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Gadoxetic acid-enhanced magnetic resonance imaging: Hepatocellular carcinoma and mimickers

Clinical and Molecular Hepatology 2019년 25권 3호 p.223 ~ 233
 ( Kim Yeun-Yoon ) - Yonsei University College of Medicine Severance Hospital Department of Radiology

 ( Park Mi-Suk ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
 ( Aljoqiman Khalid Suliman ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
최진영 ( Choi Jin-Young ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
 ( Kim Myeong-Jin ) - Yonsei University College of Medicine Severance Hospital Department of Radiology

Abstract


Gadoxetic acid, a hepatocyte-specific magnetic resonance imaging (MRI) contrast agent, has emerged as an important tool for hepatocellular carcinoma (HCC) diagnosis. Gadoxetic acid-enhanced MRI is useful for the evaluation of early-stage HCC, diagnosis of HCC precursor lesions, and highly sensitive diagnosis of HCC. Furthermore, functional information provided by gadoxetic acid-enhanced MRI can aid in the characterization of focal liver lesions. For example, whereas lesions lack functioning hepatocytes appear hypointense in the hepatobiliary phase, preserved or enhanced expression of organic anion transporting polypeptides in some HCCs as well as focal nodular hyperplasia lead to hyperintensity in the hepatobiliary phase; and a targetoid appearance on transitional phase or hepatobiliary phase imaging can be helpful for identifying the histopathological composition of tumors. While gadoxetic acid-enhanced MRI may improve the sensitivity of HCC diagnosis and provide new insights into the characterization of focal liver lesions, there are many challenges associated with its use. This article reviews the pros and cons of HCC diagnosis with gadoxetic acid-enhanced MRI and discuss some clues in the radiological differentiation of HCC from HCC mimickers.

키워드

Diagnosis; Liver neoplasm; Hepatocellular carcinoma; Magnetic resonance imaging; Gadoxetic acid
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