MR with Gd-EOB-DTPA in assessment of liver nodules in cirrhotic patients

Inchingolo, Riccardo; Faletti, Riccardo; Grazioli, Luigi; Tricarico, Eleonora; Gatti, Marco; Pecorelli, Anna; Ippolito, Davide

doi:10.4254/wjh.v10.i7.462

Cited by 24 publications

(17 citation statements)

References 69 publications

(107 reference statements)

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“…The remaining contrast agent, similar to Gd-DTPA, can be excreted through the kidney. This dual clearance pathway can compensate for each other when liver or kidney function is damaged, thereby ensuring higher safety [21]. In the hepatobiliary specific period images, normal liver cells continue to ingest when Gd-EOB-DTPA passes through the liver, which shortens the T1 relaxation time of normal liver tissues, and shows the hyperintensity signal on T1WI.…”

Section: Main Textmentioning

confidence: 99%

Application of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma

et al. 2020

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Background: Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver, and its morbidity and mortality have been increasing in recent years. The early diagnosis and prompt treatment of small HCC are crucial to improve the prognosis and quality of life of patients. In China, hepatitis B virus infection is the main cause. HCC with a single tumor nodule of ≤ 3 cm in diameter, or HCC with a number of nodules, in which each nodule is ≤ 2 cm in diameter, with a total diameter of ≤ 3 cm, is considered as small HCC. The MRI liver-specific contrast agent can detect small HCC at the early stage. This has important clinical implications for improving the survival rate of patients. Main body: Gd-EOB-DTPA-enhanced MRI can significantly improve the sensitivity and specificity of the detection of HBV-related small hepatocellular carcinoma, providing an important basis for the clinical selection of appropriate personalized treatment. Gd-EOB-DTPA-enhanced MRI can reflect the degree of HCC differentiation, and the evaluation of HCC on Gd-EOB-DTPA-enhanced MRI would be helpful for the selection of the treatment and prognosis of HCC patients. The present study reviews the progress of the application of Gd-EOB-DTPA in the early diagnosis of small HCC, its clinical treatment, the prediction of the degree of differentiation, and the assessment of recurrence and prognosis of HCC, including the pharmacoeconomics and application limitations of Gd-EOB-DTPA. The value of the application of HCC with the Gd-EOB-DTPA was summarized to provide information for improving the quality of life and prolonging the survival of patients. Conclusion: Gd-EOB-DTPA-enhanced MRI has the diagnostic capability for small HCC with a diameter of ≤ 2 cm. This will have a broader application prospect in the early diagnosis of small liver cancer with a diameter of ≤ 1 cm in the future. The relationship between GD-EOB-DTPA-MRI and the degree of HCC differentiation has a large research space, and Gd-EOB-DTPA is expected to become a potential tool for the preoperative prediction and postoperative evaluation of HCC, which would be beneficial for more appropriate treatments for HCC patients.

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Section: Main Textmentioning

confidence: 99%

Application of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma

et al. 2020

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“…Dynamic sequences should be obtained by using a bolus triggering technique. Optimal multiphasic dynamic contrast-enhanced imaging, with fewer artifacts, is feasible using multi-arterial phase imaging[ 23 ] and in fact, its role in the evaluation of hepatic lesions particularly HCC has been well studied[ 24 , 25 ].…”

Section: Role Of Gd-eob-dtpamentioning

confidence: 99%

Gadoxetic acid magnetic-enhanced resonance imaging in the diagnosis of cholangiocarcinoma

Inchingolo¹,

Maino²,

Gatti³

et al. 2020

WJG

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The use of liver magnetic resonance imaging is increasing thanks to its multiparametric sequences that allow a better tissue characterization, and the use of hepatobiliary contrast agents. This review aims to evaluate gadoxetic acid enhanced magnetic resonance imaging in the diagnosis and staging of cholangiocarcinoma and its different clinical and radiological classifications proposed in the literature. We also analyze the epidemiology, risk factors in correlation with clinical findings and laboratory data.

