Skip to main content

Advertisement

SpringerLink
Log in

Enhancements in hepatobiliary imaging: the spectrum of gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid usages in hepatobiliary magnetic resonance imaging

  • Pictorial Essay
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) is a unique hepatocyte-specific contrast agent approved for clinical use in the United States in 2008. Gd-EOB-DTPA-enhanced MR has shown to improve detection and characterization of hepatic lesions. Gd-EOB-DTPA is now being routinely used in daily clinical practice worldwide. Therefore, it is important for radiologists to be familiar with the potential uses and pitfalls of Gd-EOB-DTPA, which extends beyond the assessment of focal hepatic lesions. The purpose of this article is to review the various usages of Gd-EOB-DTPA in hepatobiliary MR imaging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20

Similar content being viewed by others

Abbreviations

Gd-EOB-DTPA:

Gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid

HCC:

Hepatocellular carcinoma

MRI:

Magnetic resonance imaging

References

  1. Gomaa AI, Khan S, Toledano MB, Waked I, Taylor-Robinson SD (2008) Hepatocellular carcinoma: epidemiology, risk factors and pathogenesis. World J Gastroenterol 14:4300–4308

    Article  PubMed  PubMed Central  Google Scholar 

  2. Liu CL, Fan S, Lo CM, et al. (2004) Hepatic resection for incidentaloma. J Gastrointest Surg 8:785–793

    Article  PubMed  Google Scholar 

  3. Hammerstingl R, Huppertz A, Breuer J, et al. (2008) Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions. Eur Radiol 18:457–467

    Article  PubMed  Google Scholar 

  4. Huppertz A, Haraida S, Kraus A, et al. (2005) Enhancement of focal liver lesions at gadoxetic acid-enhanced MR imaging: correlation with histopathologic findings and spiral CT–initial observations. Radiology 234:468–478

    Article  PubMed  Google Scholar 

  5. Cruite I, Schroeder M, Merkle EM, Sirlin CB (2010) Gadoxetate disodium-enhanced MRI of the liver: part 2, protocol optimization and lesion appearance in the cirrhotic liver. AJR Am J Roentgenol 195:29–41

    Article  PubMed  Google Scholar 

  6. Gall TM, Oniscu G, Madhavan K, Parks RW, Garden OJ (2009) Surgical management and longterm follow-up of non-parasitic hepatic cysts. HPB (Oxford) 11:235–241

    Article  Google Scholar 

  7. Huppertz A, Haraida S, Kraus A, et al. (2005) Enhancement of focal liver lesions at gadoxetic acid-enhanced MR imaging: correlation with histopathologic findings and spiral CT–initial observations. Radiology 234(2):468–478

    Article  PubMed  Google Scholar 

  8. Lee NK, Kim S, Lee JW, et al. (2009) Biliary MR imaging with Gd-EOB-DTPA and its clinical applications. Radiographics 29(6):1707–1724

    Article  PubMed  Google Scholar 

  9. Rungsinaporn KP, Phaisakamas T (2008) Frequency of abnormalities detected by upper abdominal ultrasound. J Med Assoc Thai 91(7):1072–1075

    PubMed  Google Scholar 

  10. Tamada T, Ito K, Yamamoto A, et al. (2011) Hepatic hemangiomas: evaluation of enhancement patterns at dynamic MRI with gadoxetate disodium. AJR Am J Roentgenol 196(4):824–830

    Article  PubMed  Google Scholar 

  11. Tateyama A, Fukukura Y, Takumi K, et al. (2012) Gd-EOB-DTPA-enhanced magnetic resonance imaging features of hepatic hemangioma compared with enhanced computed tomography. World J Gastroenterol 18(43):6269–6276

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Agarwal S, Grajo J, Fuentes-Orrego JM, et al. (2016) Distinguishing hemangiomas from metastases on liver MRI performed with gadoxetate disodium: value of the extended washout sign. Eur J Radiol 85:635–640

    Article  PubMed  Google Scholar 

  13. Herman P, Pugliese V, Machado MA, et al. (2000) Hepatic adenoma and focal nodular hyperplasia: differential diagnosis and treatment. World J Surg 22(6):1674–1681

