Intrahepatic periportal high intensity on hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI: imaging findings and prevalence in various hepatobiliary diseases

2012 ◽  
Vol 31 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Satoshi Kobayashi ◽  
Osamu Matsui ◽  
Toshifumi Gabata ◽  
Wataru Koda ◽  
Tetsuya Minami ◽  
...  
Keyword(s):  
High Intensity ◽  
Hepatobiliary Phase ◽  
Imaging Findings ◽  
Mri Imaging ◽  
Enhanced Mri ◽  
Phase Images ◽  
Hepatobiliary Diseases

scholarly journals Higher Enhancement Intrahepatic Nodules on the Hepatobiliary Phase of Gd-EOB-DTPA-Enhanced MRI as a Poor Responsive Marker of Anti-PD-1/PD-L1 Monotherapy for Unresectable Hepatocellular Carcinoma

Liver Cancer ◽  
2021 ◽  
pp. 1-14
Author(s):  
Tomoko Aoki ◽  
Naoshi Nishida ◽  
Kazuomi Ueshima ◽  
Masahiro Morita ◽  
Hirokazu Chishina ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Checkpoint Inhibitors ◽  
Objective Response ◽  
Evaluation Criteria ◽  
Progression Free Survival ◽  
Imaging Biomarker ◽  
Hepatobiliary Phase ◽  
Enhanced Mri ◽  
Phase Images ◽  
Magnetic Resonance Imaging Mri

<b><i>Introduction:</i></b> Immune checkpoint inhibitors (ICIs) are promising agents for the treatment of hepatocellular carcinoma (HCC). However, the establishment of noninvasive measure that could predict the response to ICIs is challenging. This study aimed to evaluate tumor responses to ICIs using the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI), which was shown to reflect Wnt/β-catenin activating mutation. <b><i>Methods:</i></b> A total of 68 intrahepatic HCC nodules from 18 patients with unresectable HCC and Child-Pugh class A liver function who received anti-programmed cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1) monotherapy were enrolled in this study. All patients had viable intrahepatic lesions evaluable using the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI within the 6 months prior to the treatment. The relative enhancement ratio was calculated, and the time to nodular progression (TTnP) defined as 20% or more increase in each nodule was compared between higher or hypo-enhancement HCC nodules. Then, the progression-free survival (PFS) and objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) were compared between patients with and without HCC nodules with higher enhancement on hepatobiliary phase images. <b><i>Results:</i></b> The median PFS was 2.7 (95% confidence interval [CI]: 1.4–4.0) months in patients with HCC nodules with higher enhancement (<i>n</i> = 8) and 5.8 (95% CI: 0.0–18.9) months in patients with hypointense HCC nodules (<i>n</i> = 10) (<i>p</i> = 0.007). The median TTnP of HCC nodules with higher enhancement (<i>n</i> = 23) was 1.97 (95% CI: 1.86–2.07) months and that of hypointense HCC nodules (<i>n</i> = 45) was not reached (<i>p</i> = 0.003). The ORR was 12.5% (1/8) versus 30.0% (3/10); the disease control rate was 37.5% (3/8) versus 70.0% (7/10), respectively, in patients with or without higher enhancement intrahepatic HCC nodules. <b><i>Conclusion:</i></b> The TTnP on HCC nodules with higher enhancement and the median PFS in patients who carried higher enhancement intrahepatic HCC nodules were significantly shorter than those in hypointense HCC nodules with anti-PD-1/PD-L1 monotherapy. The intensity of the nodule on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI is a promising imaging biomarker for predicting unfavorable response with anti-PD-1/PD-L1 monotherapy in patients with HCC.

scholarly journals A 3D Deep Neural Network for Liver Volumetry in 3T Contrast-Enhanced MRI

2020 ◽  
Author(s):  
Hinrich Winther ◽  
Christian Hundt ◽  
Kristina Imeen Ringe ◽  
Frank K. Wacker ◽  
Bertil Schmidt ◽  
...  
Keyword(s):  
Neural Network ◽  
Intraclass Correlation ◽  
Ground Truth ◽  
Hepatobiliary Phase ◽  
Dice Coefficient ◽  
Enhanced Mri ◽  
The Neural Network ◽  
Liver Volumetry ◽  
Phase Images ◽  
Mri Scans

