Gadoxetic Acid

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Young Kon Kim - One of the best experts on this subject based on the ideXlab platform.

  • Gadoxetic Acid-enhanced MRI for differentiating hepatic sclerosing hemangioma from malignant tumor.
    European journal of radiology, 2020
    Co-Authors: Yeun-yoon Kim, Young Kon Kim, Tae Wook Kang, Seong Hyun Kim, Dong Hyun Sinn, Dong Ik Cha, Ji Hye Min, Hojeong Won, Seonwoo Kim
    Abstract:

    Abstract Background To investigate the imaging features of Gadoxetic Acid-enhanced magnetic resonance imaging (MRI) to differentiate hepatic sclerosing hemangioma from malignant tumors. Methods This retrospective case-control study included 18 patients with sclerosing hemangioma and 54 patients with common hepatic malignant tumor, including hepatocellular carcinoma, metastatic adenocarcinoma, and cholangiocarcinoma, who were examined using Gadoxetic Acid-enhanced liver MRI from January 2008 to June 2019. Imaging features including signal intensity, tumor margins, enhancement pattern, and presence or absence of diffusion restriction were analyzed. Significant MRI features for predicting sclerosing hemangioma were identified using multivariable logistic regression analysis. Diagnostic performances of each imaging feature and combinations of significant imaging features were summarized. Results In the multivariable analysis, irregular margins (odds ratio [OR], 10.12; 95 % confidence interval [CI], 1.27−80.94; p = 0.029), centripetal or internal nodular enhancement in the transitional phase (OR, 13.58; 95 % CI, 1.48−124.82; p = 0.021), and absence of diffusion restriction (OR, 39.20; 95 % CI, 4.82−318.49; p = 0.001) were significant imaging features for the diagnosis of sclerosing hemangioma. Presence of at least two significant imaging features had a sensitivity, specificity, and accuracy of 88.9 %, 96.3 %, and 94.4 %, respectively, for diagnosing sclerosing hemangioma. Conclusion Combinations of two or more of the significant imaging features (irregular margins, centripetal or internal nodular enhancement in the transitional phase, and absence of diffusion restriction) were effective for differentiating hepatic sclerosing hemangioma from malignant tumors using Gadoxetic Acid-enhanced MRI.

  • Use of Gadoxetic Acid-enhanced Liver MRI and Mortality in More than 30 000 Patients with Hepatocellular Carcinoma: A Nationwide Analysis.
    Radiology, 2020
    Co-Authors: Tae Wook Kang, Young Kon Kim, Sun-young Kong, Danbee Kang, Min Woong Kang, Seong Hyun Kim, Dong Hyun Sinn, Young Ae Kim, Kui Son Choi, Eun Sook Lee
    Abstract:

    Compared with addition of non–Gadoxetic Acid–enhanced MRI, addition of Gadoxetic Acid–enhanced MRI to CT for the initial staging of hepatocellular carcinoma (HCC) is associated with a lower risk of...

  • Pretransplant diagnosis of hepatocellular carcinoma by Gadoxetic Acid–enhanced and diffusion‐weighted magnetic resonance imaging
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation S, 2014
    Co-Authors: Jiyoung Hwang, Young Kon Kim, Jong Man Kim, Won-jae Lee, Dongil Choi, Seong Sook Hong
    Abstract:

    We sought to evaluate the diagnostic performance of Gadoxetic Acid–enhanced magnetic resonance imaging (MRI) with and without additional diffusion-weighted imaging (DWI) in the detection of hepatocellular carcinoma (HCC) in pretransplant patients. We included 63 liver transplant patients (54 men and 9 women; mean age = 52 years) who had undergone Gadoxetic Acid–enhanced MRI with DWI at 3.0 T within 90 days before transplantation. Two image sets were reviewed for HCC in 2 separate sessions by 2 independent observers: the Gadoxetic Acid set and the combined set (Gadoxetic Acid plus DWI). The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each image set. In all, 113 HCCs (size range = 0.5-7.8 cm, mean = 2.0 ± 1.3 cm) were identified in the 52 liver explants. The per-lesion sensitivity of the combined set (78.8% for both observers) was higher than the sensitivity of the Gadoxetic Acid set [71.7% (P = 0.02) and 72.6% (P = 0.03) for the 2 observers], with the highest trend for Child-Pugh class A (94.4% and 97.2% for Gadoxetic Acid and 97.2% for combined), which was followed by class B (73.2% for Gadoxetic Acid and 82.9% for combined) and then class C (47.2% for Gadoxetic Acid and 55.6% for combined, P = 0.01). The per-patient negative predictive value of the combined set was higher than that of the Gadoxetic Acid set for both observers (P = 0.046). There was no difference in specificity between the 2 image sets (P > 0.05). The addition of DWI to Gadoxetic Acid–enhanced MRI resulted in significantly higher sensitivity to detect HCC. However, the sensitivity decreased with increasing cirrhosis severity for both imaging types. Liver Transpl 20:1436-1446, 2014. © 2014 AASLD.