    Google Scholar 

  14. Sutherland T, Seale M, Yap K (2014) Part 1: MRI features of focal nodular hyperplasia with an emphasis on hepatobiliary contrast agents. J Med Imaging Radiat Oncol 58(1):50–55

    Article  PubMed  Google Scholar 

  15. Seale MK, Catalano O, Saini S, Hahn PF, Sahani DV (2009) Hepatobiliary-specific MR contrast agents: role in imaging the liver and biliary tree. Radiographics 29(6):1725–1748

    Article  PubMed  Google Scholar 

  16. Barthelmes L, Tait I (2005) Liver cell adenoma and liver cell adenomatosis. HPB (Oxford) 7:186–196

    Article  Google Scholar 

  17. Khanna M, Ramanathan S, Fasih N, et al. (2015) Current updates on the molecular genetics and magnetic resonance imaging of focal nodular hyperplasia and hepatocellular adenoma. Insights Imaging 6(3):347–362

    Article  PubMed  PubMed Central  Google Scholar 

  18. Grazioli L, Olivetti L, Mazza G, Bondioni MP (2013) MR imaging of hepatocellular adenomas and differential diagnosis dilemma. Int J Hepatol.

  19. Zucman-Rossi J, Jeannot E, Nhieu JT, et al. (2006) Genotype-phenotype correlation in hepatocellular adenoma: new classification and relationship with HCC. Hepatology 43:515–524

    Article  CAS  PubMed  Google Scholar 

  20. Micchelli ST, Vivekanandan P, Boitnott JK, et al. (2008) Malignant transformation of hepatic adenomas. Mod Pathol 21:491–497

    Article  CAS  PubMed  Google Scholar 

  21. Tse JR, Naini B, Lu DS, Raman SS (2015) Qualitative and quantitative gadoxetic acid-enhanced MR imaging helps subtype hepatocellular adenomas. Radiology 27:142449

    Google Scholar 

  22. Wanless IR (1990) Micronodular transformation (nodular regenerative hyperplasia) of the liver: a report of 64 cases among 2500 autopsies and a new classification of benign hepatocellular nodules. Hepatology 11:787–797

    Article  CAS  PubMed  Google Scholar 

  23. Tanaka M, Wanless I (1998) Pathology of the liver in Budd-Chiari syndrome: portal vein thrombosis and the histogenesis of veno-centric cirrhosis, veno-portal cirrhosis, and large regenerative nodules. Hepatology 27:488–496

    Article  CAS  PubMed  Google Scholar 

  24. Maetani Y, Itoh K, Egawa H, et al. (2002) Benign hepatic nodules in Budd-Chiari syndrome: radiologic-pathologic correlation with emphasis on the central scar. AJR Am J Roentgenol 178:869–875

    Article  PubMed  Google Scholar 

  25. Brancatelli G, Federle M, Grazioli L, Golfieri R, Lencioni R (2002) Large regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: CT and MR imaging findings with clinicopathologic correlation. AJR Am J Roentgenol 178:877–883

    Article  PubMed  Google Scholar 

  26. Bureau CPJ, Péron J, Sirach E, et al. (2004) Liver nodules resembling focal nodular hyperplasia after portal vein thrombosis. Journal of hepatology 41:499–500

    Article  CAS  PubMed  Google Scholar 

  27. Duvoux C, Kracht M, Lang P, et al. (1991) Nodular regenerative hyperplasia of the liver associated with azathioprine therapy. Gastroenterol Clin Biol 15(12):968–973

    CAS  PubMed  Google Scholar 

  28. Jemal A, Bray F, Center MM, et al. (2011) Global cancer statistics. CA Cancer J Clin 61:69

    Article  PubMed  Google Scholar 

  29. Bruix J, Sherman M (2011) Management of hepatocellular carcinoma: an update. Hepatology 53:1020–1022

    Article  PubMed  PubMed Central  Google Scholar 

  30. Bruix J, Sherman M, Llovet JM, et al. (2001) EASL panel of experts on HCC, clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol 35:421–430

    Article  CAS  PubMed  Google Scholar 

  31. Pahwa ABK, Beckett K, Channual S, et al. (2014) Efficacy of the American association for the study of liver disease and barcelona criteria for the diagnosis of hepatocellular carcinoma. Abdom Imaging 39(4):753–760

