Gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging simultaneously provides both morphological and functional information by the acquisition of dynamic and hepatobiliary-phase imaging. Focal lesions with no functioning hepatocytes, where hepatobiliary metabolism is blocked or inhibited, are generally unable to uptake and excrete gadobenate dimeglumine into the bile. Such lesions are typically malignant and usually appear hypointense as compared to the normal liver parenchyma as seen on hepatobiliary-phase imaging. However, various benign hepatic lesions may also be hypointense due to (a) the presence of no functioning hepatocytes, (b) damage to the functioning hepatocytes or (c) impairment of biliary function as depicted on hepatobiliary-phase imaging. All of these imaging features may result in recognition of the benign hepatic lesions as hepatic malignancies. As depicted on three-hour delayed hepatobiliary-phase imaging, peripheral iso/hyperintensity due to fibrotic tissue compared to the hypointense center with a fuzzy margin may be a clue for the presence of a benign hepatic lesion. In contrast, peripheral hypointensity due to rich tumoral cellularity compared to the center with a clear margin may favor an indication of the presence of a malignant hepatic lesion.
Adult ; Aged ; Contrast Media/*diagnostic use ; Diagnosis, Differential ; Female ; Humans ; Image Enhancement/methods ; Liver/pathology ; Liver Diseases/diagnosis/pathology ; Liver Neoplasms/*diagnosis/*pathology ; Magnetic Resonance Imaging/*methods ; Male ; Meglumine/*analogs & derivatives/diagnostic use ; Middle Aged ; Organometallic Compounds/*diagnostic use ; Time

OBJECTIVE: To investigate the efficacy of gadobenate dimeglumine (Gd-BOPTA) enhanced MR imaging for the detection of liver lesions in patients with primary malignant hepatic neoplasms. MATERIALS AND METHODS: Thirty-one patients with histologically proven primary malignancy of the liver were evaluated before and after administration of Gd-BOPTA at dose 0.05 or 0.10 mmol/kg. T1-weighted spin echo (T1W-SE) and gradient echo (T1W-GRE) images were evaluated for lesion number, location, size and confidence by three off-site independent reviewers and the findings were compared to reference standard imaging (intraoperative ultrasound, computed tomography during arterial portography or lipiodol computed tomography). Results were analyzed for significance using a two-sided McNemar's test. RESULTS: More lesions were identified on Gd-BOPTA enhanced images than on unenhanced images and there was no significant difference in lesion detection between either concentration. The largest benefit was in detection of lesions under 1 cm in size (7 to 21, 9 to 15, 16 to 18 for reviewers A, B, C respectively). In 68% of the patients with more than one lesion, Gd-BOPTA increased the number of lesions detected. CONCLUSION: Liver MR imaging after Gd-BOPTA increases the detection of liver lesions in patients with primary malignant hepatic neoplasm.
Adenoma, Liver Cell/*diagnosis ; Adult ; Aged ; *Contrast Media ; Female ; Human ; Image Enhancement ; Liver Neoplasms/*diagnosis ; Magnetic Resonance Imaging/*methods ; Male ; Meglumine/*analogs & derivatives/*diagnostic use ; Middle Age ; Organometallic Compounds/*diagnostic use

The role of imaging is crucial for the surveillance, diagnosis, staging and treatment monitoring of hepatocellular carcinoma (HCC). Over the past few years, considerable technical advances were made in imaging of HCCs. New imaging technology, however, has introduced new challenges in our clinical practice. In this article, the current status of clinical imaging techniques for HCC is addressed. The diagnostic performance of imaging techniques in the context of recent clinical guidelines is also presented.
Carcinoma, Hepatocellular/*diagnosis/radiography/ultrasonography ; Contrast Media/chemistry ; Ferric Compounds/chemistry ; Humans ; Iron/chemistry ; Liver Neoplasms/*diagnosis/radiography/ultrasonography ; Magnetic Resonance Imaging ; Meglumine/analogs & derivatives/chemistry ; Organometallic Compounds/chemistry ; Oxides/chemistry ; Tomography, X-Ray Computed

Hepatocyte specific contrast agents including gadoxetic acid and gadobenate dimeglumine are very useful to diagnose various benign and malignant focal hepatic lesions and even helpful to estimate hepatic functional reservoir. The far delayed phase image referred to as the hepatobiliary phase makes the sensitivity of detection for malignant focal hepatic lesions increased, but specificity of malignant diseases, including hepatocellular carcinoma, metastasis and cholangiocarcinoma, characterization remained to be undetermined.
Carcinoma, Hepatocellular/radiography ; Cholangiocarcinoma/radiography ; Contrast Media/chemistry/*diagnostic use ; Hemangioma/radiography ; Humans ; Liver Diseases/*radiography ; Liver Neoplasms/radiography ; Magnetic Resonance Imaging ; Meglumine/*analogs & derivatives/chemistry/diagnostic use ; Organometallic Compounds/chemistry/*diagnostic use