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“…Gadoxetic acid-enhanced dynamic magnetic resonance imaging (MRI) has been shown to have promising applications in the assessment of liver function [1][2][3][4][5][6] and diagnosis of various pathologies in the liver. [7][8][9][10][11][12] Gadoxetic acid provides utility as a hepatobiliary contrast, allowing interrogation of the uptake of contrast into the hepatocytes as well as liver perfusion parameters. Various pharmacokinetic parameters have been used as a measure of regional liver function 1,[13][14][15] with gadoxetic acid uptake rate being among the most direct due to its correspondence with the number of functioning hepatocytes, making it a reasonable quantitative measure of regional liver function.…”

Section: Introductionmentioning

confidence: 99%

“…Gadoxetic acid–enhanced dynamic magnetic resonance imaging (MRI) has been shown to have promising applications in the assessment of liver function and diagnosis of various pathologies in the liver . Gadoxetic acid provides utility as a hepatobiliary contrast, allowing interrogation of the uptake of contrast into the hepatocytes as well as liver perfusion parameters.…”

Section: Introductionmentioning

confidence: 99%

GAN and dual‐input two‐compartment model‐based training of a neural network for robust quantification of contrast uptake rate in gadoxetic acid‐enhanced MRI

Simeth

Cao

2020

Medical Physics

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Purpose: Gadoxetic acid uptake rate (k 1 ) obtained from dynamic, contrast-enhanced (DCE) magnetic resonance imaging (MRI) is a promising measure of regional liver function. Clinical exams are typically poorly temporally characterized, as seen in a low temporal resolution (LTR) compared to high temporal resolution (HTR) experimental acquisitions. Meanwhile, clinical demands incentivize shortening these exams. This study develops a neural network-based approach to quantitation of k 1 , for increased robustness over current models such as the linearized single-input, two-compartment (LSITC) model. Methods: Thirty Liver HTR DCE MRI exams were acquired in 22 patients with at least 16 min of postcontrast data sampled at least every 13 s. A simple neural network (NN) with four hidden layers was trained on voxel-wise LTR data to predict k 1 . Low temporal resolution data were created by subsampling HTR data to contain six time points, replicating the characteristics of clinical LTR data. Both the total length and the placement of points in the training data were varied considerably to encourage robustness to variation. A generative adversarial network (GAN) was used to generate arterial and portal venous inputs for use in data augmentation based on the dual-input, two-compartment, pharmacokinetic model of gadoxetic acid in the liver. The performance of the NN was compared to direct application of LSITC on both LTR and HTR data. The error was assessed when subsampling lengths from 16 to 4 min, enabling assessment of robustness to acquisition length. Results: For acquisition lengths of 16 min NRMSE (Normalized Root-Mean-Squared Error) in k 1 was 0.60, 1.77, and 1.21, for LSITC applied to HTR data, LSITC applied to LTR data, and GAN-augmented NN applied to LTR data, respectively. As the acquisition length was shortened, errors greatly increased for LSITC approaches by several folds. For acquisitions shorter than 12 min the GAN-augmented NN approach outperformed the LSITC approach to a statistically significant extent, even with HTR data. Conclusions: The study indicates that data length is significant for LSITC analysis as applied to DCE data for standard temporal sampling, and that machine learning methods, such as the implemented NN, have potential for much greater resilience to shortened acquisition time than directly fitting to the LSITC model.

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MR with Gd-EOB-DTPA in assessment of liver nodules in cirrhotic patients

Cited by 24 publications

References 69 publications

Application of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma

Application of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma

Gadoxetic acid magnetic-enhanced resonance imaging in the diagnosis of cholangiocarcinoma

GAN and dual‐input two‐compartment model‐based training of a neural network for robust quantification of contrast uptake rate in gadoxetic acid‐enhanced MRI

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