title: Hepatobiliary MR contrast agents in hypovascular hepatocellular carcinoma.
abstract: Hepatocellular carcinoma (HCC) develops via multistep hepatocarcinogenesis, during which hypovascular/early HCC precedes the typical hypervascular HCC. The hypovascular HCC lacks the typical hallmark imaging features of HCC, such as late arterial phase enhancement and portal venous washout, limiting early detection using conventional extracellular contrast agents for dynamic magnetic resonance imaging (MRI) or computed tomography (CT) imaging. In recent years, gadolinium-based contrast agents with hepatobiliary uptake have garnered interest from radiologists and hepatologists due to their potential for improved detection of HCC during hepatobiliary phase MRI. Lesions with reduced or absent hepatocyte function appear hypointense in the hepatobiliary phase of gadoxetic acid-enhanced MRI. This behavior can be exploited for earlier detection of hypovascular HCC. This review describes the general characteristics and advantages of gadoxetic acid for the diagnosis of HCC with a particular focus on hypovascular/early HCC.
authors.affiliation: Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA; Department of Radiology, University of Yamanashi, Yamanashi, Japan.
authors.forename: Utaroh
authors.initials: U
authors.lastname: Motosugi
authors.forename: Peter
authors.initials: P
authors.lastname: Bannas
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Sano
authors.forename: Scott B
authors.initials: SB
authors.lastname: Reeder
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: early HCC; gadobenate dimeglumine, hepatocellular carcinoma; gadoxetate disodium; gadoxetic acid; hepatocarcinogenesis; liver MRI