title: Enhancement characteristics of liver metastases, hepatocellular carcinomas, and hemangiomas with Gd-EOB-DTPA: preliminary results with dynamic MR imaging.
abstract: Our objective was to study Gd-EOB-DTPA for the characterization of focal liver lesions by means of dynamic MR imaging. A double-blind and randomized dose-ranging phase-2 clinical trial was performed in 31 patients (liver metastases n = 23, hepatocellular carcinoma n = 4, and hemangioma n = 4) at a field strength of 1.0 Tesla. Gd-EOB-DTPA (Schering AG, Berlin, Germany) was administered as an IV bolus (12.5, 25, or 50 micromol/kg body weight) with dynamic T1-weighted MRI during the distribution and cellular uptake of the contrast agent at multiple time points up to 45 min post contrast. Dynamic changes in tumor signal intensity, tumor-liver contrast, enhancement patterns, side effects, and adverse events were evaluated. Monitoring of vital signs revealed no significant changes during bolus injection of Gd-EOB-DTPA. Liver metastases demonstrated an inhomogeneous uptake of Gd-EOB-DTPA during the distribution phase with a washout effect on delayed images > 3 min and highest tumor-liver contrast 20 and 45 min post contrast. Hepatocellular carcinomas showed prolonged enhancement as compared with metastases and hemangiomas. Hemangiomas exhibited an early peripheral-nodular enhancement with subsequent partial or complete filling, persisting enhancement < 10 min following injection of Gd-EOB-DTPA, and delayed washout as compared with liver metastases. Initial clinical experience suggests that Gd-EOB-DTPA as a bolus injectable hepatobiliary MR contrast agent may offer useful features for the characterization of focal liver lesions.
authors.affiliation: Institute of Clinical Radiology, Westfalian Wilhelms University Münster, Albert-Schweitzer Strasse 33, D-48129 Münster, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Reimer
authors.forename: E J
authors.initials: EJ
authors.lastname: Rummeny
authors.forename: H E
authors.initials: HE
authors.lastname: Daldrup
authors.forename: T
authors.initials: T
authors.lastname: Hesse
authors.forename: T
authors.initials: T
authors.lastname: Balzer
authors.forename: B
authors.initials: B
authors.lastname: Tombach
authors.forename: P E
authors.initials: PE
authors.lastname: Peters
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage; D019786:Gadolinium DTPA; D006391:Hemangioma / Q000175:diagnosis*; D006801:Humans; D007275:Injections, Intravenous; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage; D004369:Pentetic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C073590:gadolinium ethoxybenzyl DTPA; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA