Abstract
Objectives
To develop and evaluate a procedure for quantifying the hepatocyte-specific uptake of Gd-BOPTA and Gd-EOB-DTPA using dynamic contrast-enhanced (DCE) MRI.
Methods
Ten healthy volunteers were prospectively recruited and 21 patients with suspected hepatobiliary disease were retrospectively evaluated. All subjects were examined with DCE-MRI using 0.025 mmol/kg of Gd-EOB-DTPA. The healthy volunteers underwent an additional examination using 0.05 mmol/kg of Gd-BOPTA. The signal intensities (SI) of liver and spleen parenchyma were obtained from unenhanced and enhanced acquisitions. Using pharmacokinetic models of the liver and spleen, and an SI rescaling procedure, a hepatic uptake rate, K Hep, estimate was derived. The K Hep values for Gd-EOB-DTPA were then studied in relation to those for Gd-BOPTA and to a clinical classification of the patient’s hepatobiliary dysfunction.
Results
K Hep estimated using Gd-EOB-DTPA showed a significant Pearson correlation with K Hep estimated using Gd-BOPTA (r = 0.64; P < 0.05) in healthy subjects. Patients with impaired hepatobiliary function had significantly lower K Hep than patients with normal hepatobiliary function (K Hep = 0.09 ± 0.05 min-1 versus K Hep = 0.24 ± 0.10 min−1; P < 0.01).
Conclusions
A new procedure for quantifying the hepatocyte-specific uptake of T 1-enhancing contrast agent was demonstrated and used to show that impaired hepatobiliary function severely influences the hepatic uptake of Gd-EOB-DTPA.
Key Points
• The liver uptake of contrast agents may be measured with standard clinical MRI.
• Calculation of liver contrast agent uptake is improved by considering splenic uptake.
• Liver function affects the uptake of the liver-specific contrast agent Gd-EOB-DTPA.
• Hepatic uptake of two contrast agents (Gd-EOB-DTPA, Gd-BOPTA) is correlated in healthy individuals.
• This method can be useful for determining liver function, e.g. before hepatic surgery
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References
Tsuda N, Okada M, Murakami T (2010) New proposal for the staging of nonalcoholic steatohepatitis: evaluation of liver fibrosis on Gd-EOB-DTPA-enhanced MRI. Eur J Radiol 73:137–142
Planchamp C, Pastor CM, Balant L, Becker CD, Terrier F, Gex-Fabry M (2005) Quantification of Gd-BOPTA uptake and biliary excretion from dynamic magnetic resonance imaging in rat livers: model validation with 153Gd-BOPTA. Invest Radiol 40(11):705–714
Spinazzi A, Lorusso V, Pirovano G, Kirchin M (1999) Safety, tolerance, biodistribution, and MR imaging enhancement of the liver with gadobenate dimeglumine: results of clinical pharmacologic and pilot imaging studies in nonpatient and patient volunteers. Acad Radiol 6(5):282–291
Tsuda N, Okada M, Murakami T (2007) Potential of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for differential diagnosis of nonalcoholic steatohepatitis and fatty liver in rats using magnetic resonance imaging. Invest Radiol 42(4):242–247. doi:10.1097/01.rli.0000258058.44876.a5
Planchamp C, Gex-Fabry M, Becker CD, Pastor CM (2007) Model-based analysis of Gd-BOPTA-induced MR signal intensity changes in cirrhotic rat livers. Invest Radiol 42(7):513–521. doi:10.1097/RLI.0b013e318036b450
Motosugi U, Ichikawa T, Sou H et al (2009) Liver parenchymal enhancement of hepatocyte-phase images in Gd-EOB-DTPA-enhanced MR imaging: which biological markers of the liver function affect the enhancement? J Magn Reson Imaging 30(5):1042–1046. doi:10.1002/jmri.21956
Motosugi U, Ichikawa T, Tominaga L et al (2009) Delay before the hepatocyte phase of Gd-EOB-DTPA-enhanced MR imaging: is it possible to shorten the examination time? Eur Radiol 19(11):2623–2629. doi:10.1007/s00330-009-1467-6
Yamada A, Hara T, Li F et al (2011) Quantitative Evaluation of Liver Function with Use of Gadoxetate Disodium-enhanced MR Imaging. Radiology. doi:10.1148/radiol.11100586
