Hepatic gadoxetic acid uptake as a measure of diffuse liver disease: Where are we?

Ba‐Ssalamah, Ahmed; Bastati, Nina; Wibmer, Andreas G.; Fragner, Romana; Hodge, Jacqueline C.; Trauner, Michael; Herold, Christian; Bashir, Mustafa R.; Beers, Bernard E. Van

doi:10.1002/jmri.25518

Cited by 57 publications

(57 citation statements)

References 112 publications

(147 reference statements)

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“…17 Several studies have examined whether the uptake of a liver-specific contrast agent in the liver parenchyma is correlated with liver function and the degree of liver fibrosis, yet only a few have used histopathology data as the reference standard. Gadoxetic acid is a widely used liver-specific MRI contrast agent with combined extracellular and hepatocyteselective properties.…”

Section: Discussionmentioning

confidence: 99%

Detection of liver fibrosis using qualitative and quantitative MR elastography compared to liver surface nodularity measurement, gadoxetic acid uptake, and serum markers

Besa

Wagner

et al. 2017

Magnetic Resonance Imaging

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Section: Discussionmentioning

confidence: 99%

Detection of liver fibrosis using qualitative and quantitative MR elastography compared to liver surface nodularity measurement, gadoxetic acid uptake, and serum markers

Besa

Wagner

et al. 2017

Magnetic Resonance Imaging

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“…Suboptimal HBP is common in patients with impaired hepatobiliary function. A suboptimal HBP is characterized by liver parenchyma that is iso‐ or hypointense to the hepatic blood vessels, and by lack of excretion of contrast into the biliary tree and persistent contrast within the spleen . Excretion of gadoxetate disodium may be decreased due to a combination of diminished functional liver, cholestasis, or downregulation of or competition for transporters .…”

Section: Pitfalls Of Gadoxetate Disodium Usementioning

confidence: 99%

“…A suboptimal HBP is characterized by liver parenchyma that is iso-or hypointense to the hepatic blood vessels, and by lack of excretion of contrast into the biliary tree and persistent contrast within the spleen. [60][61][62] Excretion of gadoxetate disodium may be decreased due to a combination of diminished functional liver, cholestasis, or downregulation of or competition for transporters. 63,64 The sensitivity for liver lesion detection and subsequent characterization can be reduced when the HBP is suboptimal 65 (Fig.…”

Section: Suboptimal Hbp Imaging: Causes and Effectmentioning

confidence: 99%

Pitfalls in liver MRI: Technical approach to avoiding misdiagnosis and improving image quality

Yacoub

Elsayes

Fowler

et al. 2018

Magnetic Resonance Imaging

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The following is an illustrative review of common pitfalls in liver MRI that may challenge interpretation. This article reviews common technical and diagnostic challenges encountered when interpreting dynamic multiphasic T1‐weighted imaging, hepatobiliary phase imaging, and diffusion‐weighted imaging of the liver. Additionally, each section includes suggestions for avoiding diagnostic and technical errors. Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:41–58.

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“…3 Several MRI methods have been used to assess liver fibrosis and inflammation severity, including magnetic resonance (MR) elastography, 21 diffusion-weighted MRI, 22 MR perfusion imaging 23 and gadoxetic acid-enhanced MRI. 24 Recently, it has been shown that susceptibility-weighted MRI, by combining phase and magnitude information, is also a promising method for the staging of liver fibrosis. 25,26 Susceptibility-weighted MRI, however, remains semi-quantitative.…”

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confidence: 99%

Simultaneous MR quantification of hepatic fat content, fatty acid composition, transverse relaxation time and magnetic susceptibility for the diagnosis of non‐alcoholic steatohepatitis

et al. 2017

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Non-alcoholic steatohepatitis (NASH) is characterized at histology by steatosis, hepatocyte ballooning and inflammatory infiltrates, with or without fibrosis. Although diamagnetic material in fibrosis and inflammation can be detected with quantitative susceptibility imaging, fatty acid composition changes in NASH relative to simple steatosis have also been reported. Therefore, our aim was to develop a single magnetic resonance (MR) acquisition and post-processing scheme for the diagnosis of steatohepatitis by the simultaneous quantification of hepatic fat content, fatty acid composition, T * transverse relaxation time and magnetic susceptibility in patients with non-alcoholic fatty liver disease. MR acquisition was performed at 3.0 T using a three-dimensional, multi-echo, spoiled gradient echo sequence. Phase images were unwrapped to compute the B field inhomogeneity (ΔB ) map. The ΔB -demodulated real part images were used for fat-water separation, T * and fatty acid composition quantification. The external and internal fields were separated with the projection onto dipole field method. Susceptibility maps were obtained after dipole inversion from the internal field map with single-orientation Bayesian regularization including spatial priors. Method validation was performed in 32 patients with biopsy-proven, non-alcoholic fatty liver disease from which 12 had simple steatosis and 20 NASH. Liver fat fraction and T * did not change significantly between patients with simple steatosis and NASH. In contrast, the saturated fatty acid fraction increased in patients with NASH relative to patients with simple steatosis (48 ± 2% versus 44 ± 4%; p < 0.05) and the magnetic susceptibility decreased (-0.30 ± 0.27 ppm versus 0.10 ± 0.14 ppm; p < 0.001). The area under the receiver operating characteristic curve for magnetic susceptibility as NASH marker was 0.91 (95% CI: 0.79-1.0). Simultaneous MR quantification of fat content, fatty acid composition, T * and magnetic susceptibility is feasible in the liver. Our preliminary results suggest that quantitative susceptibility imaging has a high diagnostic performance for the diagnosis of NASH.

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Hepatic gadoxetic acid uptake as a measure of diffuse liver disease: Where are we?

Abstract: 3 J. Magn. Reson. Imaging 2017;45:646-659.

Cited by 57 publications

References 112 publications

Detection of liver fibrosis using qualitative and quantitative MR elastography compared to liver surface nodularity measurement, gadoxetic acid uptake, and serum markers

Detection of liver fibrosis using qualitative and quantitative MR elastography compared to liver surface nodularity measurement, gadoxetic acid uptake, and serum markers

Pitfalls in liver MRI: Technical approach to avoiding misdiagnosis and improving image quality

Simultaneous MR quantification of hepatic fat content, fatty acid composition, transverse relaxation time and magnetic susceptibility for the diagnosis of non‐alcoholic steatohepatitis

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