OBJECTIVE: This study was designed to determine the optimal mixture ratio of gadolinium and iodinated contrast agent for simultaneous direct MR arthrography and CT arthrography. MATERIALS AND METHODS: An in vitro study was performed utilizing mixtures of gadolinium at six different concentrations (0.625, 1.25, 2.5, 5.0, 10 and 20 mmol/L) and iodinated contrast agent at seven different concentrations (0, 12.5, 25, 37.5, 50, 75 and 92-99.9%). These mixtures were placed in tissue culture plates, and were then imaged with CT and MR (with T1-weighted sequences, proton-density sequences and T2-weighted sequences). CT numbers and signal intensities were measured. Pearson's correlation coefficients were used to assess the correlations between the gadolinium/iodinated contrast agent mixtures and the CT numbers/MR signal intensities. Scatter diagrams were plotted for all gadolinium/iodinated contrast agent combinations and two radiologists in consensus identified the mixtures that yielded the optimal CT numbers and MR signal intensities. RESULTS: The CT numbers showed significant correlation with iodinated contrast concentrations (r = 0.976, p < 0.001), whereas the signal intensities as measured on MR images showed a significant correlation with both gadolinium and iodinated contrast agent concentrations (r = -484 to -0.719, p < 0.001). A review of the CT and MR images, graphs, and scatter diagram of 42 combinations of the contrast agent showed that a concentration of 1.25 mmol/L gadolinium and 25% iodinated contrast agent was the best combination for simultaneous CT and MR imaging. CONCLUSION: A mixture of 1.25 mmol/L gadolinium and 25% iodinated contrast agent was found to be optimal for simultaneous direct MR arthrography and CT arthrography.
*Arthrography ; Contrast Media/*administration & dosage ; Gadolinium/administration & dosage/*diagnostic use ; Iohexol/administration & dosage/*analogs & derivatives/diagnostic use ; *Magnetic Resonance Imaging ; Meglumine/administration & dosage/*diagnostic use ; Organometallic Compounds/administration & dosage/*diagnostic use ; Phantoms, Imaging ; *Tomography, X-Ray Computed

OBJECTIVETo compare gadobenate dimeglumine (Gd-BOPTA) and gadopentetate dimeglumine (Gd-DTPA) for their efficacy as contrast agents in contrast-enhanced magnetic resonance imaging (MRI) for diagnosis of solitary brain metastases (SBM).

METHODSWe conducted an intra-individual study of contrast-enhanced T1-weighted MRI (T(1)WI) data from 27 Chinese patients with suspected SBM to compare the enhancement findings of two different MRI contrast agents, Gd-BOPTA and Gd-DTPA (at equivalent doses of 0.1 mmol/kg), for the detection of SBM. All the patients underwent two identical MRI examinations on a 3.0-T MRI scanner first with Gd-DTPA and then with Gd-BOPTA. Evaluation of the contrast enhancement was performed qualitatively (border delineation, extent, internal morphology, and contrast enhancement) and quantitatively (lesion-to-brain ratio, contrast-to-noise ratio, and percent enhancement) by 3 independent, fully blinded, and highly experienced neuroradiologists.

RESULTSQualitative assessment by readers revealed a significant overall preference (P<0.05) for Gd-BOPTA over Gd-DOTA in terms of lesion border delineation, extent, lesion internal morphology, and contrast enhancement. Quantitative assessment also revealed a significant better performance of Gd-BOPTA in light of lesion-to-brain ratio (P<0.05), contrast-to-noise ratio (P<0.05), and percent enhancement (P<0.05).

CONCLUSIONAt an equivalent dose, Gd-BOPTA allows better contrast enhancement of SBM than Gd-DTPA in MRI.

Adult ; Aged ; Brain Neoplasms ; diagnosis ; pathology ; secondary ; Breast Neoplasms ; pathology ; Contrast Media ; Female ; Gadolinium DTPA ; Humans ; Image Enhancement ; methods ; Lung Neoplasms ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Meglumine ; analogs & derivatives ; Middle Aged ; Organometallic Compounds

OBJECTIVETo evaluate the safety, tolerance and efficacy of Gd-BOPTA and Gd-DTPA in contrast-enhanced MR imaging of the liver.

METHODSForty-two patients having been suspected of suffering from primary liver tumor or hepatic metastasis by ultrasonography (US) or CT received Gd-BOPTA or Gd-DTPA in contrast-enhanced MRI examination pre- and post-contrast MRI. T(1)- and T(2)-weighted spin-echo, and T(1)-weighted gradient-echo images were acquired before injection. Dynamic T(1)-weighted gradient-echo images were obtained at 15 - 45 s, 1 - 2, 2 - 3, 4 - 5 and 8 min, respectively, after intravenous injection of Gd-BOPTA or Gd-DTPA at the same dose of 0.1 mmol/kg, and delayed T(1)-weighted spin-echo and gradient-echo images were acquired at 40 - 120 minutes after injection. All the images were assessed in three matched pairs including pre-contrast images vs. early post-contrast images; pre-contrast images vs. delayed post-contrast images; and pre-contrast images vs. early and delayed post-contrast images. The assessment was made in terms of 4 aspects including improved conspicuousness and/or delineation of liver lesions, improved confidence in lesion detection or exclusion, improved assessment of lesion internal morphology, and improved confidence in lesion characterization. The results of assessments were statistically compared inside every group or between two groups, and the radiological utility of contrast enhancement was also evaluated at the end of the study.