    Article  PubMed  Google Scholar 

  32. Ebara M, Ohto M, Watanabe Y, et al. (1986) Diagnosis of small hepatocellular carcinoma: correlation of MR imaging and tumor histologic studies. Radiology 159(2):371–377

    Article  CAS  PubMed  Google Scholar 

  33. Nishie A, Asayama A, Ishigami K, et al. (2014) Clinicopathological significance of the peritumoral decreased uptake area of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid in hepatocellular carcinoma. J Gastroenterol Hepatol 29(3):561–567

    Article  CAS  PubMed  Google Scholar 

  34. Forner A, Vilana R, Ayuso C, et al. (2008) Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology 47:97–104

    Article  PubMed  Google Scholar 

  35. Darnell A, Forner A, Rimola J, Reig M, et al. (2015) Liver imaging reporting and data system with mr imaging: evaluation in nodules 20 mm or smaller detected in cirrhosis at screening US. Radiology 275(3):698–707

    Article  PubMed  Google Scholar 

  36. Saito K, Moriyasu F, Sugimoto K, et al. (2011) Diagnostic efficacy of gadoxetic acid-enhanced MRI for hepatocellular carcinoma and dysplastic nodule. World J Gastroenterol 17(30):3503–3509

    Article  PubMed  PubMed Central  Google Scholar 

  37. Haimerl M, Wächtler M, Platzek I, et al. (2013) Added value of Gd-EOB-DTPA-enhanced Hepatobiliary phase MR imaging in evaluation of focal solid hepatic lesions. BMC Med Imaging 13:41

    Article  PubMed  PubMed Central  Google Scholar 

  38. van den Bos IC, Hussain SM, Terkivatan T, Zondervan PE, de Man RA (2006) Stepwise carcinogenesis of hepatocellular carcinoma in the cirrhotic liver: demonstration on serial MR imaging. J Magn Reson Imaging 24:1071–1080

    Article  PubMed  Google Scholar 

  39. International Consensus Group for Hepatocellular Neoplasia (2009) Pathologic diagnosis of early hepatocellular carcinoma: a report of the international consensus group for hepatocellular neoplasia. Hepatology 49:658–664

    Article  Google Scholar 

  40. Channual S, Tan N, Siripongsakun S, et al. (2015) Gadoxetate disodium-enhanced MRI to differentiate dysplastic nodules and grade of hepatocellular carcinoma: correlation with histopathology. AJR Am J Roentgenol 205(3):546–553

    Article  PubMed  Google Scholar 

  41. Asayama Y, Tajima T, Nishie A, et al. (2011) Uptake of Gd-EOB-DTPA by hepatocellular carcinoma: radiologic-pathologic correlation with special reference to bile production. Eur J Radiol 80:e243–e248

    Article  PubMed  Google Scholar 

  42. Narita M, Hatano E, Arizono S, et al. (2009) Expression of OATP1B3 determines uptake of Gd-EOB-DTPA in hepatocellular carcinoma. J Gastroenterol 44:793–798

    Article  CAS  PubMed  Google Scholar 

  43. Shanbhogue AK, Prasad S, Takahashi N, Vikram R, Sahani DV (2011) Recent advances in cytogenetics and molecular biology of adult hepatocellular tumors: implications for imaging and management. Radiology 258(3):673–693

    Article  PubMed  Google Scholar 

  44. Chung YE, Kim M, Park YN, et al. (2009) Varying appearances of cholangiocarcinoma: radiologic-pathologic correlation. Radiographics 29(3):683–700

    Article  PubMed  Google Scholar 

  45. Han JK, Choi BI, Kim TK, et al. (1997) Hilar cholangiocarcinoma: thin-section spiral CT findings with cholangiographic correlation. Radiographics 17(6):1475–1485

    Article  CAS  PubMed  Google Scholar 

  46. Soyer P, Bluemke DA, Reichle R, et al. (1995) Imaging of intrahepatic cholangiocarcinoma: 2. Hilar cholangiocarcinoma. AJR Am J Roentgenol 165(6):1433–1436

    Article  CAS  PubMed  Google Scholar 

  47. Jarnagin WR, Shoup M (2004) Surgical management of cholangiocarcinoma. Semin Liver Dis 24(2):189–199

    Article  PubMed  Google Scholar 

  48. Seidensticker R, Seidensticker M, Doegen K, et al (2016) Extensive use of interventional therapies improves survival in unresectable or recurrent intrahepatic cholangiocarcinoma. Gastroenterol Res Pract;8732521.