Purpose To create a fully automated, reliable, and fast segmentation tool for Gd-EOB-DTPA-enhanced MRI scans using deep learning. Materials and Methods Datasets of Gd-EOB-DTPA-enhanced liver MR images of 100 patients were assembled. Ground truth segmentation of the hepatobiliary phase images was performed manually. Automatic image segmentation was achieved with a deep convolutional neural network. Results Our neural network achieves an intraclass correlation coefficient (ICC) of 0.987, a Sørensen–Dice coefficient of 96.7 ± 1.9 % (mean ± std), an overlap of 92 ± 3.5 %, and a Hausdorff distance of 24.9 ± 14.7 mm compared with two expert readers who corresponded to an ICC of 0.973, a Sørensen–Dice coefficient of 95.2 ± 2.8 %, and an overlap of 90.9 ± 4.9 %. A second human reader achieved a Sørensen–Dice coefficient of 95 % on a subset of the test set. Conclusion Our study introduces a fully automated liver volumetry scheme for Gd-EOB-DTPA-enhanced MR imaging. The neural network achieves competitive concordance with the ground truth regarding ICC, Sørensen–Dice, and overlap compared with manual segmentation. The neural network performs the task in just 60 seconds. Key Points:  Citation Format

Use of hepatobiliary phase images in Gd-EOB-DTPA-enhanced MRI of breast cancer hepatic metastasis to predict response to chemotherapy

2017 ◽  
Vol 43 ◽  
pp. 127-131 ◽  
Author(s):  
Hyun Ji Lee ◽  
Chang Hee Lee ◽  
Jeong Woo Kim ◽  
Yang Shin Park ◽  
Jongmee Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hepatic Metastasis ◽  
Hepatobiliary Phase ◽  
Enhanced Mri ◽  
Response To Chemotherapy ◽  
Phase Images

Hepatobiliary phase images of gadoxetic acid-enhanced MRI may improve accuracy of predicting the size of hepatocellular carcinoma at pathology

2021 ◽  
pp. 028418512110141
Author(s):  
San-Yuan Dong ◽  
Yu-Tao Yang ◽  
Wen-Tao Wang ◽  
Shuo Zhu ◽  
Wei Sun ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Correlation Coefficient ◽  
Tumor Size ◽  
Pearson Correlation ◽  
Gadoxetic Acid ◽  
Arterial Phase ◽  
Hepatobiliary Phase ◽  
Enhanced Mri ◽  
Phase Images ◽  
Mri Sequences

Background Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has been widely used in clinical practice. However, scientific evidence is lacking for recommending a particular sequence for measuring tumor size. Purpose To retrospectively compare the size of hepatocellular carcinoma (HCC) measured on different gadoxetic acid-enhanced MRI sequences using pathology as a reference. Material and Methods A total of 217 patients with single HCC who underwent gadoxetic acid-enhanced MRI before surgery were included. The size of the HCC was measured by two abdominal radiologists independently on the following sequences: T1-weighted; T2-weighted; b-500 diffusion-weighted imaging (DWI); and arterial, portal venous, transitional, and hepatobiliary phases. Tumor size measured on MRI was compared with pathological size by using Pearson correlation coefficient, independent-sample t test, and Bland–Altman plot. Agreement between two readers was evaluated with intraclass correlation coefficient (ICC). Results Correlation between the MR images and pathology was high for both readers (0.899–0.955). Absolute error between MRI and pathologic assessment was lowest on hepatobiliary phase images for both readers (reader 1, 2.8±4.2 mm; reader 2, 3.2±3.4 mm) and highest on arterial phase images for reader 1 (4.9±4.4 mm) and DWI phase images for reader 2 (5.1±4.9 mm). Absolute errors were significantly different for hepatobiliary phase compared with other sequences for both readers (reader 1, P≤0.012; reader 2, P≤0.037). Inter-reader agreements for all sequence measurements were strong (0.971–0.997). Conclusion The performance of gadoxetic acid-enhanced MRI sequences varied with HCC size, and the hepatobiliary phase may be optimal among these sequences.

