Delayed MR imaging of hepatocellular carcinoma enhanced by gadobenate dimeglumine (Gd-BOPTA)

Abstract

The purpose of this study was to determine the efficacy of gadobenate dimeglumine (Gd‐BOPTA)‐enhanced magnetic resonance (MR) imaging for evaluation of hepatocellular carcinoma HCC. MR images were obtained in 14 patients with 31 HCC nodules as a part of a phase III clinical trial. T1‐ and T2‐weighted images were obtained before and after iv administration of 0.1 mmol/kg of Gd‐BOPTA. Two blinded readers evaluated pre‐ and delayed postcontrast images separately for detection of tumor nodules. Quantitative measurements of signal‐to‐noise (SNR) and tumor/liver contrast‐to‐noise (CNR) ratios were also performed. A signal/intensity ratio was calculated. Tumor enhancement was correlated with histologic findings. Consensus agreement of precontrast T1‐ and T2‐weighted images revealed 23/31 HCC nodules in 14 patients; postcontrast T1‐weighted images demonstrated 24/31 HCC nodules in the same number of patients. Combining both pre‐ and postcontrast images, 27/31 lesions were detected. Four patients had four well‐differentiated HCC nodules detected only on postcontrast images, while three well‐differentiated lesions in two patients were only seen on precontrast images. Quantitative evaluation showed an SNR ratio increase in both liver parenchyma and HCC nodules, as well as a significant increase in the absolute CNR ratio on postcontrast T1‐weighted gradient‐recalled images (P < 0.05). Well‐differentiated HCC lesions showed a greater enhancement than poorly differentiated HCC lesions. J. Magn. Reson. Imaging 1999;9:704–710. © 1999 Wiley‐Liss, Inc.

Contribution of the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI to Dynamic MRI in the detection of hypovascular small (≤2 cm) HCC in cirrhosis

“…The pathological explanation of the absent arterial enhancement is the weak development of non-triadal arteries in HGDN/early HCC, making their characterization based on dynamic MR phases impossible [46][47][48][49]. These results support the hypothesis that hypointensity in the HB-phase indicates the malignant nature of the lesion [24,27] and that hypointensity gradually increases as the nodule evolves towards malignancy [25].…”

“…Only one case of well-differentiated HCC was recently reported by Ahn et al [27] displaying a typical vascular pattern at dynamic MRI but appearing isointense in the HB-phase, thus expressing residual hepatocyte activity [44][45][46]. In our study population, all HCCs with a typical appearance at Dynamic MRI were also confirmed in the HB-phase by the absence of uptake.…”

Hepatocellular Carcinoma in Liver Transplantation Candidates: Detection with Gadobenate Dimeglumine–Enhanced MRI

“…Nodules exhibiting enhancement during the hepatic arterial phase and lacking portal venous supply during the portal venous or equilibrium phase were regarded as HCC nodules [4,[34][35][36]. Nodules exhibiting enhancement during the hepatic arterial phase and hypointensity on the 1-hour delayed phase images were also regarded as HCC [37]. A hypointense lesion on dynamic sequences and delayed images with a signal intensity higher than that of adjacent liver parenchyma but lower than that of CSF or gallbladder on T2-weighted turbo spin-echo sequences also was regarded as HCC [38,39].…”

The role of contrast-enhanced ultrasound in the detection of focal liver leasions

“…The sensitivity achieved by current MRI technology is essentially equivalent to that of helical CT for larger HCCs, especially when state-of-the-art liver MRI protocols including dynamic contrast-enhanced acquisitions are adopted [29][30][31]. In addition, paramagnetic hepatocytespecific contrast agents are showing promise in their ability to improve detection of HCC [32,33]. However, despite substantial technological improvements in MRI and CT over the past decade, detection of small (less than 2 cm) HCCs still remains a significant challenge [34].…”