Jackson A (2004) Analysis of dynamic contrast enhanced MRI. Br J Radiol 77(Spec No 2):S154–166
Treier R, Steingoetter A, Fried M, Schwizer W, Boesiger P (2007) Optimized and combined T1 and B1 mapping technique for fast and accurate T1 quantification in contrast-enhanced abdominal MRI. Magn Reson Med 57(3):568–576. doi:10.1002/mrm.21177
Huang W, Wang Y, Panicek DM, Schwartz LH, Koutcher JA (2009) Feasibility of using limited-population-based average R10 for pharmacokinetic modeling of osteosarcoma dynamic contrast-enhanced magnetic resonance imaging data. Magn Reson Imaging 27(6):852–858. doi:10.1016/j.mri.2009.01.020
Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R (1973) Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 60(8):646–649
Kamath PS, Wiesner RH, Malinchoc M et al (2001) A model to predict survival in patients with end-stage liver disease. Hepatology 33(2):464–470
de Bazelaire CM, Duhamel GD, Rofsky NM, Alsop DC (2004) MR imaging relaxation times of abdominal and pelvic tissues measured in vivo at 3.0 T: preliminary results. Radiology 230(3):652–659. doi:10.1148/radiol.2303021331
Ernst RR, Anderson WA (1966) Application of fourier transform spectroscopy to magnetic resonance. Review of Scientific Instruments 37(1):93–102
Pintaske J, Martirosian P, Graf H et al (2006) Relaxivity of Gadopentetate Dimeglumine (Magnevist), Gadobutrol (Gadovist), and Gadobenate Dimeglumine (MultiHance) in human blood plasma at 0.2, 1.5, and 3 Tesla. Invest Radiol 41(3):213–221. doi:10.1097/01.rli.0000197668.44926.f7
Levitt DG (2003) The pharmacokinetics of the interstitial space in humans. BMC Clin Pharmacol 3:3. doi:10.1186/1472-6904-3-3
Stricker D (2008) BrightStat.com: free statistics online. Comput Methods Programs Biomed 92(1):135–143. doi:10.1016/j.cmpb.2008.06.010
Thomsen C, Christoffersen P, Henriksen O, Juhl E (1990) Prolonged T1 in patients with liver cirrhosis: an in vivo MRI study. Magn Reson Imaging 8(5):599–604
Van Lom KJ, Brown JJ, Perman WH, Sandstrom JC, Lee JK (1991) Liver imaging at 1.5 tesla: pulse sequence optimization based on improved measurement of tissue relaxation times. Magn Reson Imaging 9(2):165–171
Warntjes JB, Leinhard OD, West J, Lundberg P (2008) Rapid magnetic resonance quantification on the brain: optimization for clinical usage. Magn Reson Med 60(2):320–329. doi:10.1002/mrm.21635
Hamm B, Staks T, Muhler A et al (1995) Phase I clinical evaluation of Gd-EOB-DTPA as a hepatobiliary MR contrast agent: safety, pharmacokinetics, and MR imaging. Radiology 195(3):785–792
Tajima T, Takao H, Akai H et al (2010) Relationship between liver function and liver signal intensity in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging. J Comput Assist Tomogr 34(3):362–366. doi:10.1097/RCT.0b013e3181cd330400004728-201005000-00007
Lee MS, Lee JY, Kim SH et al (2011) Gadoxetic acid disodium-enhanced magnetic resonance imaging for biliary and vascular evaluations in preoperative living liver donors: comparison with gadobenate dimeglumine-enhanced MRI. J Magn Reson Imaging 33(1):149–159. doi:10.1002/jmri.22429
Acknowledgements
Financial support from the Swedish research council (VR/M 2007–2884), the Medical Research Council of Southeast Sweden (FORSS 12621), and the Linköping University Hospital Research Foundations are gratefully acknowledged. We thank research nurse Annika Hall at the Center for Medical Image Science and Visualization (CMIV) for assistance with volunteer data collection.
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Dahlqvist Leinhard, O., Dahlström, N., Kihlberg, J. et al. Quantifying differences in hepatic uptake of the liver specific contrast agents Gd-EOB-DTPA and Gd-BOPTA: a pilot study. Eur Radiol 22, 642–653 (2012). https://doi.org/10.1007/s00330-011-2302-4
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DOI: https://doi.org/10.1007/s00330-011-2302-4