Gadoxetic acid disodium-enhanced MR imaging of cholangiolocellular carcinoma of the liver: imaging characteristics and histopathological correlations

Abstract

• Gadoxetic acid-enhanced MR features of cholangiolocellular carcinoma (CoCC) resembled those of intrahepatic cholangiocarcinoma (ICC). • Gadoxetic acid-enhanced MR features of CoCC largely differed from those of hepatocellular carcinoma. • Dot-/band-like internal enhancement of CoCC may be helpful for differentiating from ICC. • Arterial ring enhancement of CoCC was larger than that of ICC.

Optimal Combination of Features on Gadoxetate Disodium-enhanced MR Imaging for Non-invasive Differential Diagnosis of Hepatocellular Carcinoma: The JAMP-HCC Study

“…our study included many mimickers of HCC, such as intrahepatic cholangiocarcinoma, cholangiolocellular carcinoma, neuroendocrine tumor, and hypervascular pseudolesion, which can be misdiagnosed as HCC because of non-rim APHE [29][30][31][32] and hypointensity on HBP. 33 According to the Liver Cancer Study Group of Japan registry data in 2006-2007, the ratio of intrahepatic cholangiocarcinoma vs. HCC was 208:15250 (≈1:73) in patients with chronic liver disease.…”

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

“…The presence of a lesser degree of central hypointensity is thought to be due to extracellular/extravascular contrast retention in the fibrotic stroma rather than active uptake by cellular transporters . Single‐center, retrospective studies report that a targetoid appearance in the TP or HBP can be seen in 42–79% of iCCAs . Additionally, a targetoid appearance on the TP/HBP is an independent predictor of iCCA, and is more common in non‐HCC malignancies than in hypovascular HCCs (86% vs. 17%, respectively) …”

“…118 Singlecenter, retrospective studies report that a targetoid appearance in the TP or HBP can be seen in 42-79% of iCCAs. [118][119][120][121] Additionally, a targetoid appearance on the TP/HBP is an independent predictor of iCCA, and is more common in non-HCC malignancies than in hypovascular HCCs (86% vs. 17%, respectively). 122 ANCILLARY FEATURES FAVORING MALIGNANCY IN GENERAL.…”

Smart MRI Agents for Detecting Extracellular Events In Vivo: Progress and Challenges

“…Gadoxetic acid is a linear, gadolinium-based contrast agent with a lipophilic ethoxybenzyl (EOB) moiety ( Figure 3) [33,34]. The EOB moiety gives the molecule an amphipathic characteristic and interacts with the organic anion transporter polypeptide 1 on the hepatocytes to facilitate uptake into cells [33][34][35]. Following uptake, gadoxetic acid is secreted into the bile via the multidrug-resistant transporter; since there is a significant dwell time within bile, this allows contrast imaging of the liver.…”

“…Imaging with gadoxetic acid requires an additional scan; typically, the agent is given as a bolus with arterial phase imaging, followed by portal venous phase imaging; after approximately 20 min, enough uptake into hepatocytes has occurred to allow additional biliary phase imaging. Gadoxetic acid has been shown to increase diagnostic certainty of liver lesions, particularly in cirrhotic cases when fibrous tissue within the liver can make conventional imaging challenging to interpret [35,36]. Gadobenate meglumine (MultiHance) is generally considered an ECF agent; however, it does display a 3-5% uptake in hepatocytes, allowing for hepatobiliary imaging as off-label use [33,34].…”