Double-dose gadoxetic Acid-enhanced magnetic resonance imaging in patients with chronic liver disease

Invest Radiol. 2011 Feb;46(2):141-5. doi: 10.1097/RLI.0b013e3181f9c487.

Abstract

Objectives: determine the effect of double-dose gadoxetic-acid (Gd-EOB-DTPA) on lesion-liver contrast ratio in arterial- and hepatocyte-phase images and arterial-phase image quality in patients with chronic liver disease.

Materials and methods: the ethics committee at our institute approved this study. This study included 28 patients (13 with Child-Pugh class A and 15 with class B) with 54 hepatocellular carcinomas. All patients received the standard Gd-EOB-DTPA dose (0.025 mmol/kg bodyweight) and double dose (0.050 mmol/kg bodyweight). The lesion-liver contrast ratio was evaluated in arterial- and hepatocyte-phase images. The artifacts in arterial-phase images were evaluated with a 4-point scale. Wilcoxon signed-rank test were used for comparisons.

Results: the hepatocyte-phase lesion-liver contrast ratio after the double dose was significantly higher than that after the standard dose in patients with Child-Pugh class B disease(standard dose vs. double dose; 0.20 ± 0.16 vs. 0.25 ± 0.17; P < 0.0001); however, the ratio after both the standard and double doses was equivalent in patients with Child-Pugh class A disease (0.35 ± 0.18 vs. 0.35 ± 0.14; P = 0.3038). The double dose significantly increased the arterial-phase lesion-liver contrast ratio (0.34 ± 0.19 vs. 0.58 ± 0.33; P < 0.0001). The artifacts in the arterial-phase images were more prominent after the standard dose (2.7 vs. 2.4 for reader 1, 2.8 vs. 2.4 for reader 2; P = 0.0195 and 0.0010).

Conclusions: administration of double dose of Gd-EOB-DTPA provided better arterial enhancement of hepatocellular carcinomas in patients with chronic liver disease, and also improved the lesion-liver contrast in hepatocyte-phase images in patients with Child-Pugh class B disease.

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / diagnosis*
  • Carcinoma, Hepatocellular / pathology
  • Chronic Disease
  • Contrast Media* / administration & dosage
  • Female
  • Gadolinium DTPA* / administration & dosage
  • Humans
  • Image Processing, Computer-Assisted
  • Liver Diseases / diagnosis
  • Liver Diseases / pathology
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / pathology
  • Magnetic Resonance Imaging / instrumentation*
  • Magnetic Resonance Imaging / methods
  • Male
  • Statistics as Topic
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed

Substances

  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA