This poster was previously presented and awarded at the 70th Korean Congress of Radiology (KCR 2014) in Seoul. This poster is published under an
open license. Please read the
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Type:
Educational Exhibit
Keywords:
Liver, MR, Education, Cancer, Neoplasia
Authors:
J. W. Kim, C. H. Lee, Y. S. Park, J. Lee, J. W. Choi, K. A. Kim, C. M. Park; Seoul/KR
DOI:
10.1594/ecr2015/C-2640
Background
Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA,
also known as gadoxetic acid or gadoxetate disodium) is a newly developed MRI contrast agent that was first approved in Europe in 2004 and then by Food and Drug Administration (FDA) in the United States in 2008 for the detection and characterization of focal liver lesion.
Gd-EOB-DTPA has not only conventional extracellular properties but also hepatocyte-selective properties.
These combined properties make Gd-EOB-DTPA taken by hepatocyte via the organic anion trasporter proteins (OATPs) and excreted into the biliary canaliculi via the multidrug resistance-associated proteins (MRPs). While normal liver parenchyma that can uptake Gd-EOB-DTPA show maximal enhancement in the hepatobiliary phase (HBP) obtained 20 minutes after injection,
focal liver lesions that lack functioning hepatocytes cannot accumulate Gd-EOB-DTPA,
allowing for improved detection of them.
Some focal liver lesions of hepatocellular origin such as focal nodular hyperplasia (FNH) show iso- or hyperintensity in the HBP.
In clinical practice,
however,
focal liver lesions sometimes show paradoxical uptake or unusual defect in the HBP of gadoxetic acid-enhanced liver MRI.