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Liver perfusion in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI): comparison of enhancement in Gd-BT-DO3A and Gd-EOB-DTPA in normal liver parenchyma

  • Gastrointestinal
  • Published:
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Abstract

Purpose

Within-patient comparison of the enhancement patterns of normal liver parenchyma after gadobutrol and gadoxetate disodium, with emphasis on the start of hepatocytic uptake of gadoxetate disodium.

Materials and methods

Twenty-one patients (12 female, 9 male) without chronic liver disease underwent 1.5-T contrast-enhanced MRI twice, once with an extracellular contrast agent (gadobutrol) and once with a hepatospecific agent (gadoxetate disodium), using a T1-weighted keyhole sequence. Fifteen whole-liver datasets were acquired up to 5 min for both contrast agents and two additional datasets, up to 20 min, for gadoxetate. Signal intensities (SI) of the parenchyma, aorta and portal vein were measured and analysed relative to pre-contrast parenchymal SI.

Results

After gadoxetate, in 29 % of the patients the parenchymal SI decreased by ≥5 % after the initial vascular-phase-induced peak, while in the other 71 % the parenchymal SI remained stable or gradually increased until up to 20 min after the initial peak. The hepatocytic gadoxetate uptake started at a mean of 37.8 s (SD 14.7 s) and not later than 76 s after left ventricle enhancement.

Conclusion

Parenchymal enhancement due to hepatocytic uptake of gadoxetate can start as early as in the late arterial phase. This may confound the assessment of lesion appearance as compared to extracellular contrast such as gadobutrol.

Key Points

• Gadoxetate-enhanced liver MRI results in early enhancement of normal parenchyma in patients

• The start of the hepatobiliary phase coincides with the late arterial phase

• This may confound the assessment of lesion appearance compared to extracellular contrast

• Different parenchymal enhancement patterns after gadoxetate were found for normal parenchyma

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Abbreviations

DCE:

dynamic contrast enhanced

MRI:

magnetic resonance imaging

SENSE:

sensitivity encoding

TFE:

turbo field echo

DWI:

diffusion-weighted imaging

4D-THRIVE:

four-dimensional T1-weighted high-resolution imaging with volume examination

ROI:

region of interest

SI:

signal intensity

SD:

standard deviation

LOA:

limits of agreement

CI:

confidence interval

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Acknowledgments

The scientific guarantor of this publication is Dr. M.S. van Leeuwen. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this article. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, experimental study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, University Medical Center Utrecht, PO Box 58800, 3584 CX, Utrecht, The Netherlands

    Hanke J. Schalkx, Maurice A. A. J. van den Bosch, Wouter B. Veldhuis & Maarten S. van Leeuwen

  2. Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands

    Marijn van Stralen & Josien P. W. Pluim

  3. Clinical epidemiologist, Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands

    Helena M. Verkooijen

  4. Department of Radiology, AZ St.-Jan Brugge-Oostende AV, Bruges, Belgium

    Kenneth Coenegrachts

  5. Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

    Charlotte S. van Kessel & Richard van Hillegersberg

  6. Department of Gastroenterology, University Medical Center Utrecht, Utrecht, The Netherlands

    Karel J. van Erpecum

Authors
  1. Hanke J. Schalkx
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  2. Marijn van Stralen
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  3. Kenneth Coenegrachts
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  4. Maurice A. A. J. van den Bosch
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  5. Charlotte S. van Kessel
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  8. Helena M. Verkooijen
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  9. Josien P. W. Pluim
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  11. Maarten S. van Leeuwen
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Correspondence to Hanke J. Schalkx.

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Schalkx, H.J., van Stralen, M., Coenegrachts, K. et al. Liver perfusion in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI): comparison of enhancement in Gd-BT-DO3A and Gd-EOB-DTPA in normal liver parenchyma. Eur Radiol 24, 2146–2156 (2014). https://doi.org/10.1007/s00330-014-3275-x

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  • DOI: https://doi.org/10.1007/s00330-014-3275-x

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