  49. Maithel SK, Gamblin TC, Kamel I, et al. (2013) Multidisciplinary approaches to intrahepatic cholangiocarcinoma. Cancer 119(22):3929–3942

    Article  PubMed  Google Scholar 

  50. Jeong HT, Kim M, Chung YE, et al. (2013) Gadoxetate disodium-enhanced MRI of mass-forming intrahepatic cholangiocarcinomas: imaging-histologic correlation. AJR Am J Roentgenol 201(4):W603–W611

    Article  PubMed  Google Scholar 

  51. Piscaglia FI, Iavarone M, Galassi M, et al. (2015) Cholangiocarcinoma in cirrhosis: value of hepatocyte specific magnetic resonance imaging. Dig Dis 33(6):735–744

    Article  PubMed  Google Scholar 

  52. Lodge JP (2000) Modern surgery for liver metastases. Cancer Imaging 11(1):77–85

    Article  Google Scholar 

  53. Fusai G, Davidson B (2003) Management of colorectal liver metastases. Colorectal Dis 5(1):2–23

    Article  CAS  PubMed  Google Scholar 

  54. Schneider G, Maas R, Schultze Kool L, et al. (2003) Low-dose gadobenate dimeglumine versus standard dose gadopentetate dimeglumine for contrast-enhanced magnetic resonance imaging of the liver: an intra-individual crossover comparison. Investig Radiol 38(2):85–94

    Article  CAS  Google Scholar 

  55. Sahani DV, Kalva S, Fischman AJ, et al. (2005) Detection of liver metastases from adenocarcinoma of the colon and pancreas: comparison of mangafodipir trisodium-enhanced liver MRI and whole-body FDG PET. AJR Am J Roentgenol 185(1):239–246

    Article  PubMed  Google Scholar 

  56. del Frate C, Bazzocchi M, Mortele KJ, et al. (2002) Detection of liver metastases: comparison of gadobenate dimeglumine-enhanced and ferumoxides-enhanced MR imaging examinations. Radiology 225(3):766–772

    Article  PubMed  Google Scholar 

  57. Papanikolaou N, Prassopoulos P, Eracleous E, et al. (2001) Contrast-enhanced magnetic resonance cholangiography versus heavily T2-weighted magnetic resonance cholangiography. Investig Radiol 36(11):682–686

    Article  CAS  Google Scholar 

  58. Lee VS, Krinsky G, Nazzaro CA, et al. (2004) Defining intrahepatic biliary anatomy in living liver transplant donor candidates at mangafodipir trisodium-enhanced MR cholangiography versus conventional T2-weighted MR cholangiography. Radiology 233(3):659–666

    Article  PubMed  Google Scholar 

  59. Fayad LM, Kamel I, Mitchell DG, Bluemke DA (2005) Functional MR cholangiography: diagnosis of functional abnormalities of the gallbladder and biliary tree. AJR Am J Roentgenol 184(5):1563–1571

    Article  PubMed  Google Scholar 

  60. Sheppard DA, Allan L, Martin P, et al. (2004) Contrast-enhanced magnetic resonance cholangiography using mangafodipir compared with standard T2 W MRC sequences: a pictorial essay. J Magn Reson Imaging 20(2):256–263

    Article  PubMed  Google Scholar 

  61. Park MS, Kim K, Yu JS, et al. (2004) Early biliary complications of laparoscopic cholecystectomy: evaluation on T2-weighted MR cholangiography in conjunction with mangafodipir trisodium-enhanced 3D T1-weighted MR cholangiography. AJR Am J Roentgenol 183(6):1559–1566

    Article  PubMed  Google Scholar 

  62. Ke Z, Hao X, Ning W, Mao-Heng Z, Yu-Fei F (2015) Fibrinolysis status in the Budd-Chiari syndrome in China. Blood Coagul Fibrinolysis 26(7):721–726

