Comparison of enhancement patterns of histologically confirmed hepatocellular carcinoma between gadoxetate- and ferucarbotran-enhanced magnetic resonance imaging.
OBJECTIVE
To compare enhancenent patterns of hepatocellular carcinoma (HCC) and dysplastic nodule (DN) between gadoxetate- and ferucarbotran-enhanced MRI.


METHODS
Patients recruited from ultrasound surveillance for HCC in chronic liver diseases were enrolled in this prospective study approved by institutional review board. Thirty-six patients with 37 histologically proven HCC, including 22 well-differentiated HCCs (wHCC), 15 moderately to poorly differentiated HCCs (mpHCCs), and 4 DNs, underwent gadoxetate-enhanced and ferucarbotran-enhanced MRI. We compared hepatobiliary phase image of gadoxetate-enhanced MRI with ferucarbotran-enhanced MR image regarding signal intensity of HCC and DN relative to surrounding liver parenchyma. We calculated contrast ratios between tumor and liver on pre-enhancement, hepatobiliary phase of gadoxetate-enhanced MRI and ferucarbotran-enhanced MRI.


RESULTS
On ferucarbotran-enhanced MRI, all mpHCCs showed hyper-intensity, while 14 wHCCs (14/22;63%) showed iso-intensity. On hepatobiliary phase of gadoxetate-enhanced MRI, 13 mpHCCs (13/15;86%) and 20 wHCCs (20/22;91%) showed hypo-intensity. Two DNs and the other two showed iso- and hypo-intensity, respectively, on gadoxetate-enhanced MRI, whereas all DNs revealed iso-intensity on ferucarbotran-enhanced MRI. Gadoxetate-postcontrast ratio was significantly lower than ferucarbotran-postcontrast ratio in wHCC (P = 0.015).


CONCLUSIONS
The uptake function of hepatocytes that are targeted by gadoxetate is more sensitive than that of Kupffer cells targeted by ferucarbotran in stepwise hepatocarcinogenesis.
Okada
Masahiro
M
Department of Radiology, Kinki University School of Medicine, Osaka, Japan.
Imai
Yasuharu
Y
Kim
Tonsok
T
Kogita
Sachiyo
S
Takamura
Manabu
M
Kumano
Seishi
S
Onishi
Hiromitsu
H
Hori
Masatoshi
M
Fukuda
Kazuto
K
Hayashi
Norio
N
Wakasa
Kenichi
K
Sakamoto
Michiie
M
Murakami
Takamichi
T
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology*; D002454:Cell Differentiation; D003287:Contrast Media / Q000494:pharmacology*; D003911:Dextrans / Q000494:pharmacology*; D005260:Female; D019786:Gadolinium DTPA / Q000494:pharmacology*; D006801:Humans; D007728:Kupffer Cells / Q000473:pathology*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; C073590:gadolinium ethoxybenzyl DTPA; C065507:ferumoxides; D019786:Gadolinium DTPA