scholarly journals Patterns of enhancement in the hepatobiliary phase of gadoxetic acid-enhanced MRI

2020 ◽  
Vol 93 (1112) ◽  
pp. 20190989
Author(s):  
Cathryn L Hui ◽  
Marcela Mautone
Keyword(s):  
Liver Parenchyma ◽  
Gadoxetic Acid ◽  
Hepatobiliary Phase ◽  
Liver Lesions ◽  
Enhanced Mri

A variety of patterns of enhancement of liver lesions and liver parenchyma is observed in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI. It is becoming increasingly apparent that many lesions may exhibit HBP enhancement. Much of the literature regarding the role of gadoxetic acid-enhanced MRI in characterising liver lesions is dichotomous, focusing on whether lesions are enhancing or non-enhancing in the HBP, rather than examining the patterns of enhancement. We provide a pattern-based description of HBP enhancement of liver parenchyma and of liver lesions. The role of OATP1B3 transporters, hepatocyte function and lesion composition in influencing patterns of HBP hyperintensity are discussed.

scholarly journals MRI characterization of focal liver lesions in non-cirrhotic patients: assessment of added value of gadoxetic acid-enhanced hepatobiliary phase imaging

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Bardia Moosavi ◽  
Anuradha S. Shenoy-Bhangle ◽  
Leo L. Tsai ◽  
Robert Reuf ◽  
Koenraad J. Mortele
Keyword(s):  
Gadoxetic Acid ◽  
Added Value ◽  
Rank Test ◽  
Focal Liver Lesions ◽  
Hepatobiliary Phase ◽  
Liver Lesions ◽  
Enhanced Mri ◽  
Phase Images ◽  
Cirrhotic Patients

Abstract Background To evaluate the added value of the hepatobiliary (HPB) phase in gadoxetic acid-enhanced magnetic resonance imaging (MRI) in characterizing newly discovered indeterminate focal liver lesions in non-cirrhotic patients. Results One-hundred and twenty-five non-cirrhotic patients (median age, 46 years; range, 20–85 years; 100 females) underwent gadoxetic acid-enhanced MRI, including the 20-min delayed HPB phase, for characterization of newly discovered focal liver lesions. Images were independently evaluated by two blinded, board-certified abdominal radiologists (R1 and R2) who characterized liver lesions without and with assessment of the HPB phase images in two separate readout sessions. Confidence in diagnosis was scored on a scale from 0 to 3. Inter-observer agreement was assessed using Cohen κ statistics. Change in diagnosis and confidence in diagnosis were evaluated by Wilcoxon signed rank test. There was no significant change in diagnosis before and after evaluation of the HPB phase for both readers (p = 1.0 for R1; p = 0.34 for R2). Confidence in diagnosis decreased from average 2.8 ± 0.45 to 2.6 ± 0.59 for R1 and increased from 2.6 ± 0.83 to 2.8 ± 0.46 for R2. Change in confidence was only statistically significant for R1 (p = 0.003) but not significant for R2 (p = 0.49). Inter-reader agreement in diagnosis was good without (k = 0.66) and with (k = 0.75) inclusion of the HPB phase images. Conclusions The added information obtained from the HPB phase of gadoxetic acid-enhanced MRI does not change the diagnosis or increase confidence in diagnosis when evaluating new indeterminate focal liver lesions in non-cirrhotic patients.

scholarly journals Does Hepatic Steatosis Influence the Detection Rate of Metastases in the Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI?

2020 ◽  
Vol 10 (1) ◽  
pp. 98
Author(s):  
Ingo G. Steffen ◽  
Thomas Weissmann ◽  
Jan Holger Rothe ◽  
Dominik Geisel ◽  
Sascha S. Chopra ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Detection Rate ◽  
Liver Parenchyma ◽  
Gadoxetic Acid ◽  
Hepatobiliary Phase ◽  
Relative Signal Intensity ◽  
Enhanced Mri ◽  
Phase Images ◽  
Fat Fraction ◽  
Magnetic Resonance Imaging Mri

