title: Double-dose gadoxetic Acid-enhanced magnetic resonance imaging in patients with chronic liver disease.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: First Department of Radiology, University of Yamanashi, Yamanashi, Japan.
authors.forename: Utaroh
authors.initials: U
authors.lastname: Motosugi
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Sano
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sou
authors.forename: Kojiro
authors.initials: K
authors.lastname: Onohara
authors.forename: Ali
authors.initials: A
authors.lastname: Muhi
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kitamura
authors.forename: Fumitake
authors.initials: F
authors.lastname: Amemiya
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Enomoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Matsuda
authors.forename: Masami
authors.initials: M
authors.lastname: Asakawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Araki
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology; D002908:Chronic Disease; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008107:Liver Diseases / Q000175:diagnosis / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000295:instrumentation* / Q000379:methods; D008297:Male; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA