Hepatobiliary-specific MR Contrast Agents: Role in Imaging the Liver and Biliary Tree

Abstract

Hepatobiliary-specific contrast agents are one of several classes of contrast agents available for magnetic resonance (MR) imaging of the liver. These agents are taken up by functioning hepatocytes and excreted in the bile, and their paramagnetic properties cause shortening of the longitudinal relaxation time (T1) of the liver and biliary tree. The three contrast agents that have been developed are mangafodipir trisodium (Mn-DPDP), gadobenate dimeglumine (Gd-BOPTA), and gadoxetic acid (Gd-EOB-DTPA). These three MR contrast agents vary in mode of administration and dose, mechanism of cellular uptake, degree of excretion through the biliary pathway, and imaging characteristics. In the liver, hepatobiliary-specific agents can be used to improve lesion detection, to characterize lesions as hepatocellular or nonhepatocellular, and to specifically characterize some hepatocellular lesions, notably focal nodular hyperplasia. Biliary excretion of these agents can be used to evaluate the anatomic structure and function of the biliary tree. In the future, hepatobiliary-specific contrast agents may have wider applications, such as grading of cirrhosis and quantification of liver function.

Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors

“…In addition to providing the dynamic enhancement data, Gd-EOB-DTPA has an added value of hepatobiliary phase, which has been shown to be an important adjunct to the detection and characterization of hepatic masses in both patients with normal and cirrhotic livers (1)(2)(3)(4). In patients with hepatic cirrhosis as well as in those without it, lesion detection and characterization heavily rely on comparison of the lesion's signal intensity to that of the background hepatic parenchyma (3,4).…”

Diagnosing the duct of Luschka injury at magnetic resonance imaging with hepatospecific contrast agents after laparoscopic cholecystectomy

“…Ayrica radyasyona maruz kalinir, pankreatit, kanama ve kolanjit gibi komplikasyonlar görülebilir [14]. Hepatospesifik kontrast madde kullanarak yapilan MRG ise ameliyat sonrasi aktif safra kaçaği tam anatomik lokalizasyonu belirlenerek noninvaziv olarak gösterilebilir [6].…”

“…Bu tekniklerle safra kaçağini düşündürebilecek ancak spesifik olmayan sivi koleksiyonu gibi bulgular saptanabilir [1]. Hepatospesifik kontrast maddelerle yapilan MRG' de ise direk kontrast madde ekstravazasyon alaninin gösterilmesiyle aktif safra kaçaği noninvaziv bir şekilde saptanabilir [6]. Biz bu çalişmamizda LK sonrasi Gd-EOB-BOPTA ile noninvaziv olarak Lushka kanalindan safra kaçaği saptanan olguyu sunmaktayiz.…”

MRI of hepatocellular carcinoma: an update of current practices

“…However, the routine use of this agent for HCC screening remains controversial, with contradicting results published in the literature. Approximately 10%-15% of HCC may retain contrast on delayed hepatobiliary phase images, thereby appearing isointense or hyperintense to background hepatic parenchyma, enhancement features that are similar to benign regenerative or dysplastic nodules (7,23). In addition, liver uptake will be impaired in patients with active or more advanced CLD yielding potentially variable hepatic phase enhancement (23).…”

“…Approximately 10%-15% of HCC may retain contrast on delayed hepatobiliary phase images, thereby appearing isointense or hyperintense to background hepatic parenchyma, enhancement features that are similar to benign regenerative or dysplastic nodules (7,23). In addition, liver uptake will be impaired in patients with active or more advanced CLD yielding potentially variable hepatic phase enhancement (23). The cost of Gd-EOB-DTPA can be significantly higher than other GBCAs, which is an important consideration with regards to cost-effectiveness considerations.…”