To describe the pharmacodynamic properties of Gadoxetic acid.  To illustrate the Gadoxetic Acid-enhanced MRI findings of commonbenign and malignant focal liver lesions.  To highlight the benefits of using this liver-specific contrast agent in thedifferential diagnosis of focal liver lesions.

Because of the high prevalence of benign liver lesions in the adult population, their characterization is a primary objective in the liver imaging studies, especially in the assessment of cancer patients and those with chronic liver disease, in which can coexist both benign and malignant lesions. The accurate diagnosis is also very important to plan surgery and minimally invasive tumor therapies. The Gadoxetic Acid, formerly known as Gd-EOB-DTPA (Primovist) is a bimodal MR contrast agent that combines the properties of an extracellular agent in the...

Gd-EOB-DTPA is a specific, bimodal hepatobiliary contrast agent that combines the properties of an extracellular agent allowing the dynamic study after a bolus injection, and a late hepatobiliary phase because it is captured by the Hepatocytes. EOB-DTPA shows an uptake by hepatocytes and subsequent biliary excretion. After IV injection, Gd-EOB-DTPA is transported into the hepatocytes by the ATP-dependent organic anion transporting polypeptide 1 (OATP1). Regarding excretion, the contrast is excreted through Multidrug Resistance-associated Proteins (MRPs) to bile canaliculi (MRP2 = apical transporter) or sinusoidal spaces...

Gadoxetic Acid-enhanced MRI provides additional information that improves the characterization and diagnostic accuracy of many focal liver lesions. Gadoxetic Acid-enhanced MRI has great utility to differentiate the NFH from the adenoma due to the differences in the behavior of these lesions in the hepatobiliary phase. Gadoxetic Acid-enhanced MRIis also useful in the detection of small HCCs (<2 cm) in which it is difficult to evaluate the washout in the dynamic phases; and also helps us to differentiate dysplastic nodules from regenerative nodules.

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