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Abdom Radiol (NY). 2016 Aug;41(8):1522-31. doi: 10.1007/s00261-016-0703-1.

Comparison of hepatocellular carcinoma conspicuity on hepatobiliary phase images with gadoxetate disodium vs. delayed phase images with extracellular cellular contrast agent.

Author information

1
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap 2-dong, Songpa-ku, Seoul, 138-736, Korea.
2
Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University College of Medicine, No. 5, Fuxing St, Guishan Township, Taoyuan, Taoyuan County, 333, Taiwan.
3
Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143-0628, USA.
4
Beijing Friendship Hospital, Capital Medical University, No 95, Yong'an Road, Xicheng District, Beijing, 100050, China.
5
Tri-Service General Hospital and National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, Neihu, Taipei, Taiwan.
6
Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143-0628, USA. ben.yeh@ucsf.edu.

Abstract

OBJECTIVE:

To compare the conspicuity of hepatocellular carcinoma (HCC) on hepatobiliary phase of gadoxetate disodium-enhanced vs. delayed phase of gadodiamide-enhanced MR images, relative to liver function.

METHODS AND MATERIALS:

We retrospectively identified 86 patients with newly diagnosed HCC between 2010 and 2013 and recorded the severity of liver disease by Child-Pugh class (CPC). 38 patients had gadodiamide-enhanced 5-min delayed and 48 had gadoxetate disodium-enhanced 20-min delayed hepatobiliary MR images. The conspicuity of 86 HCCs (mean size, 2.7 cm) was graded visually on a 3-point scale and quantified by liver-to-tumor contrast ratios (LTC). The relative liver parenchymal enhancement (RPE) was measured. For different CPCs, we compared the conspicuity of HCC and RPE between gadodiamide and gadoxetate.

RESULTS:

In patients with CPC A, the visual conspicuity and LTC of the 27 HCCs imaged with gadodiamide were significantly lower than those of the 38 HCCs with gadoxetate (P < 0.01, <0.01, respectively). RPE was lower in gadodiamide scans than gadoxetate scans (P < 0.01). Conversely, in patients with CPC B and C, HCCs appeared more frequently as definite hypointensity when imaged with gadodiamide (72.7%, 8/11) than gadoxetate (20%, 2/10, P = 0.03). LTC (mean 18.1 vs. 7.5, P = 0.04) and RPE (mean 75.5 vs. 45.4, P = 0.04) was significantly higher in the gadodiamide than gadoxetate scans.

CONCLUSION:

In patients with compromised liver function, hypointensity of HCC is more conspicuous in the gadodiamide delayed phase than the gadoxetate hepatobiliary phase. This likely reflects the high extracellular accumulation of gadodiamide and poor hepatocyte uptake of gadoxetate in patients with compromised liver function.

KEYWORDS:

Gadoxetate; Hepatocellular carcinoma; Liver MRI; Washout

Comment in

PMID:
26971341
PMCID:
PMC5297255
DOI:
10.1007/s00261-016-0703-1
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

So Yeon Kim declares that she has no conflict of interest. En-Haw Wu declares that he has no conflict of interest. Seong Ho Park declares that he has no conflict of interest. Zhen Jane Wang received grants from the National Institutes of Health and is a shareholder of Nextrast, Inc. Thomas Hope is a consultant, grant recipient, and speaker for General Electric Healthcare. Judy Yee is a grant recipient of EchoPixel, Inc. and the National Institutes of Health. Li-qin Zhao declares that she has no conflict of interest. Wei-Chou Chang declares that he has no conflict of interest. Benjamin M. Yeh received grants from the National Institutes of Health, General Electric Healthcare, General Electric Global Research Center, and NeuWave Inc, received book royalties from Oxford University Press, and is a shareholder of Nextrast, Inc.

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