Imaging characteristics of hepatocellular carcinoma using the hepatobiliary contrast agent GD-EOB-DTPA

Abstract

dder U. Imaging characteristics of hepatocellular carcinoma using the hepatobiliary contrast agent Gd-EOB-DTPA. Acta Radiol 2006;47:15-23.Purpose: To evaluate the ability of contrast-enhanced magnetic resonance imaging (MRI) with Gd-EOB-DTPA in comparison with non-enhanced imaging and spiral computed tomography (CT) to provide additional information for classification and characterization of hepatocellular carcinoma. Material and Methods: Forty patients with histopathology-proven hepatocellular carcinoma were selected for this subgroup analysis from a phase-III multicenter study in 235 patients with known or suspected liver lesions. The primary analysis was comparison of the proportion of hepatocellular carcinoma correctly classified and characterized by combined pre-/post-contrast MRI compared with pre-contrast MRI alone or with spiral CT. All images were evaluated on site, and in a blinded reading by three independent readers off site. Results: In the on-site evaluation, the lesions were correctly classified as a malignant tumor with combined MRI in 90.3%, with pre-contrast imaging alone in 82.9% and with spiral CT in 87.8% (n.s.). The proportion of correct characterization (lesion type diagnosis) with combined MRI was 85.4%, 75.6% for pre-contrast imaging, and 77.5% for spiral CT (n.s.), respectively. In the blinded reading, one reader showed a significant increase in the proportion of correctly characterized lesions by 27% (Pv0.05). The other two readers showed a reduction in the proportion of correct characterization by 12% and 15%, respectively (n.s.). Conclusion: With regard to lesion classification, no difference was found between combined pre-/post-contrast MRI and spiral CT. A non-significant trend in favor of Gd-EOB-DTPA-enhanced MRI with regard to characterization of hepatocellular carcinoma was found, although the CT scans were not optimized as the MRI scans.

Gadoxetic acid‐enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria

“…However, it is unknown whether this limitation has a clinical impact on the selection of recipients and their prognosis. According to previous reports, 9% to 27% of HCC can be isointense or hyperintense on gadoxetic acid-enhanced hepatobiliary phase images (18,(33)(34)(35). The reason why no early HCC showed hyperintensity on gadoxetic acid-enhanced hepatobiliary phase images in the present study is unknown.…”

Outcome of hypovascular hepatic nodules revealing no gadoxetic acid uptake in patients with chronic liver disease

“…Gadoxetic acid can effectively be used in dynamic and liver-specific static MRI with accurate delineation, classification, and characterization of liver tumors, in which excellent sensitivity and characterization for hepatocellular lesions are provided (10,12,14,(16)(17)(18)(19). The diagnosis of early HCC is one of the potential indication (20,21).…”

Diffusion- and T2-weighted MR Imaging of the Liver: Effect of Intravenous Administration of Gadoxetic Acid Disodium

“…[1][2][3][4][5] Uptake by hepatocytes of approximately half the injected dose of gadoxetic acid improves detection of liver malignancies on hepatocyte-phase imaging. [6][7][8] When gadoxetic acid is used, hepatocyte-phase imaging can be acquired 10 to 20 min after injection of the contrast material.…”