title: Hepatic gadoxetic acid uptake as a measure of diffuse liver disease: Where are we?
abstract: MRI has emerged as the most comprehensive noninvasive diagnostic tool for focal liver lesions and diffuse hepatobiliary disorders. The introduction of hepatobiliary contrast agents, most notably gadoxetic acid (GA), has expanded the role of MRI, particularly in the functional imaging of chronic liver diseases, such as nonalcoholic fatty liver disease (NAFLD). GA-enhanced MRI (GA-MRI) may help to distinguish between the two subgroups of NAFLD, simple steatosis and nonalcoholic steatohepatitis. Furthermore, GA-MRI can be used to stage fibrosis and cirrhosis, predict liver transplant graft survival, and preoperatively estimate the risk of liver failure should major resection be undertaken. The amount of GA uptake can be estimated, using static images, by the relative liver enhancement, hepatic uptake index, and relaxometry of T1-mapping during the hepatobiliary phase. On the contrary, the hepatic extraction fraction and liver perfusion can be measured on dynamic imaging. Importantly, there is currently no clear consensus as to which of these MR-derived parameters is the most suitable for assessing liver dysfunction. This review article aims to describe the current role of GA-enhanced MRI in quantifying liver function, primarily in diffuse hepatobiliary disorders.
  
  
  
  3 J. Magn. Reson. Imaging 2017;45:646-659.
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Austria.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ba-Ssalamah
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, General Hospital of Vienna (AKH), Austria.
authors.forename: Nina
authors.initials: N
authors.lastname: Bastati
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Wibmer
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Austria.
authors.forename: Romana
authors.initials: R
authors.lastname: Fragner
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Austria.
authors.forename: Jacqueline C
authors.initials: JC
authors.lastname: Hodge
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, General Hospital of Vienna (AKH), Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Trauner
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Austria.
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Herold
authors.affiliation: Department of Radiology and Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, North Carolina, USA.|Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Mustafa R
authors.initials: MR
authors.lastname: Bashir
authors.affiliation: Laboratory of Imaging Biomarkers, UMR 1149, INSERM - University Paris Diderot and Department of Radiology, University Hospital Paris Nord - Beaujon, France.
authors.forename: Bernard E
authors.initials: BE
authors.lastname: Van Beers
mesh_terms: D003198:Computer Simulation; D003287:Contrast Media / Q000493:pharmacokinetics; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D019317:Evidence-Based Medicine; D019786:Gadolinium DTPA / Q000493:pharmacokinetics*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008099:Liver / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000473:pathology; D008111:Liver Function Tests; D008657:Metabolic Clearance Rate; D008954:Models, Biological; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014018:Tissue Distribution
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: MRI; chronic liver diseaes; functional imaging; gadoxetic acid; liver failure; liver transplant graft survival