Quantifying differences in hepatic uptake of the liver specific contrast agents Gd-EOB-DTPA and Gd-BOPTA: a pilot study
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To develop and evaluate a procedure for quantifying the hepatocyte-specific uptake of Gd-BOPTA and Gd-EOB-DTPA using dynamic contrast-enhanced (DCE) MRI.
Ten healthy volunteers were prospectively recruited and 21 patients with suspected hepatobiliary disease were retrospectively evaluated. All subjects were examined with DCE-MRI using 0.025 mmol/kg of Gd-EOB-DTPA. The healthy volunteers underwent an additional examination using 0.05 mmol/kg of Gd-BOPTA. The signal intensities (SI) of liver and spleen parenchyma were obtained from unenhanced and enhanced acquisitions. Using pharmacokinetic models of the liver and spleen, and an SI rescaling procedure, a hepatic uptake rate, K Hep, estimate was derived. The K Hep values for Gd-EOB-DTPA were then studied in relation to those for Gd-BOPTA and to a clinical classification of the patient’s hepatobiliary dysfunction.
K Hep estimated using Gd-EOB-DTPA showed a significant Pearson correlation with K Hep estimated using Gd-BOPTA (r = 0.64; P < 0.05) in healthy subjects. Patients with impaired hepatobiliary function had significantly lower K Hep than patients with normal hepatobiliary function (K Hep = 0.09 ± 0.05 min-1 versus K Hep = 0.24 ± 0.10 min−1; P < 0.01).
A new procedure for quantifying the hepatocyte-specific uptake of T 1-enhancing contrast agent was demonstrated and used to show that impaired hepatobiliary function severely influences the hepatic uptake of Gd-EOB-DTPA.
• The liver uptake of contrast agents may be measured with standard clinical MRI.
• Calculation of liver contrast agent uptake is improved by considering splenic uptake.
• Liver function affects the uptake of the liver-specific contrast agent Gd-EOB-DTPA.
• Hepatic uptake of two contrast agents (Gd-EOB-DTPA, Gd-BOPTA) is correlated in healthy individuals.
• This method can be useful for determining liver function, e.g. before hepatic surgery
KeywordsGadolinium ethoxybenzyl diethylenetriaminepentaacetic acid Gadobenate Dimeglumine Dynamic contrast-enhanced MRI Pharmacokinetics Liver
Financial support from the Swedish research council (VR/M 2007–2884), the Medical Research Council of Southeast Sweden (FORSS 12621), and the Linköping University Hospital Research Foundations are gratefully acknowledged. We thank research nurse Annika Hall at the Center for Medical Image Science and Visualization (CMIV) for assistance with volunteer data collection.
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