    CAS  PubMed  Google Scholar 

  63. Abraham SC, Kamath P, Eghtesad B, Demetris AJ, Krasinskas AM (2006) Liver transplantation in precirrhotic biliary tract disease: portal hypertension is frequently associated with nodular regenerative hyperplasia and obliterative portal venopathy. Am J Surg Pathol 30(11):1454–1461

    Article  PubMed  Google Scholar 

  64. Krishnan P, Fiel M, Rosenkrantz AB, et al. (2012) Hepatoportal sclerosis: CT and MRI appearance with histopathologic correlation. AJR Am J Roentgenol 198(2):370–376

    Article  PubMed  Google Scholar 

  65. Cruite I, Schroeder M, Merkle EM, Sirlin CB (2010) Gadoxetate disodium-enhanced MRI of the liver: part 2, protocol optimization and lesion appearance in the cirrhotic liver. AJR Am J Roentgenol 195(1):29–41

    Article  PubMed  Google Scholar 

  66. Goodwin MD, Dobson J, Sirlin CB, Lim BG, Stella DL (2011) Diagnostic challenges and pitfalls in MR imaging with hepatocyte-specific contrast agents. Radiographics 31(6):1547–1568

    Article  PubMed  Google Scholar 

  67. Davenport MS, Viglianti V, Al-Hawary MM, et al. (2013) Comparison of acute transient dyspnea after intravenous administration of gadoxetate disodium and gadobenate dimeglumine: effect on arterial phase image quality. Radiology 266(2):452–461

    Article  PubMed  Google Scholar 

  68. Kim SY, Park S, Wu EH, et al. (2015) Transient respiratory motion artifact during arterial phase MRI with gadoxetate disodium: risk factor analyses. AJR Am J Roentgenol 204(6):1220–1227

    Article  PubMed  Google Scholar 

  69. Motosugi U, Ichikawa T, Sou H, et al. (2009) Dilution method of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). J Magn Reson Imaging 30(4):849–854

    Article  PubMed  Google Scholar 

  70. Tanimoto A, Higuchi N, Ueno A (2012) Reduction of ringing artifacts in the arterial phase of gadoxetic acid-enhanced dynamic MR imaging. Magn Reson Med Sci 11(2):91–97

    Article  PubMed  Google Scholar 

  71. Bollow M, Taupitz M, Hamm B, et al. (1997) Gadolinium-ethoxybenzyl-DTPA as a hepatobiliary contrast agent for use in MR cholangiography: results of an in vivo phase-I clinical evaluation. Eur Radiol 7(1):126–132

    Article  CAS  PubMed  Google Scholar 

  72. Péporté AR, Sommer W, Nikolaou K, Reiser MF, Zech CJ (2013) Imaging features of intrahepatic cholangiocarcinoma in Gd-EOB-DTPA-enhanced MRI. Eur J Radiol 82(3):e101–e106

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, 757 Westwood Plaza Rm 1921H, Los Angeles, CA, 90095, USA

    Stephanie Channual, David S. Lu & Steven S. Raman

  2. Department of Radiological Sciences, Olive View-UCLA Medical Center, David Geffen School of Medicine at UCLA, 14445 Olive View Drive, Sylmar, CA, 91342, USA

    Anokh Pahwa

Authors
  1. Stephanie Channual
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anokh Pahwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David S. Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Steven S. Raman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephanie Channual.

Ethics declarations

Funding

This review article was not funded by a grant.

Conflict of interest/Disclosures

David S. Lu, MD and Steven S. Raman, MD are consultants with Bayer Healthcare. The other authors have no disclosures.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was waived as this is a review article.

Additional information

CME activity This article has been selected as the CME activity for the current month. Please visit https://ce.mayo.edu/node/24283 and follow the instructions to complete this CME activity.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Channual, S., Pahwa, A., Lu, D.S. et al. Enhancements in hepatobiliary imaging: the spectrum of gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid usages in hepatobiliary magnetic resonance imaging. Abdom Radiol 41, 1825–1841 (2016). https://doi.org/10.1007/s00261-016-0767-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-016-0767-y

Keywords

Search

Navigation