Gadobenate dimeglumine (BOPTA) enhanced MR imaging: Patterns of enhancement in normal liver and cirrhosis

Abstract

To determine whether gadobenate dimeglumine (BOPTA) will adequately enhance cirrhotic liver parenchyma, and to document the enhancement patterns in cirrhosis, 14 cirrhotic and 20 non-cirrhotic patients were evaluated before and 60-120 minutes after gadolinium-BOPTA. Proof of liver cirrhosis was biopsy (6), surgical resection (3), and clinical follow-up (5). Enhancement effects were compared quantitatively by determining the liver signal-to-noise ratio (SNR) and signal enhancement in both populations. Qualitatively assessment of the liver enhancement was performed and classified as homogeneous or heterogeneous. Quantitative analysis: cirrhotic liver parenchyma presented a higher increase in SNR values, relative to non-cirrhotic liver parenchyma, on postcontrast images. Likewise the signal enhancement of cirrhotic liver parenchyma was superior to non-cirrhotic liver on T1-weighted SE images (P = .02) and in-phase GRE images (P < .001). There was no statistical difference on out-of-phase GRE images. Qualitative analysis: on T1-weighted SE postcontrast images, cirrhotic liver parenchyma showed a homogeneous enhancement in 7 patients and heterogeneous in 7. Whereas on GRE images, cirrhotic parenchyma showed heterogeneous enhancement in 9 patients and homogeneous in 5 patients. The heterogeneous enhancement was due to the presence of hypointense nodules in 7 patients and hyperintense nodules in 2 patients. In conclusion, our study has shown that the hepatobiliary contrast agent Gd-BOPTA is effective in the cirrhotic liver, demonstrating an increased liver enhancement compared with non-cirrhotic patients.

Magnetic Resonance Imaging With Hepatospecific Contrast Agents in Cirrhotic Rat Livers

“…One hour after the injection of Gd-BOPTA (0.1 mmol/kg), the parenchymal SI is either altered (the decreased SI parallels the alteration of hepatic tests and the extent of fatty metaplasia 20 ) or higher than the SI obtained in normal patients. 21 In this last study, the increased enhancement in cirrhotic livers have been attributed to a preserved transport in regenerating nodules and a high extracellular distribution. An increased extracellular distribution was confirmed in our experimental model because the maximal SI of Gd-DTPA is significantly increased in BDL-60 rats.…”

Function of Both Sinusoidal and Canalicular Transporters Controls the Concentration of Organic Anions within Hepatocytes

“…After BOPTA injection, early dynamic images obtained during arterial, portal, and interstitial phases are useful to characterize focal lesions. Acquisition of delayed images also increases the potential for lesion detection (Manfredi et al, 1998;Grazioli et al, 2001). With these late images, BOPTA associates nonspecific extracellular distribution with intrahepatocyte accumulation, as well as possible retention in bile canaliculus, the role of BOPTA concentrations within hepatocytes being the greatest contributor to signal intensities at this phase.…”

Gd-BOPTA Transport Into Rat Hepatocytes: Pharmacokinetic Analysis of Dynamic Magnetic Resonance Images Using a Hollow-Fiber Bioreactor

“…2 Primary parameters of the model were rate constants k 10 , k 12 , k 21 , and a single proportionality constant g 1 ϭ g 2 (all analyses were compatible with a single proportionality constant). Secondary parameters were rate constants ␣ and ␤, with corresponding half-lives t 1/2 (␣) and t 1/2 (␤).…”

“…On the one hand, it is used as an extracellular agent for MRI similarly to Gd-DTPA, and on the other hand, it can be used in the liver to facilitate MRI detection and characterization of focal and diffuse hepatic diseases. [1][2][3][4] Gd-BOPTA is taken up into hepatocytes and excreted without biotransformation. 5,6 In rats, 50% of the dose injected is excreted into the bile, the remaining being excreted into urine.…”