scholarly journals Manifestations of Hepatic Focal Nodular Hyperplasia in Hepatobiliary Phase of Enhancement by Hepatocyte-specific Contrast Agent: Comparison With Pathologic Findings

2021 ◽  
Author(s):  
Jiangfeng Xu ◽  
Liqing Zhang ◽  
Jianxun Li ◽  
Xiaojian Cui ◽  
Qingping Jiang ◽  
...  
Keyword(s):  
Focal Nodular Hyperplasia ◽  
High Intensity ◽  
The Other ◽  
Hepatobiliary Phase ◽  
Imaging Data ◽  
Low Intensity ◽  
Enhanced Mri ◽  
Pathologic Findings ◽  
Nodular Hyperplasia ◽  
Fibrous Tissues

Abstract Background: To explore the signals and diagnostic value of hepatic focal nodular hyperplasia (FNH) in the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) enhanced MRI.Methods: Imaging data of 43 pathologically proven FNH lesions from 39 patients who underwent Gd-EOB-DTPA enhanced MRI scanning at our hospital between January 2016 and June 2019 were retrospectively analyzed. The signal characteristics in the hepatobiliary phase were analyzed and compared with the pathologic findings.Results: According to the characteristics of signals in the hepatobiliary phase, the signals were classified as follows: homogenous iso-high intensity signals in 20.93% (9/43) lesions, heterogeneous iso-high intensity signals in 67.44% (29/43) lesions, homogenous low-intensity signals in 4.65% (2/43) lesions, and heterogeneous low-intensity signals in 6.98% (3/43) lesions. Two patients were with multiple lesions, where one was with 2 lesions of heterogeneous high-intensity signals, and the other with 3 lesions of heterogeneous low-intensity signals. Pathologic findings were as follows: the slices of the 38 lesions with high-intensity signals in a hepatobiliary phase were with hyperplasic hepatocytes, inflammatory cell infiltration, and malformed blood vessels. Twenty-nine of the lesions were with fiber tissues of different degrees and were classified as classic type. The remaining 9 lesions were without fibrous scars and were classified as non-classic type. The other 5 of the 43 lesions were non-classic FNH with no evident fibrous tissues, while 4 of them were with >40% steatosis in the hyperplasic hepatocytes; the immunohistochemistry showed CK7(-)/CK19(-) in 1 lesion and β-catenin (nucleus +) in another lesion. Comparisons of pathologic with imaging findings were as follows: twenty-nine lesions were with heterogeneous iso-high intensity signals, of which the slices showed evident fibrous tissues of different degrees, and the slices of 9 lesions with homogenous iso-high intensity signals in the hepatobiliary phase showed no fibrous tissues. Three lesions with heterogeneous low-intensity signals in the hepatobiliary phase showed about 80% mixed steatosis in hyperplasic hepatocytes. The other two lesions both showed homogeneous low-intensity signals in the hepatobiliary phase, where 1 lesion was with >40% macrovesicular steatosis and CK7/CK19 (-), while the other only showed β-catenin (nucleus +) by immunohistochemistry. Conclusions: The signals of FNH in the hepatobiliary phase showed various characteristics, where the signal differences were mainly associated with the number of hyperplastic hepatocytes in lesions, presence of steatosis, fibrous scars, and conditions of small bile ducts, and potentially associated with β-catenin (nucleus+). Low-intensity signals were relatively rare for FNH, thus representing a relatively major challenge for diagnosing this type FNH.

scholarly journals Hyperintense Liver Masses at Hepatobiliary Phase Gadoxetic Acid–enhanced MRI: Imaging Appearances and Clinical Importance

