Comparison of Dynamic Phase Enhancement of Hepatocellular Carcinoma Using Gadoxetate Disodium vs Gadobenate Dimeglumine

Abstract

PURPOSETo determine the differences in enhancement pattern of hepatocellular carcinoma (HCC) during first 5 minutes of post-contrast phases MRI with gadoxetic acid (Gd-EOB-DTPA) versus gadobenate dimeglumine (Gd-BOPTA) using the FDA approved doses. METHODS AND MATERIALS95 patients with HCC were examined on 1.5 T scanner; 74 patients with Gd-BOPTA and 21 with Gd-EOB-DTPA. Using the same MRI parameters, post-contrast imaging was performed at pre-contrast, arterial, portal venous, equilibrium, and 5 minute delayed phases. Gd-EOB-DTPA was administered at a dose of 0.025 mmol/kg body weight and Gd-BOPTA at a dose of 0.1 mmol/kg body weight. Both agents were injected at rate of 2 mL/sec and arterial phase was timed by using bolus-triggering software. The contrast-tonoise ratio (CNR) was calculated by (SI lesion -SI liver )/SD background . (SD=Standard Deviation, SI=signal intensity) RESULTSMean CNRs were not statistically significant different in arterial (p=0.3), portal venous (p=0

Use of gadoxetate disodium in patients with chronic liver disease and its implications for liver imaging reporting and data system (LI‐RADS)

“…In addition to a lower administered volume, the lower approved gadolinium dose may lead to reduced peak enhancement of the organs on the AP and PVP compared with other agents . Similarly, peak enhancement of HCC may be diminished: in one study, there was a tendency toward a lower contrast‐to‐noise ratio of HCC on the AP with gadoxetate compared with gadobenate, although the difference was not statistically significant …”

“…Imaging in the HBP is a major advantage of gadoxetate. By achieving high signal‐to‐noise and contrast‐to‐noise ratios, the HBP may show HCC with higher conspicuity than other sequences . Some lesions detected in the HBP are identified and characterized in retrospect on other sequences …”

“…By achieving high signal-to-noise and contrast-to-noise ratios, the HBP may show HCC with higher conspicuity than other sequences. [7][8][9][10][11][12] Some lesions detected in the HBP are identified and characterized in retrospect on other sequences. 13,14 FIGURE 1: A 49-year-old man with chronic hepatitis B. MRI with gadoxetate (a-d) and MRI with extracellular contrast agent (ECA) (eg) were performed 6 months apart.…”

“…3 Similarly, peak enhancement of HCC may be diminished: in one study, there was a tendency toward a lower contrast-to-noise ratio of HCC on the AP with gadoxetate compared with gadobenate, although the difference was not statistically significant. 10 Additionally, motion may impact AP quality with gadoxetate. Gadoxetate is associated with an increased incidence of transient self-limiting dyspnea (also known as transient severe motion or TSM), which occurs shortly after injection, at around the time of the late AP.…”

Troubleshooting Arterial-Phase MR Images of Gadoxetate Disodium-Enhanced Liver

“…The effects of the small administered volume and gadolinium content are reflected in the weak arterial enhancement on images ( 6 7 ) and can pose challenges to capturing optimal arterial-phase imaging ( 10 ). Recent studies revealed that weak arterial enhancement can possibly affect the lesion conspicuity of hypervascular tumors such as HCCs and focal nodular hyperplasias during the arterial phase of gadoxetate-enhanced liver MR imaging in comparison with gadobenate dimeglumine-enhanced MR imaging ( 17 18 ).…”