Pictured left to right: A Furlan, A Borhani
Cannella R, Brancatelli G, Rangaswamy B, Minervini MI, Borhani AA, Furlan A. Enhancement pattern of hepatocellular adenoma (HCA) on MR imaging performed with Gd-EOB-DTPA versus other Gd-based contrast agents (GBCAs): An intraindividual comparison. Eur J Radiol. 2019 Aug 6;119:108633. doi: 10.1016/j.ejrad.2019.08.002. PubMed PMID: 31437747.
ABSTRACT
PURPOSE: To conduct an intraindividual comparison of the enhancement pattern of hepatocellular adenoma (HCA) on dynamic MRI study obtained following the injection of Gadoxetic acid (Gd-EOB-DTPA) and other gadolinium-based contrast agents (GBCAs).
METHOD: This is a retrospective, Institutional Review Board-approved study conducted in a single institution. A search of medical records between 2008 and 2017 revealed 17 patients (all females) with at least one pathologically-proven HCA who underwent liver MRI with Gd-EOB-DTPA and another GBCA within 1€¯year. Enhancement of each lesion on hepatic arterial (HAP), portal venous (PVP), 2€¯min and 4-5€¯minutes phases was subjectively evaluated by two abdominal radiologists. Lesions were categorized as hyper-, iso- or hypointense compared to the surrounding liver parenchyma. The presence of a peripheral pseudocapsule was also recorded. The differences in lesion enhancement were assessed using the McNemar Test. A p-value <0.05 was considered statistically significant.
RESULTS: The final population included 35 HCAs (83% inflammatory subtype). There was no significant difference in lesion size (P€¯=€¯0.708) and enhancement on HAP (P€¯=€¯0.625) or PVP (P€¯=€¯0.125). HCAs showed more frequently hypointensity on 2€¯min (13/35 vs. 1/35, P€¯<€¯0.001) and 4-5€¯minutes (P€¯<€¯0.001) images obtained after injection of Gd-EOB-DTPA compared to those obtained after other GBCAs. A pseudocapsule was more frequently noted after administration of Gd-EOB-DTPA (13/35 vs 1/35, P€¯=€¯0.002).
CONCLUSIONS: Enhancement pattern of HCA differs significantly after the injection of Gd-EOB-DTPA compared to other GBCAs. Lesion hypointensity on 2€¯min and 4-5€¯minutes images is more frequent when using Gd-EOB-DTPA.
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