title: P4 radiology of hepatobiliary diseases with gadoxetic acid-enhanced MRI as a biomarker.
abstract: A recent paradigm shift in radiology has focused on the globalization of so-called P4 radiology. P4 radiology represents delivery of imaging results that are predictive, personalized, pre-emptive and participatory. The combination of the P4 approach and biomarkers is particularly pertinent to MRI, especially with technological advances such as diffusion-weighted imaging. The development of new liver-specific MRI contrast media, particularly gadoxetic acid, demonstrate specific pharmacokinetic properties, which provide combined morphologic and functional information in the same setting. The evaluation of hepatobiliary pathology beyond morphology gives rise to the possibilty of using gadoxetic acid-enhanced MRI as an imaging biomarker of hepatobiliary diseases. The integration of functional imaging with an understanding of complex disease mechanisms forms the basis for P4 radiology, which may ultimately lead to individualized, cost-effective, targeted therapy for patients. This will enable radiologists to determine the prognosis of the disease and estimate early response to treatment, with the participation of all the required medical disciplines.
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, The General Hospital of the Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ba-Ssalamah
authors.forename: Aliya
authors.initials: A
authors.lastname: Qayyum
authors.forename: Nina
authors.initials: N
authors.lastname: Bastati
authors.forename: Negar
authors.initials: N
authors.lastname: Fakhrai
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Herold
authors.forename: Filipe
authors.initials: F
authors.lastname: Caseiro Alves
mesh_terms: D001660:Biliary Tract Diseases / Q000175:diagnosis* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D003952:Diagnostic Imaging / Q000379:methods; D019786:Gadolinium DTPA / Q000378:metabolism*; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods*; D057285:Precision Medicine / Q000379:methods; D011871:Radiology / Q000379:methods
chemical_list: D015415:Biomarkers; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA