Efficacy and Safety of MR Imaging with Liver-specific Contrast Agent: U.S. Multicenter Phase III Study

Bluemke, David A.; Sahani, Dushyant V.; Amendola, Marco A.; Balzer, Thomas; Breuer, Josy; Brown, Jeffrey J.; Casalino, David D.; Davis, Peter L.; Francis, Isaac R.; Krinsky, Glenn A.; Lee, Fred T.; Lu, David; Paulson, Erik K.; Schwartz, Lawrence H.; Siegelman, Evan S.

doi:10.1148/radiol.2371031842

Cited by 209 publications

(177 citation statements)

References 29 publications

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“…Previous studies have demonstrated that Gd-EOB-DTPA is well tolerated and has no substantial adverse events and minor adverse events of 5.9% (6,7,19). In fact, there were no severe adverse effects in our study population.…”

Section: Discussionsupporting

confidence: 50%

Dynamic contrast‐enhanced magnetic resonance imaging of abdominal solid organ and major vessel: Comparison of enhancement effect between Gd‐EOB‐DTPA and Gd‐DTPA

Tamada

Ito

Sone

et al. 2009

Magnetic Resonance Imaging

110

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Purpose:To evaluate the differences in enhancement of the abdominal solid organ and the major vessel on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) obtained with gadolinium ethoxybenzyldiethylenetriamine pentaacetic acid (Gd-EOB-DTPA: EOB) and gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) in the same patients. Materials and Methods:A total of 13 healthy volunteers underwent repeat assessments of abdominal MR examinations with DCE-MRI using either Gd-DTPA at a dose of 0.1 mmol/kg body weight or EOB at a dose of 0.025 mmol/kg body weight. DCE images were obtained at precontrast injection and in the arterial phase (AP: 25 seconds), portal phase (PP: 70 seconds), and equilibrium phase (EP: 3 minutes). The signal intensities (SIs) of liver at AP, PP, and EP; the SIs of spleen, renal cortex, renal medulla, pancreas, adrenal gland, aorta at AP; and the SIs of portal vein and inferior vena cava (IVC) at PP were defined using region-ofinterest measurements, and were used for calculation of signal intensity ratio (SIR). There was no significant difference in mean SIR of liver at PP between EOB (0.529 Ϯ 0.124) and Gd-DTPA (0.564 Ϯ 0.139). Conversely, the mean SIR of liver at EP was significantly higher with EOB (0.576 Ϯ 0.167) than with Gd-DTPA (0.396 Ϯ 0.093) (P Ͻ 0.001). Results Conclusion:Lower arterial vascular and parenchymal enhancement with Gd-EOB, as compared with Gd-DTPA, may require reassessment of its dose, despite the higher late venous phase liver parenchymal enhancement.

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Section: Discussionsupporting

confidence: 50%

Dynamic contrast‐enhanced magnetic resonance imaging of abdominal solid organ and major vessel: Comparison of enhancement effect between Gd‐EOB‐DTPA and Gd‐DTPA

Tamada

Ito

Sone

et al. 2009

Magnetic Resonance Imaging

110

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“…For gadobenate dimeglumine-enhanced MRI, the reported imaging window for the acquisition of hepatobiliary phase images is 40-180 minutes after injection of the contrast material (30)(31)(32). In contrast, gadoxetate disodium-enhanced hepatobiliary phase images can be obtained after a shorter delay time of 20 minutes (13,17,29,(33)(34)(35), and some studies have implied that a scan delay for the acquisition of gadoxetate disodium-enhanced hepatobiliary phase images can be even further reduced (20,21). In a study including 23 patients with hepatic metastases, Reimer et al (20) showed that lesion-to-liver contrast-to-noise ratios of hepatic metastases are comparable between gadoxetate disodium-enhanced 10-minute and 20-minute delayed images but did not compare the sensitivity for the two image sets.…”

Section: Discussionmentioning

confidence: 99%

Detection of liver metastases using gadoxetic‐enhanced dynamic and 10‐ and 20‐minute delayed phase MR imaging

