Gd-EOB-DTPA enhanced MRI for hepatocellular carcinoma: quantitative evaluation of tumor enhancement in hepatobiliary phase.
ABSTRACT The purpose of this study was to evaluate the utility of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for the quantitative evaluation of hepatocellular carcinoma (HCC) and dysplastic nodules in the hepatobiliary phase.
The subjects comprised 12 patients with 27 lesions (22 HCCs and 5 dysplastic nodules). Chemical-shift-selective fat-suppressed T1-weighted sequences were obtained before and 10, 20, and 40 min after the injection of Gd-EOB-DTPA. Quantitative analyses were performed with the enhancement ratio of the lesion and the contrast-to-noise (C/N) ratio.
The enhancement ratios of the HCCs were 44.0+/-36.5, 44.7+/-46.8, and 47.7+/-52.8 (%) at 10, 20, and 40 min, respectively, after the injection of Gd-EOB-DTPA. The enhancement ratios of the dysplastic nodules were 36.2+/-34.3, 44.3+/-37.3, and 40.1+/-46.8 (%). The C/N ratios of the HCCs were 0.2+/-6.6 for the precontrast image, and -9.2+/-12.6, -9.9+/-14.8, and -12.7+/-15.7 at 10, 20, and 40 min, respectively, after the injection of Gd-EOB-DTPA. The C/N ratios of the dysplastic nodules were 1.4+/-8.0, -13.7+/-11.1, -13.3+/-7.6, and -13.1+/-10.4. No significant differences were found between the HCCs and the dysplastic nodules in the enhancement ratio and the C/N ratio. Only two HCCs showed a positive C/N ratio value, and these HCCs were pathologically confirmed to be a well differentiated and a moderately differentiated carcinoma, respectively.
HCCs and some of the dysplastic nodules showed hypointensity in the hepatobiliary phase in Gd-EOB-DTPA-enhanced MRI. No specific enhancement was observed, regardless of tumor differentiation.
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ABSTRACT: To compare signal intensity (SI) correction using scale and rescale slopes with SI correction using SIs of spleen and muscle for quantifying multiphase hepatic contrast enhancement with Gd-EOB-DTPA by assessing their correlation with T1 values generated from Look-Locker turbo-field-echo (LL-TFE) sequence data (ER-T1). Thirty patients underwent Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in this prospective clinical study. For each patient, breath-hold T1-weighted fat-suppressed three-dimensional (3D) gradient echo sequences (e-THRIVE) were acquired before and 2 (first phase), 10 (second phase), and 20min (third phase) after intravenous Gd-EOB-DTPA. Look-Locker turbo-field-echo (LL-TFE) sequences were acquired before and 1.5 (first phase), 8 (second phase), and 18min (third phase) postcontrast. The liver parenchyma enhancement ratios (ER) of each phase were calculated using the SI from e-THRIVE sequences (ER-SI) and the T1 values generated from LL-TFE sequence data (ER-T1) respectively. ER-SIs were calculated in three ways: (1) comparing with splenic SI (ER-SI-s), (2) comparing with muscle SI (ER-SI-m), (3) using scale and rescale slopes obtained from DICOM headers (ER-SI-c), to eliminate the effects of receiver gain and scaling. For each of the first, second and third phases, correlation and agreement were assessed between each ER-SI and ER-T1. In the first phase, all ER-SIs correlated weakly with ER-T1. In the second and third phases, ER-SI-c showed a stronger linear correlation with ER-T1 (r(2)=0.71-0.72, p<0.01) than did ER-SI-s (r(2)=0.37-0.39, p<0.01) or ER-SI-m (r(2)=0.30-0.41, p<0.01). SI correction using scale and rescale slopes from DICOM data is the most acceptable algorithm for evaluating delayed-phase Gd-EOB-DTPA hepatic enhancement. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.European Journal of Radiology 11/2014; 84(3). DOI:10.1016/j.ejrad.2014.11.014 · 2.16 Impact Factor
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ABSTRACT: The value of cross-sectional liver imaging is evaluated by the accuracy, sensitivity, and specificity of the specific imaging technique. Magnetic resonance imaging (MRI) has become a key technique for the characterization and detection of focal and diffuse liver disease. More recently, gadoxetic acid, the hepatocyte-specific MR contrast agent, was clinically approved and introduced in many countries. Gadoxetic acid may be considered a "molecular imaging" probe because the compound is actively taken into hepatocytes via the ATP-dependent organic anion transport system in the plasma membrane for the hepatic uptake. The transport of gadoxetic acid from the cytoplasm to the bile is mainly determined by the capacity of the transport protein glutathione-S-transferase. Gadoxetic acid enhances hepatocyte-containing lesions and improves detection of lesions devoid of normal hepatocytes, such as metastases. Innovative rapid MR acquisition techniques with near isotropic 3D pulse sequences with fat saturation parallel the technical progress made by multidetector computed tomography combined with an impressive improvement in tumor-liver contrast when used for gadoxetic acid-enhanced MRI. The purpose of this review is to provide an overview of the development, clinical testing, and applications of this novel MR contrast agent.Biologics: Targets & Therapy 08/2010; 4:199-212. DOI:10.2147/BTT.S6479
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ABSTRACT: PurposeThe objective was to investigate the dynamic enhancement patterns in focal solid liver lesions after the administration of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) by means of dynamic magnetic resonance imaging (MRI) including hepatobiliary phase (HP) images 20 min after Gd-EOB-DTPA administration.Materials and MethodsNon-enhanced T1/T2-weighted as well as dynamic magnetic resonance (MR) images during the arterial phase (AP), the portal venous phase (PVP), the late phase (LP), and the HP (20 min) were obtained from 83 patients (54 male, 29 female, mean age 62.01 years) with focal solid liver lesions. MRI was conducted by means of a 1.5-T system for 63 patients with malignant liver lesions (HCCs: n = 34, metastases: n = 29) and for 20 patients with benign liver lesions (FNH lesions: n = 14, hemangiomas: n = 3, adenomas: n = 3). For quantitative analysis, signal-to-noise ratios (SNR), contrast enhancement ratios (CER), lesion-to-liver contrast ratios (LLC), and signal intensity (SI) ratios were measured.ResultsThe SNR of liver parenchyma significantly increased in each dynamic phase after Gd-EOB-DTPA administration compared to the SNR of non-enhanced images (p<0.001). The CER of HCCs and metastases significantly decreased between LP and HP images (p = 0.0011, p<0.0001). However, FNH lesions did not show any significant difference, whereas an increased CER was found in hemangiomas. The mean LLCs of FNH lesions were significantly higher than those of HCCs and metastases. The LLC values of hemangiomas remained negative during the entire time course, whereas the LLC of adenomas indicated hyperintensity from the AP to the LP. Furthermore, adenomas showed hypointensity in HP images.ConclusionGd-EOB-DTPA-enhanced MRI may help diagnose focal solid liver lesions by evaluating their enhancement patterns.PLoS ONE 06/2014; 9(6):e100315. DOI:10.1371/journal.pone.0100315 · 3.53 Impact Factor