title: Gadoxetate disodium in patients with primary sclerosing cholangitis: an analysis of hepatobiliary contrast excretion.
abstract: OBJECTIVE
  To assess hepatobiliary excretion of gadoxetate disodium in patients with primary sclerosing cholangitis (PSC) over time and to determine a possible correlation with severity of the disease.
  
  
  METHODS
  A total of 111 patients (36 females, 75 males, mean age 41.5 yr) with confirmed diagnosis of PSC who underwent gadoxetate disodium enhanced hepatic MRI were included in this retrospective institutional review board-approved study. Hepatocyte phase images (10-493 min post injection [p.i.]) were evaluated by one radiologist for the presence of contrast agent in the intrahepatic bile ducts (IBD), common bile duct (CBD), gallbladder (GB), and duodenum. In 54 patients, in whom hepatocyte phase scans were acquired within 10-20 min p.i., hepatobiliary excretion was compared with data collected in a previous study from patients without liver disease (controls; Mann-Whitney U-test). Excretion was further correlated with liver function tests (Kruskal-Wallis test).
  
  
  RESULTS
  Compared with controls, excretion was significantly delayed in patients with PSC: 20 min p.i. gadoxetate disodium could be detected in the IBD in 55.6% (controls:100%), CBD 53.7% (controls:100%), GB 39.6% (controls:87%), duodenum 13% (controls:66%), respectively. Contrast appearance in different bile duct sections increased over time and correlated significantly with serum bilirubin and AP levels (P < 0.05).
  
  
  CONCLUSIONS
  Hepatobiliary excretion of gadoxetate disodium in PSC patients is significantly delayed. Excretion correlates with bilirubin levels, and thus indirectly with severity of disease.
authors.affiliation: Hannover Medical School, Department of Diagnostic and Interventional Radiology, Hannover, Germany.
authors.forename: Kristina I
authors.initials: KI
authors.lastname: Ringe
authors.forename: Jan
authors.initials: J
authors.lastname: Hinrichs
authors.forename: Elmar M
authors.initials: EM
authors.lastname: Merkle
authors.forename: Tobias J
authors.initials: TJ
authors.lastname: Weismüller
authors.forename: Frank
authors.initials: F
authors.lastname: Wacker
authors.forename: Bernhard C
authors.initials: BC
authors.lastname: Meyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015209:Cholangitis, Sclerosing / Q000378:metabolism* / Q000473:pathology*; D003287:Contrast Media / Q000493:pharmacokinetics; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics*; D065669:Hepatobiliary Elimination; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Gd‐EOB‐DTPA; PSC; gadoxetate disodium