Vascular Enhancement in Early Dynamic Liver MR Imaging in an Animal Model: Comparison of Two Injection Regimen and Two Different Doses Gd-EOB-DTPA (Gadoxetic Acid) With Standard Gd-DTPA

Zech, Christoph J.; Vos, Bernhard; Nordell, Anders; Urich, Matthias; Blomqvist, Lennart; Breuer, Josy; Reiser, Maximilian; Weinmann, Hanns‐Joachim

doi:10.1097/rli.0b013e3181a24512

Cited by 111 publications

(75 citation statements)

References 25 publications

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“…Other institutions administer it with a slower injection rate of 1 ml/s to spread the contrast bolus, thereby reducing the risk of a poorly timed arterial phase [6,10,11,13,25]. Dilution of gadoxetate disodium with saline is an alternative approach to spread the contrast bolus [9].…”

Section: Influence Of Contrast Injection Ratementioning

confidence: 99%

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Well

Weinrich

Adam

et al. 2017

Fortschr Röntgenstr

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Background Gadoxetate disodium is an intracellular contrast agent for magnetic resonance imaging (MRI) of the liver. Recent publications revealed that injection of gadoxetate disodium can lead to imaging artifacts due to transient severe motion (TSM) in the arterial phase of contrast-enhanced liver MRI. In this review we present and discuss published frequencies of TSM, contrast injection and image acquisition protocols, potential risk factors, and proposed strategies to avoid or minimize the effects of TSM. Method Two reviewers independently searched the PubMed search engine for “transient severe motion artifact” and related terms. Reference lists of retrieved articles were also searched. The two reviewers selected in consensus nine studies that reported both frequencies of TSM and potential risk factors. Study data were extracted by both reviewers, and disagreement was resolved by consensus. Results and Conclusion TSM is caused by impaired breath-hold ability after gadoxetate disodium injection and occurs in 5 – 22 % of patients. The dose of applied contrast agent, repeated exposure to gadoxetate disodium, high BMI and pulmonary disease have been described as potential risk factors for TSM. However, there are only few concordant results on this topic and the pathophysiology of TSM has not been identified. Proposed strategies for the prevention of TSM are slow injection rates and low doses of diluted gadoxetate disodium. Accelerated and free-breathing MRI sequence protocols and breath-hold training may minimize the effects of TSM. Further prospective studies are needed to confirm these strategies and to identify the underlying mechanism of TSM. Key Points Citation Format

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Section: Influence Of Contrast Injection Ratementioning

confidence: 99%

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Well

Weinrich

Adam

et al. 2017

Fortschr Röntgenstr

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“…10 A recent study revealed that use of a slow injection rate (one mL/s) can facilitate equivalent arterial enhancements between gadoxetic acid and extracellular GBCAs. 11 Currently, no published data compare enhancement of liver lesions on arterial phase images enhanced by gadoxetic acid and extracellular GBCAs. In our experience, however, the 2 agents provide visually equivalent enhancements.…”

Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 99%

Rules, Roles, and Room for Discussion in Gadoxetic Acid-enhanced Magnetic Resonance Liver Imaging: Current Knowledge and Future Challenges

Ichikawa

Araki

2013

magn reson med sci

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Since its launch onto the world medical market, gadoxetic acid has received a great deal of attention from a diverse group of researchers, including gastroenterologists, hepatologists, and abdominal radiologists. Gadoxetic acid in liver magnetic resonance (MR) imaging might be considered to have excellent utility. However, several issues remain that radiologists should keep in mind when utilizing this product. We compiled this review to introduce gadoxetic acid, describe how it should be used, highlight the situations in which it is most and least reliable, and suggest potential avenues for future research.

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“…Recently, a new MRI contrast medium-gadoxetic acid or Gd-EOB-DTPA (Primovist, Bayer Schering Pharma, Berlin, Germany)-with the properties of both extracellular gadolinium chelate and a liver-specific (hepatocyte-targeting) contrast agent has become available. A bolus injection of gadoxetic acid enables the assessment of tumor vascularity on arterial-phase images as well as a functional hepatic (i.e., hepatocyte-phase) images (8,9). The hepatocyte-phase assessments can be performed approximately 20 min after administration of the contrast agent, when approximately 50% of the agent has been taken up by the hepatocytes (10)(11)(12).…”

mentioning

confidence: 99%

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

Motosugi

Ichikawa

Sano

et al. 2011

Magnetic Resonance Imaging

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Purpose: To elucidate the natural history of hypovascular nodules that appear hypointense on hepatocyte-phase gadoxetic acid-enhanced MR images by focusing on hypervascularization over time. Materials and Methods:In this study, 135 hypovascular nodules revealing no gadoxetic acid uptake in 53 patients were examined. All nodules were retrospectively examined using serial follow-up computed tomography (CT) and MRI examinations until hypervascularity was observed on arterial-phase dynamic CT or gadoxetic acid-enhanced MR images, or on CT during hepatic arteriography. Logistic regression analysis was used to investigate the association between hypervascularization and MR findings including a presence of fat assessed by a signal drop on opposed-phase T1-weighted images.Results: Of the 135 nodules, 16 underwent hypervascularization. The size of the nodules and the presence of fat in the nodules were independent indicators of hypervascularization. The 1-year cumulative risk of hypervascularization was 15.6%. This risk was significantly increased in the case of nodules >10 mm (37.6%, P < 0.01) and fatcontaining nodules (26.5%, P < 0.01).Conclusion: Hypovascular nodules that appear hypointense on hepatocyte-phase gadoxetic acid-enhanced MR images may progress to conventional hypervascular hepatocellular carcinoma. Nodules more than 10 mm in diameter and containing fat are at high risk for developing hypervascularization.

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Vascular Enhancement in Early Dynamic Liver MR Imaging in an Animal Model: Comparison of Two Injection Regimen and Two Different Doses Gd-EOB-DTPA (Gadoxetic Acid) With Standard Gd-DTPA

Cited by 111 publications

References 25 publications

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Rules, Roles, and Room for Discussion in Gadoxetic Acid-enhanced Magnetic Resonance Liver Imaging: Current Knowledge and Future Challenges

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

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