Consensus Statements From a Multidisciplinary Expert Panel on the Utilization and Application of a Liver-Specific MRI Contrast Agent (Gadoxetic Acid)

Jhaveri, Kartik; Cleary, Sean P.; Audet, Pascale; Balaa, Fady; Bhayana, Deepak; Burak, Kelly W.; Chang, Silvia D.; Dixon, Elijah; Haider, Masoom A.; Molinari, Michele; Reinhold, Caroline; Sherman, Morris

doi:10.2214/ajr.13.12399

Cited by 77 publications

(75 citation statements)

References 115 publications

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“…The late arterial phase, occurring 30 s after intravenous contrast injection, is important for lesion and vascular assessment (Fig. 4B) [16,19]. Signs of an adequate phase include presence of contrast in the hepatic artery and early enhancement of the portal vein, with no or minimal liver parenchymal enhancement [2,16].…”

Section: Extra-cellular Agentsmentioning

confidence: 99%

“…The portal venous phase, occurring 60-70 s after the injection, is important for detection of hypovascular lesions and for characterization, looking up for washout (Fig. 4C) [16,19]. A correct portal phase is characterized by enhancement of the entire hepatic vasculature as well as strong liver parenchymal enhancement [2,16].…”

Section: Extra-cellular Agentsmentioning

confidence: 99%

“…5) [2,10,16,19]. They offer improved lesion detection and characterization, as well as functional and biliary assessment [1,5,10,14].…”

Section: Hepato-biliary Agentsmentioning

confidence: 99%

“…There is rapid uptake and the hepatobiliary phase is obtained just 20 min after administration, when maximum parenchymal enhancement is seen [14,16,20]. There is growing evidence that in normal functioning livers a 10 min delay may suffice [1,19]. Considering its pharmacodynamic profile there is no true interstitial phase but a transitional phase in which cellular contrast retention already contributes to lesion enhancement [18].…”

Section: H Donato Et Almentioning

confidence: 99%

“…Future applications of hepato-specific agents may include fibrosis staging and quantification of liver function [19,20].…”

Section: H Donato Et Almentioning

confidence: 99%

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Liver MRI: From basic protocol to advanced techniques

Donato

França

Candelária

et al. 2017

European Journal of Radiology

102

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A B S T R A C TLiver MR is a well-established modality with multiparametric capabilities. However, to take advantage of its full capacity, it is mandatory to master the technique and optimize imaging protocols, apply advanced imaging concepts and understand the use of different contrast media. Physiologic artefacts although inherent to upper abdominal studies can be minimized using triggering techniques and new strategies for motion control. For standardization, the liver MR protocol should include motion-resistant T2-w sequences, in-op phase GRE T1 and T2-w fast spin echo sequences with fat suppression. Diffusion-weighted imaging (DWI) is mandatory, especially for detection of sub-centimetre metastases. Contrast-enhanced MR is the cornerstone of liver MR, especially for lesion characterization. Although extracellular agents are the most extensively used contrast agents, hepatobiliary contrast media can provide an extra-layer of functional diagnostic information adding to the diagnostic value of liver MR. The use of high field strength (3T) increases SNR but is more challenging especially concerning artefact control. Quantitative MR belongs to the new and evolving field of radiomics where the use of emerging biomarkers such as perfusion or DWI can derive new information regarding disease detection, prognostication and evaluation of tumour response. This information can overcome some of the limitations of current tests, especially when using vascular disruptive agents for oncologic treatment assessment. MR is, today, a robust, mature, multiparametric imaging modality where clinical applications have greatly expanded from morphology to advanced imaging. This new concept should be acknowledged by all those involved in producing high quality, high-end liver MR studies.

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Section: Extra-cellular Agentsmentioning

confidence: 99%

Section: Extra-cellular Agentsmentioning

confidence: 99%

“…5) [2,10,16,19]. They offer improved lesion detection and characterization, as well as functional and biliary assessment [1,5,10,14].…”

Section: Hepato-biliary Agentsmentioning

confidence: 99%

Section: H Donato Et Almentioning

confidence: 99%

“…Future applications of hepato-specific agents may include fibrosis staging and quantification of liver function [19,20].…”

Section: H Donato Et Almentioning

confidence: 99%

See 3 more Smart Citations

Liver MRI: From basic protocol to advanced techniques

Donato

França

Candelária

et al. 2017

European Journal of Radiology

102

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Predictive value of gadoxetic acid enhanced magnetic resonance imaging for posthepatectomy liver failure after a major hepatectomy

Orimo

Kamiyama

Kamachi

et al. 2020

J Hepato Biliary Pancreat

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Purpose: We assessed the usefulness of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging for the prediction of posthepatectomy liver failure (PHLF) after a major hepatectomy. Methods:We reviewed 140 cases involving a hepatectomy of two or more sections between 2010 and 2016 (study cohort). We used the standardized remnant hepatocellular uptake index (SrHUI) which was calculated by: SrHUI = future remnant liver volume × [(signal intensity of remnant liver on hepatobiliary phase images / signal intensity of spleen on hepatobiliary phase images) − 1] / body surface area. Validation of the SrHUI was performed in another cohort of 52 major hepatectomy cases between 2017 and 2018 (validation cohort). Results:The SrHUI of patients with PHLF was significantly lower than that of non-PHLF cases. Receiver operating characteristic analysis and the Youden index revealed that the SrHUI cutoff value for the prediction of PHLF and PHLF grade >B were 0.313 L/m 2 and 0.257 L/m 2 , respectively. In the validation cohort, the cutoff value of SrHUI for the prediction of PHLF or PHLF grade >B had a sensitivity of 75.0% or 88.8%, and specificity of 78.1% or 91.6%, respectively.

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Editorial for “Abbreviated Gadoxetic Acid‐Enhanced MRI for the Detection of Liver Metastases in Patients With Potentially Resectable Pancreatic Ductal Adenocarcinoma”

Shaikh

2022

Magnetic Resonance Imaging

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Consensus Statements From a Multidisciplinary Expert Panel on the Utilization and Application of a Liver-Specific MRI Contrast Agent (Gadoxetic Acid)

Cited by 77 publications

References 115 publications

Liver MRI: From basic protocol to advanced techniques

Liver MRI: From basic protocol to advanced techniques

Predictive value of gadoxetic acid enhanced magnetic resonance imaging for posthepatectomy liver failure after a major hepatectomy

Editorial for “Abbreviated Gadoxetic Acid‐Enhanced MRI for the Detection of Liver Metastases in Patients With Potentially Resectable Pancreatic Ductal Adenocarcinoma”

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