  • Is Gadoxetic Acid-enhanced MRI limited in tumor characterization for patients with chronic liver disease?
    Magnetic resonance imaging, 2014
    Co-Authors: Soyi Kwon, Young Kon Kim, Won-jae Lee, Hyun Jeong Park, Woo Kyoung Jeong, Dongil Choi
    Abstract:

    Abstract Purpose There are pros and cons to the use of Gadoxetic Acid in hepatocellular carcinoma (HCC) workup due to the potential for high false positive diagnosis. This study was conducted to investigate the preoperative diagnostic performance of Gadoxetic Acid-enhanced MRI protocol including diffusion-weighted imaging (DWI) with emphasis on tumor characterization developed in high risk HCC patients. Materials and methods We included 144 patients (102 men, 42 women; age range 33–74 years) with chronic viral hepatitis or cirrhosis and 183 focal hepatic tumors (size range, 0.4–11.0 cm; mean, 3.2 cm), including 148 HCCs, 13 cholangiocarcinomas, 12 hemangiomas, three hepatocellular adenomas, two focal nodular hyperplasias, and five other tumors. All patients underwent Gadoxetic Acid-enhanced MRI protocol with DWI. MRIs were independently interpreted by three observers for the detection and characterization of hepatic tumors. Results Sensitivities for detecting all 183 liver tumors were 98.4%, 97.8%, and 96.2% for each observer, respectively, with a 97.5% for pooled data. Among 183 hepatic tumors, 91.3% (n = 167), 87.4% (n = 160), and 86.9% (n = 159) were correctly characterized according to their reference standard by each observer, respectively. In 13 cholangiocarcinomas, one to three were misinterpreted as HCC, and the remaining tumors were correctly characterized by each observer. The accuracies (Az) of MRI for HCC diagnosis were 0.952 for observer 1, 0.906 for observer 2, and 0.910 for observer 3, with 0.922 for pooled data. There was good inter-observer agreement. Conclusion The Gadoxetic Acid-enhanced MRI including DWI showed a reasonable performance for tumor characterization with high sensitivity for tumor detection in patients with chronic liver disease, despite concerns of high false positive diagnosis of hypervascular tumors.

  • Infiltrative hepatocellular carcinoma on Gadoxetic Acid-enhanced and diffusion-weighted MRI at 3.0T.
    Journal of magnetic resonance imaging : JMRI, 2013
    Co-Authors: Sanghyeok Lim, Young Kon Kim, Won-jae Lee, Dongil Choi, Hyun Jeong Park, Min Jung Park
    Abstract:

    Purpose To determine imaging features of infiltrative hepatocellular carcinoma (HCC) on 3T magnetic resonance imaging (MRI) including Gadoxetic Acid-enhanced and diffusion-weighted imaging (DWI). Materials and Methods Eighteen patients with infiltrative HCC underwent liver MRI that consisted of T1- and T2-weighted image (T2WI), Gadoxetic Acid-enhanced arterial, portal, 3-min late and 20-min hepatobiliary phase (HBP), and DWI. Two reviewers evaluated in consensus tumor characteristics and lesion conspicuity using a 4-point scale. The tumor-to-liver contrast ratio was also measured. Results Most of the tumors (n = 16, 88.9%) were seen as irregular permeative masses (4.0–23.0 cm, mean 10.5 cm in diameter) and the remaining two as poorly defined amorphous infiltration among thrombosed portal veins. Internal reticulation within the tumor was characteristic and was most frequently observed on 3-min late phase (n = 18), followed by HBP (n = 15). Tumor conspicuity and tumor-to-liver contrast ratio was highest with b-800 DWI, which was significantly higher than those of other images (P < 0.05). Conclusion DWI provides the highest conspicuity for infiltrative HCC compared to unenhanced T1- and T2WI and Gadoxetic Acid-enhanced MRI. The Gadoxetic Acid-enhanced 3-min late image is useful in characterizing infiltrative HCC, as it clearly depicts internal reticulation in all tumors. J. Magn. Reson. Imaging 2014;39:1238–1245. © 2013 Wiley Periodicals, Inc.