The aim of this exploratory study was to evaluate the influence of hepatic steatosis on the detection rate of metastases in gadoxetic acid-enhanced liver magnetic resonance imaging (MRI). A total of 50 patients who underwent gadoxetic acid-enhanced MRI (unenhanced T1w in- and opposed-phase, T2w fat sat, unenhanced 3D-T1w fat sat and 3-phase dynamic contrast-enhanced (uDP), 3D-T1w fat sat hepatobiliary phase (HP)) were retrospectively included. Two blinded observers (O1/O2) independently assessed the images to determine the detection rate in uDP and HP. The hepatic signal fat fraction (HSFF) was determined as the relative signal intensity reduction in liver parenchyma from in- to opposed-phase images. A total of 451 liver metastases were detected (O1/O2, n = 447/411). O1/O2 detected 10.9%/9.3% of lesions exclusively in uDP and 20.2%/15.5% exclusively in HP. Lesions detected exclusively in uDP were significantly associated with a larger HSFF (area under curve (AUC) of receiver operating characteristic (ROC) analysis, 0.93; p < 0.001; cutoff, 41.5%). The exclusively HP-positive lesions were significantly associated with a smaller diameter (ROC-AUC, 0.82; p < 0.001; cutoff, 5 mm) and a smaller HSFF (ROC-AUC, 0.61; p < 0.001; cutoff, 13.3%). Gadoxetic acid imaging has the advantage of detecting small occult metastatic liver lesions in the HP. However, using non-optimized standard fat-saturated 3D-T1w protocols, severe steatosis (HSFF > 30%) is a potential pitfall for the detection of metastases in HP.

Visibility of focal liver lesions: Comparison between kupffer phase of CEUS with sonazoid and hepatobiliary phase of gadoxetic acid-enhanced MRI

2017 ◽  
Vol 45 (9) ◽  
pp. 542-550
Author(s):  
Woo Young Yang ◽  
Hee Sun Park ◽  
Young Jun Kim ◽  
Mi Hye Yu ◽  
Sung Il Jung ◽  
...  
Keyword(s):  
Gadoxetic Acid ◽  
Focal Liver Lesions ◽  
Hepatobiliary Phase ◽  
Liver Lesions ◽  
Enhanced Mri

Feasibility of semiautomated MR volumetry using gadoxetic acid-enhanced MRI at hepatobiliary phase for living liver donors

2013 ◽  
Vol 72 (3) ◽  
pp. 640-645 ◽  
Author(s):  
Jeongjin Lee ◽  
Kyoung Won Kim ◽  
So Yeon Kim ◽  
Bohyoung Kim ◽  
So Jung Lee ◽  
...  
Keyword(s):  
Gadoxetic Acid ◽  
Hepatobiliary Phase ◽  
Enhanced Mri ◽  
Living Liver Donors ◽  
Mr Volumetry ◽  
Liver Donors

scholarly journals Characterization of small (≤3 cm) hepatic lesions with atypical enhancement feature and hypointensity in hepatobiliary phase of gadoxetic acid-enhanced MRI in cirrhosis

Medicine ◽  
2017 ◽  
Vol 96 (29) ◽  
pp. e7278 ◽  
Author(s):  
Seung Kak Shin ◽  
Yun Soo Kim ◽  
Seung Joon Choi ◽  
Young Sup Shim ◽  
Dong Hae Jung ◽  
...  
Keyword(s):  
Gadoxetic Acid ◽  
Hepatobiliary Phase ◽  
Enhanced Mri ◽  
Hepatic Lesions

scholarly journals Quantification of liver function using gadoxetic acid-enhanced MRI

2020 ◽  
Vol 45 (11) ◽  
pp. 3532-3544
Author(s):  
Sarah Poetter-Lang ◽  
Nina Bastati ◽  
Alina Messner ◽  
Antonia Kristic ◽  
Alexander Herold ◽  
...  
Keyword(s):  
Liver Function ◽  
Liver Diseases ◽  
Organic Anion ◽  
Liver Perfusion ◽  
Dynamic Imaging ◽  
Gadoxetic Acid ◽  
Functional Evaluation ◽  
Nonalcoholic Fatty Liver ◽  
Enhanced Mri

Abstract The introduction of hepatobiliary contrast agents, most notably gadoxetic acid (GA), has expanded the role of MRI, allowing not only a morphologic but also a functional evaluation of the hepatobiliary system. The mechanism of uptake and excretion of gadoxetic acid via transporters, such as organic anion transporting polypeptides (OATP1,3), multidrug resistance-associated protein 2 (MRP2) and MRP3, has been elucidated in the literature. Furthermore, GA uptake can be estimated on either static images or on dynamic imaging, for example, the hepatic extraction fraction (HEF) and liver perfusion. GA-enhanced MRI has achieved an important role in evaluating morphology and function in chronic liver diseases (CLD), allowing to distinguish between the two subgroups of nonalcoholic fatty liver diseases (NAFLD), simple steatosis and nonalcoholic steatohepatitis (NASH), and help to stage fibrosis and cirrhosis, predict liver transplant graft survival, and preoperatively evaluate the risk of liver failure if major resection is planned. Finally, because of its noninvasive nature, GA-enhanced MRI can be used for long-term follow-up and post-treatment monitoring. This review article aims to describe the current role of GA-enhanced MRI in quantifying liver function in a variety of hepatobiliary disorders.

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