizes the methods for the differential diagnosis of pre-malignant dysplastic nodule (DN) and small hepatocellular carcinoma during the carcinogenesis of cirrhosis and reviews their application. In addition, a discussion on some recently patented medical imaging development was also presented.

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Added Value of Gadoxetic Acid–enhanced Hepatobiliary Phase MR Imaging in the Diagnosis of Hepatocellular Carcinoma

Abstract: Hepatobiliary phase images obtained after gadoxetic acid-enhanced dynamic MR imaging may improve diagnosis of HCC and assist in surgical planning.

Cited by 308 publications

References 30 publications

Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors

Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors

Natural Course of Hypovascular Nodules Detected on Gadoxetic Acid-enhanced MR Imaging: Presence of Fat is a Risk Factor for Hypervascularization

The Role of Multimodality Imaging Techniques on Differential Diagnosis of Precancerous Nodules and Hepatocellular Carcinoma

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