RESULTS1. There were significant differences between pre-contrast images vs. early post-contrast images and pre-contrast images vs. delayed post-contrast images inside the Gd-DTPA group, and the early post-contrast images were superior to delayed images. 2. There were significant differences between the two groups in terms of pre-contrast images vs. delayed post-contrast images, and Gd-BOPTA was superior to Gd-DTPA. 3. The quality of post-contrast images were improved obviously with a rate of 72.7% for Gd-BOPTA and 70.0% for Gd-DTPA, respectively, but without significant difference.

CONCLUSIONThe early post-contrast phase of Gd-DTPA-enhanced MR imaging is superior to delayed phase. The effects of Gd-BOPTA and Gd-DTPA in early post-contrast imaging are comparable, but Gd-BOPTA is significantly superior to Gd-DTPA in delayed post-contrast imaging.

Adult ; Aged ; Carcinoma, Hepatocellular ; diagnosis ; pathology ; Contrast Media ; Double-Blind Method ; Female ; Gadolinium DTPA ; Humans ; Liver Neoplasms ; diagnosis ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Meglumine ; analogs & derivatives ; Middle Aged ; Organometallic Compounds

OBJECTIVE: To compare the efficacy of Mangafodipir trisodium (Mn-DPDP) -enhanced MR cholangiogrphy (MRC) and Gadobenate dimeglumine (Gd-BOPTA) -enhanced MRC in visualizing a non-dilated biliary system. MATERIALS AND METHODS: Eighty-eight healthy liver donor candidates underwent contrast-enhanced T1-weighted MRC. Mn-DPDP and Gd-BOPTA was used in 36 and 52 patients, respectively. Two radiologists reviewed the MR images and rated the visualization of the common duct, the right and left hepatic ducts, and the second-order branches using a 4-point scale. The contrast-to-noise ratio (CNR) of the common duct to the liver in the two groups was also compared. RESULTS: Mn-DPDP MRC and Gd-BOPTA MRC both showed similar visualization grades in the common duct (p = .380, Mann-Whitney U test). In the case of the proximal bile ducts, the median visualization grade was significantly higher with Gd-BOPTA MRC than with Mn-DPDP MRC (right hepatic duct: p = 0.016, left hepatic duct: p = 0.014, right secondary order branches: p = 0.006, left secondary order branches, p = 0.003). The common duct-to-liver CNR of the Gd-BOPTA MRC group was significantly higher (38.90+/-24.50) than that of the Mn-DPDP MRC group (24.14+/-17.98) (p = .003, Student's t test). CONCLUSION: Gd-BOPTA, as a biliary contrast agent, is a potential substitute for Mn-DPDP.
Pyridoxal Phosphate/*analogs & derivatives/diagnostic use ; Organometallic Compounds/*diagnostic use ; Middle Aged ; Meglumine/*analogs & derivatives/diagnostic use ; Male ; *Magnetic Resonance Imaging ; Humans ; Hepatic Duct, Common/anatomy & histology ; Female ; Feasibility Studies ; Edetic Acid/*analogs & derivatives/diagnostic use ; *Contrast Media ; Common Bile Duct/anatomy & histology ; Bile Ducts/*anatomy & histology ; Aged ; Adult

OBJECTIVE: This study was designed to compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with gadobenate dimeglumine-enhanced MRI for preoperatively detecting hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Eighteen consecutive patients (17 men and one woman, age range: 31-73 years) with 22 HCCs underwent examinations with gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI on a 3.0-Tesla unit. The diagnosis of HCC was established after surgical resection and pathological conformation. Three observers independently reviewed each MR image in a random order on a tumor-by-tumor basis. The diagnostic accuracy of these techniques for the detection of HCC was assessed by performing an alternative free-response receiver operating characteristic (ROC) analysis. The sensitivity and positive predictive values were evaluated. RESULTS: The average value of the area under the ROC curve (Az) for gadoxetic acid enhanced MRI (0.887) was not significantly different from the Az (0.899) for gadobenate dimeglumine-enhanced MRI (p > 0.05). The overall sensitivities of gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI were 80% and 83%, respectively, with no significant difference (p > 0.05). The differences of the positive predictive values for the two contrast agents for each observer were not statistically significant (p > 0.05). CONCLUSION: The diagnostic performance of gadoxetic acid-enhanced MRI and gadobenate dimeglumine-enhanced MRI for preoperatively detecting HCC is quite similar.
Adult ; Aged ; Carcinoma, Hepatocellular/*diagnosis ; Female ; Gadolinium DTPA/*diagnostic use ; Humans ; Image Interpretation, Computer-Assisted ; Liver Neoplasms/*diagnosis ; Magnetic Resonance Imaging/*methods ; Male ; Meglumine/*analogs & derivatives/diagnostic use ; Middle Aged ; Organometallic Compounds/*diagnostic use ; Predictive Value of Tests ; ROC Curve ; Sensitivity and Specificity ; Statistics, Nonparametric