title: Hepatic hemangiomas: difference in enhancement pattern on 3T MR imaging with gadobenate dimeglumine versus gadoxetate disodium.
abstract: OBJECTIVE
  To compare intraindividual differences in enhancement pattern of hepatic hemangiomas between gadobenate dimeglumine (Gd-BOPTA) and gadoxetate disodium (Gd-EOB-DTPA)-enhanced 3T MR imaging.
  
  
  METHODS
  This is a HIPAA-compliant, IRB-approved retrospective study with waiver for informed consent granted. From 10/07 to 5/09, 10 patients (2 males, 8 females; mean age, 57.3 years) with 15 hepatic hemangiomas (mean diameter, 4.4 ± 5.6 cm) underwent both Gd-BOPTA- and Gd-EOB-DTPA-enhanced 3T MR imaging (mean interval, 266 days; range, 38-462 days). Diagnosis of hemangioma was based on strict imaging criteria. MR imaging was obtained during three arterial, portal venous, and up to four delayed phases. During each phase, hemangioma-to-liver contrast-to-noise ratio (CNR) was measured for each lesion on both examinations. Statistical analysis was performed using paired Student's t-test.
  
  
  RESULTS
  Hemangioma-to-liver CNR peaked during the portal venous phase (Gd-BOPTA: 48.9 ± 65.8, Gd-EOB-DTPA: 0.7 ± 3.8). During all imaging phases except the first arterial phase, hemangioma-to-liver CNR was significantly lower on Gd-EOB-DTPA-enhanced compared to Gd-BOPTA-enhanced MR images (p<0.05). Notably, Gd-EOB-DTPA yielded negative hemangioma-to-liver CNR (-2.5 ± 2.4) compared to Gd-BOPTA (40.7 ± 56.4) during the first delayed phase (7-8 min after contrast administration), remaining negative for the rest of the delayed phases (up to 26 min after contrast administration).
  
  
  CONCLUSIONS
  The enhancement patterns of hepatic hemangiomas differs significantly between Gd-BOPTA and Gd-EOB-DTPA-enhanced 3T MR imaging. The smaller dose, shorter plasma half-life, and increased hepatobiliary uptake of Gd-EOB-DTPA leads to a negative CNR of hemangioma-to-liver on delayed phases and could create an imaging pitfall with this agent.
authors.affiliation: Duke University Medical Center, Department of Radiology, DUMC 3808, Durham, NC 27710, USA. rajan.gupta@duke.edu
authors.forename: Rajan T
authors.initials: RT
authors.lastname: Gupta
authors.forename: Daniele
authors.initials: D
authors.lastname: Marin
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Boll
authors.forename: Daniela B
authors.initials: DB
authors.lastname: Husarik
authors.forename: Drew E
authors.initials: DE
authors.lastname: Davis
authors.forename: Sebastian
authors.initials: S
authors.lastname: Feuerlein
authors.forename: Elmar M
authors.initials: EM
authors.lastname: Merkle
mesh_terms: D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006391:Hemangioma / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C073590:gadolinium ethoxybenzyl DTPA; C064572:gadobenic acid; D008536:Meglumine; D019786:Gadolinium DTPA