Utaroh Motosugi - One of the best experts on this subject based on the ideXlab platform.

  • Dose-dependence of transient respiratory motion artifacts on Gadoxetic Acid-enhanced arterial phase MR images
    Journal of magnetic resonance imaging : JMRI, 2017
    Co-Authors: Hiroyuki Morisaka, Utaroh Motosugi, Shintaro Ichikawa, Hiroshi Onishi
    Abstract:

    Purpose To compare the occurrence of transient respiratory motion (TM) artifacts between 0.05 mmol/kg and 0.025 mmol/kg Gadoxetic-Acid on arterial phase MRI intra-individually for evaluating dose-dependence of Gadoxetic Acid. Materials and Methods This retrospective study involved 91 patients who underwent dynamic MRI at 1.5T at different times, one time with 0.05 mmol/kg and the other 0.025 mmol/kg Gadoxetic-Acid. Examinations with 0.05 mmol/kg totaled 91 scans, and examinations with 0.025 mmol/kg totaled 375 scans (due to multiple exams for several patients). The scan with 0.025 mmol/kg closest in time to the 0.05 mmol/kg scan was selected to minimize temporal effects. Two radiologists graded TM artifacts in the arterial phase images using a four-point scale: no, mild, moderate, and severe artifacts. Results were compared between the two protocols (0.05 mmol/kg versus all 0.025 mmol/kg and 0.05 mmol/kg versus selected 0.025 mmol/kg), and the odds ratio for moderate-to-severe artifacts was calculated. Results Significantly more TM artifacts were observed in the double dose (16/91 [17%]) scans compared with either all (17/375 [4%]; P 

  • Combined Gadoxetic Acid and gadofosveset enhanced liver MRI for detection and characterization of liver metastases
    European Radiology, 2017
    Co-Authors: Peter Bannas, Utaroh Motosugi, Candice A. Bookwalter, Timothy J. Ziemlewicz, Theodora A. Potretzke, Scott K. Nagle, Alejandro Munoz Del Rio, Scott B. Reeder
    Abstract:

    Purpose To compare Gadoxetic Acid alone and combined Gadoxetic Acid/gadofosveset trisodium-enhanced liver MRI for detection of metastases and differentiation of metastases from haemangiomas. Methods Ninety-one patients underwent Gadoxetic Acid-enhanced liver MRI before and after additional injection of gadofosveset. First, two readers retrospectively identified metastases on Gadoxetic Acid alone enhanced delayed hepatobiliary phase T1-weighted images together with all other MR images (dynamic images, T2-weighted images, diffusion-weighted images). Second, readers assessed additional T1-weighted images obtained after administration of gadofosveset trisodium. For both interpretations, readers rated lesion conspicuity and confidence in differentiating metastases from haemangiomas. Results were compared using alternative free-response receiver-operating characteristic (AFROC) and conventional ROC methods. Histology and follow-up served as reference standard. Results There were 145 metastases and 16 haemangiomas. Both readers detected more metastases using combined Gadoxetic Acid/gadofosveset (reader 1 = 130; reader 2 = 124) compared to Gadoxetic Acid alone (reader 1 = 104; reader 2 = 103). Sensitivity of combined Gadoxetic Acid/gadofosveset (reader 1 = 90 %; reader 2 = 86 %) was higher than that of Gadoxetic Acid alone (reader 1 = 72 %; reader 2 = 71 %, both P  

  • Combined Gadoxetic Acid and gadofosveset enhanced liver MRI for detection and characterization of liver metastases
    European Radiology, 2016
    Co-Authors: Peter Bannas, Utaroh Motosugi, Candice A. Bookwalter, Timothy J. Ziemlewicz, Alejandro Munoz Del Rio, Theodora A. Potretzke, Scott K. Nagle, Scott B. Reeder
    Abstract:

    Purpose To compare Gadoxetic Acid alone and combined Gadoxetic Acid/gadofosveset trisodium-enhanced liver MRI for detection of metastases and differentiation of metastases from haemangiomas.