Radiographics ◽  
2020 ◽  
Vol 40 (1) ◽  
pp. 72-94 ◽  
Author(s):  
Nobuhiro Fujita ◽  
Akihiro Nishie ◽  
Yoshiki Asayama ◽  
Kousei Ishigami ◽  
Yasuhiro Ushijima ◽  
...  
Keyword(s):  
Clinical Importance ◽  
Gadoxetic Acid ◽  
Hepatobiliary Phase ◽  
Mri Imaging ◽  
Enhanced Mri

Hyperintense HCC on hepatobiliary phase images of gadoxetic acid-enhanced MRI: Correlation with clinical and pathological features

2012 ◽  
Vol 81 (12) ◽  
pp. 3877-3882 ◽  
Author(s):  
Ja Young Kim ◽  
Myeong-Jin Kim ◽  
Kyung Ah Kim ◽  
Hyeon Tae Jeong ◽  
Young Nyun Park
Keyword(s):  
Gadoxetic Acid ◽  
Hepatobiliary Phase ◽  
Pathological Features ◽  
Enhanced Mri ◽  
Phase Images ◽  
Clinical And Pathological Features

Comparison of 10- and 20-min hepatobiliary phase images on Gd-EOB-DTPA-enhanced MRI T1 mapping for liver function assessment in clinic

2017 ◽  
Vol 42 (9) ◽  
pp. 2272-2278 ◽  
Author(s):  
Zhi-Peng Zhou ◽  
Li-Ling Long ◽  
Wei-Jia Qiu ◽  
Ge Cheng ◽  
Li-Juan Huang ◽  
...  
Keyword(s):  
Liver Function ◽  
T1 Mapping ◽  
Hepatobiliary Phase ◽  
Enhanced Mri ◽  
Phase Images ◽  
Function Assessment

scholarly journals MRI characterization of focal liver lesions in non-cirrhotic patients: assessment of added value of gadoxetic acid-enhanced hepatobiliary phase imaging

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Bardia Moosavi ◽  
Anuradha S. Shenoy-Bhangle ◽  
Leo L. Tsai ◽  
Robert Reuf ◽  
Koenraad J. Mortele
Keyword(s):  
Gadoxetic Acid ◽  
Added Value ◽  
Rank Test ◽  
Focal Liver Lesions ◽  
Hepatobiliary Phase ◽  
Liver Lesions ◽  
Enhanced Mri ◽  
Phase Images ◽  
Cirrhotic Patients

Abstract Background To evaluate the added value of the hepatobiliary (HPB) phase in gadoxetic acid-enhanced magnetic resonance imaging (MRI) in characterizing newly discovered indeterminate focal liver lesions in non-cirrhotic patients. Results One-hundred and twenty-five non-cirrhotic patients (median age, 46 years; range, 20–85 years; 100 females) underwent gadoxetic acid-enhanced MRI, including the 20-min delayed HPB phase, for characterization of newly discovered focal liver lesions. Images were independently evaluated by two blinded, board-certified abdominal radiologists (R1 and R2) who characterized liver lesions without and with assessment of the HPB phase images in two separate readout sessions. Confidence in diagnosis was scored on a scale from 0 to 3. Inter-observer agreement was assessed using Cohen κ statistics. Change in diagnosis and confidence in diagnosis were evaluated by Wilcoxon signed rank test. There was no significant change in diagnosis before and after evaluation of the HPB phase for both readers (p = 1.0 for R1; p = 0.34 for R2). Confidence in diagnosis decreased from average 2.8 ± 0.45 to 2.6 ± 0.59 for R1 and increased from 2.6 ± 0.83 to 2.8 ± 0.46 for R2. Change in confidence was only statistically significant for R1 (p = 0.003) but not significant for R2 (p = 0.49). Inter-reader agreement in diagnosis was good without (k = 0.66) and with (k = 0.75) inclusion of the HPB phase images. Conclusions The added information obtained from the HPB phase of gadoxetic acid-enhanced MRI does not change the diagnosis or increase confidence in diagnosis when evaluating new indeterminate focal liver lesions in non-cirrhotic patients.

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