Jeong

Kim

Park

et al. 2011

Magnetic Resonance Imaging

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Purpose: To assess the incremental value of hepatobiliary phase images in gadoxetate disodium-enhanced magnetic resonance imaging (MRI), and to compare diagnostic accuracy and lesion conspicuity on 10-and 20-minute delayed images for preoperative detection of hepatic metastases with subgroup analysis according to size and history of chemotherapy. Materials and Methods:Forty-six patients with 107 metastases who underwent surgery after gadoxetate disodium-enhanced MRI were evaluated. Four observers independently interpreted three sets: dynamic set comprising precontrast T1-, T2-weighted, and dynamic images; 10-minute set comprising dynamic set and 10-minute delayed; 20-minute set comprising 10-minute set and 20-minute delayed. Diagnostic accuracy was compared with subgroup analysis. Liver-to-lesion signal ratio (SR) was calculated using the region of interest method and compared.Results: Mean A z and sensitivities were significantly higher for 10-(A z ¼ 0.894, sensitivity ¼ 95.6%) and 20-minute (0.910, 97.2%) than dynamic set (0.813, 79.9%) (P < 0.001), with no significant difference between 10-and 20-minute sets (P ¼ 0.140). In patients with small ( 1 cm) metastases and a history of chemotherapy, sensitivities were significantly higher with 10-(88.2%) and 20-minute (91.6%) sets than dynamic set (48.6%) (P < 0.001). SR was significantly higher for 10-and 20-minute delayed than precontrast and dynamic, with significantly higher SR on 20-than 10-minute delayed. Conclusion:Regardless of size or prior chemotherapy, detection of hepatic metastases was significantly improved by adding hepatobiliary phase images without significant differences between 10-and 20-minute delayed.

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“…Recently, gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MR imaging has been used for the diagnosis of HCC. The detection rate of liver nodules was reported to be higher than that of CT [28,29]. However, the most lesions they assessed were metastatic tumors and the rate of detection for small HCC lesions (\10 mm) was low.…”

Section: Discussionmentioning

confidence: 94%

Outcome of small liver nodules detected by computed tomographic angiography in patients with hepatocellular carcinoma

et al. 2010

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Purpose Hepatic lesions identified by computed tomography (CT) during arterial portography (CTAP) or CT hepatic arteriography (CTHA) in hepatocellular carcinoma (HCC) patients are sometimes too small to be diagnosed as HCC. We undertook this cohort study to assess whether these small lesions are actually HCC, and to clarify the effectiveness of these imaging examinations in a clinical setting. Methods We assessed the characteristics of 74 tiny lesions detected by CTAP and/or CTHA, but not by CT in 67 patients. Results Seven out of 10 nodules were histologically confirmed as HCC and 18 out of 64 lesions increased in size and showed typical findings of HCC during the followup period. Multivariate analysis revealed that the size of the main tumor ([30 mm in diameter) was associated with the presence of tiny additional HCC lesions (P = 0.002). Conclusions These findings indicate that CTAP and CTHA are recommended for determining the stage of HCC, especially when the HCC nodule is larger than 30 mm in diameter.

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Efficacy and Safety of MR Imaging with Liver-specific Contrast Agent: U.S. Multicenter Phase III Study

Abstract: Compared with precontrast MR imaging, postcontrast MR imaging with Gd-EOB-DTPA demonstrated improved sensitivity for lesion detection in the majority of blinded readers, with no substantial adverse events.

Cited by 209 publications

References 29 publications

Dynamic contrast‐enhanced magnetic resonance imaging of abdominal solid organ and major vessel: Comparison of enhancement effect between Gd‐EOB‐DTPA and Gd‐DTPA

Dynamic contrast‐enhanced magnetic resonance imaging of abdominal solid organ and major vessel: Comparison of enhancement effect between Gd‐EOB‐DTPA and Gd‐DTPA

Detection of liver metastases using gadoxetic‐enhanced dynamic and 10‐ and 20‐minute delayed phase MR imaging

Outcome of small liver nodules detected by computed tomographic angiography in patients with hepatocellular carcinoma

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