  • combined Gadoxetic Acid and gadofosveset enhanced liver mri a feasibility and parameter optimization study
    Magnetic Resonance in Medicine, 2016
    Co-Authors: Peter Bannas, Utaroh Motosugi, Diego Hernando, James H. Holmes, Mahdi Salmani Rahimi, Scott B. Reeder
    Abstract:

    Purpose Demonstration of feasibility and protocol optimization for the combined use of gadofosveset trisodium with Gadoxetic Acid for delayed T1-weighted liver MRI. Methods Eleven healthy volunteers underwent hepatobiliary phase imaging at 3 Tesla (T) using Gadoxetic Acid. Multiple breathheld T1-weighted three-dimensional spoiled gradient echo sequences were performed at varying flip angles before and after injection of gadofosveset. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured to determine optimal T1-weighting. Examples of three patients with focal liver lesions were acquired. Results The addition of gadofosveset to the hepatobiliary phase of Gadoxetic Acid renders vessels isointense to liver tissue at low flip angles due to increased vessel SNR (P < 0.001). The lowest CNR of liver relative to portal vein (CNR = 15; 95% confidence interval [CI]: -14–44) was observed at a 10o flip angle. The highest CNR of liver relative to muscle (CNR = 214; 95% CI: 191–237) was observed at a 20o flip angle. The combined enhancement leads to homogenously enhanced liver tissue and liver vasculature. Cysts were detected in three volunteers and metastases were detected in two patients. In these anecdotal cases the cysts and metastases stood out as conspicuous focal hypointensities on combined Gadoxetic Acid and gadofosveset enhanced images. Conclusion Combined Gadoxetic Acid and gadofosveset enhanced liver MRI is feasible, with low flip angles minimizing contrast between vessels and liver. Further clinical studies are needed to confirm that low flip angles provide an optimal combination of sensitivity and specificity for lesion detection in patients. Magn Reson Med, 2015. © 2015 Wiley Periodicals, Inc.

  • An Investigation of Transient Severe Motion Related to Gadoxetic Acid-enhanced MR Imaging.
    Radiology, 2015
    Co-Authors: Utaroh Motosugi, Peter Bannas, Candice A. Bookwalter, Katsuhiro Sano, Scott B. Reeder
    Abstract:

    Severe motion-related artifacts on arterial phase of Gadoxetic Acid–enhanced liver MR imaging are associated with breath-hold failure but not with subjective feelings of dyspnea or a substantial decrease in blood oxygen saturation.

Moon-gyu Lee - One of the best experts on this subject based on the ideXlab platform.

Scott B. Reeder - One of the best experts on this subject based on the ideXlab platform.

  • Combined Gadoxetic Acid and gadofosveset enhanced liver MRI for detection and characterization of liver metastases
    European Radiology, 2017
    Co-Authors: Peter Bannas, Utaroh Motosugi, Candice A. Bookwalter, Timothy J. Ziemlewicz, Theodora A. Potretzke, Scott K. Nagle, Alejandro Munoz Del Rio, Scott B. Reeder
    Abstract:

    Purpose To compare Gadoxetic Acid alone and combined Gadoxetic Acid/gadofosveset trisodium-enhanced liver MRI for detection of metastases and differentiation of metastases from haemangiomas. Methods Ninety-one patients underwent Gadoxetic Acid-enhanced liver MRI before and after additional injection of gadofosveset. First, two readers retrospectively identified metastases on Gadoxetic Acid alone enhanced delayed hepatobiliary phase T1-weighted images together with all other MR images (dynamic images, T2-weighted images, diffusion-weighted images). Second, readers assessed additional T1-weighted images obtained after administration of gadofosveset trisodium. For both interpretations, readers rated lesion conspicuity and confidence in differentiating metastases from haemangiomas. Results were compared using alternative free-response receiver-operating characteristic (AFROC) and conventional ROC methods. Histology and follow-up served as reference standard. Results There were 145 metastases and 16 haemangiomas. Both readers detected more metastases using combined Gadoxetic Acid/gadofosveset (reader 1 = 130; reader 2 = 124) compared to Gadoxetic Acid alone (reader 1 = 104; reader 2 = 103). Sensitivity of combined Gadoxetic Acid/gadofosveset (reader 1 = 90 %; reader 2 = 86 %) was higher than that of Gadoxetic Acid alone (reader 1 = 72 %; reader 2 = 71 %, both P  

  • Combined Gadoxetic Acid and gadofosveset enhanced liver MRI for detection and characterization of liver metastases
    European Radiology, 2016
    Co-Authors: Peter Bannas, Utaroh Motosugi, Candice A. Bookwalter, Timothy J. Ziemlewicz, Alejandro Munoz Del Rio, Theodora A. Potretzke, Scott K. Nagle, Scott B. Reeder
    Abstract:

    Purpose To compare Gadoxetic Acid alone and combined Gadoxetic Acid/gadofosveset trisodium-enhanced liver MRI for detection of metastases and differentiation of metastases from haemangiomas.

  • combined Gadoxetic Acid and gadofosveset enhanced liver mri a feasibility and parameter optimization study
    Magnetic Resonance in Medicine, 2016
    Co-Authors: Peter Bannas, Utaroh Motosugi, Diego Hernando, James H. Holmes, Mahdi Salmani Rahimi, Scott B. Reeder
    Abstract:

    Purpose Demonstration of feasibility and protocol optimization for the combined use of gadofosveset trisodium with Gadoxetic Acid for delayed T1-weighted liver MRI. Methods Eleven healthy volunteers underwent hepatobiliary phase imaging at 3 Tesla (T) using Gadoxetic Acid. Multiple breathheld T1-weighted three-dimensional spoiled gradient echo sequences were performed at varying flip angles before and after injection of gadofosveset. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured to determine optimal T1-weighting. Examples of three patients with focal liver lesions were acquired. Results The addition of gadofosveset to the hepatobiliary phase of Gadoxetic Acid renders vessels isointense to liver tissue at low flip angles due to increased vessel SNR (P < 0.001). The lowest CNR of liver relative to portal vein (CNR = 15; 95% confidence interval [CI]: -14–44) was observed at a 10o flip angle. The highest CNR of liver relative to muscle (CNR = 214; 95% CI: 191–237) was observed at a 20o flip angle. The combined enhancement leads to homogenously enhanced liver tissue and liver vasculature. Cysts were detected in three volunteers and metastases were detected in two patients. In these anecdotal cases the cysts and metastases stood out as conspicuous focal hypointensities on combined Gadoxetic Acid and gadofosveset enhanced images. Conclusion Combined Gadoxetic Acid and gadofosveset enhanced liver MRI is feasible, with low flip angles minimizing contrast between vessels and liver. Further clinical studies are needed to confirm that low flip angles provide an optimal combination of sensitivity and specificity for lesion detection in patients. Magn Reson Med, 2015. © 2015 Wiley Periodicals, Inc.

  • An Investigation of Transient Severe Motion Related to Gadoxetic Acid-enhanced MR Imaging.
    Radiology, 2015
    Co-Authors: Utaroh Motosugi, Peter Bannas, Candice A. Bookwalter, Katsuhiro Sano, Scott B. Reeder
    Abstract:

    Severe motion-related artifacts on arterial phase of Gadoxetic Acid–enhanced liver MR imaging are associated with breath-hold failure but not with subjective feelings of dyspnea or a substantial decrease in blood oxygen saturation.

  • Intraindividual Crossover Comparison of Gadoxetic Acid Dose for Liver MRI in Normal Volunteers
    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine, 2015
    Co-Authors: Utaroh Motosugi, Peter Bannas, Diego Hernando, Salmani Rahimi, James H. Holmes, Scott B. Reeder
    Abstract:

    PURPOSE We performed a quantitative intraindividual comparison of the performance of 0.025- and 0.05-mmol/kg doses for Gadoxetic Acid-enhanced liver magnetic resonance (MR) imaging. MATERIALS AND METHODS Eleven healthy volunteers underwent liver MR imaging twice, once with a 0.025- and once with a 0.05-mmol/kg dose of Gadoxetic Acid. MR spectroscopy and 3-dimensional gradient-echo T1-weighted images (3D-GRE) were obtained before and 3, 10, and 20 min after injection of the contrast medium to measure T1 and T2 values and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) performance. During the dynamic phase, highly time-resolved 3D-GRE was used to estimate the relative CNR (CNRrel) of the hepatic artery and portal vein (PV) to the liver. We used paired t-tests to compare the results of different doses. RESULTS During the hepatobiliary phase, we observed shorter T1 values and higher SNRs of the liver (P < 0.001) and higher liver-to-PV and liver-to-muscle CNRs (P < 0.002) using 0.05 mmol/kg compared to 0.025 mmol/kg. Increasing the dose to 0.05 mmol/kg yielded a greater T1-shortening effect at 10 min delay even compared with 0.025 mmol/kg at 20 min (P < 0.001). During the dynamic phase, the peak CNRrel for the hepatic artery and portal vein were higher using 0.05 mmol/kg (P = 0.007 to 0.035). CONCLUSION Use of Gadoxetic Acid at a dose of 0.05 mmol/kg leads to significantly higher SNR and CNR performance than with 0.025 mmol/kg. Quantitatively, a 10-min delay may be feasible for hepatobiliary-phase imaging when using 0.05 mmol/kg of Gadoxetic Acid.

Hyo Jung Park - One of the best experts on this subject based on the ideXlab platform.

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