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Contrast-enhanced magnetic resonance cholangiography with Gd-BOPTA and Gd-EOB-DTPA in healthy subjects
Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping.ORCID iD: 0000-0002-4111-1693
Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping.ORCID iD: 0000-0002-9446-6981
Karolinska Institutet, CLINTEC, Röntgenavdelningen, Karolinska Universitetssjukhuset Huddinge.
Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping.ORCID iD: 0000-0002-7750-1917
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2007 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 48, no 4, 362-368 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To evaluate the biliary enhancement dynamics of the two gadolinium chelates Gd-BOPTA (MultiHance) and Gd-EOB-DTPA (Primovist) in normal healthy subjects. MATERIAL AND METHODS: Ten healthy volunteers were evaluated with both agents by magnetic resonance (MR) imaging at 1.5T using a breath-hold gradient-echo T1-weighted VIBE sequence. The relative signal intensity (SI) differences between the common hepatic duct (CHD) and liver parenchyma were measured before and 10, 20, 30, 40, 130, 240, and 300 min after contrast medium injection. RESULTS: Biliary enhancement was obvious 10 min post-injection for Gd-EOB-DTPA and was noted at 20 min for Gd-BOPTA. At 40 min delay, Gd-BOPTA reached its peak biliary enhancement, but at neither 30 nor 40 min delay was there any significant difference compared with that of Gd-EOB-DTPA. At later delays, the contrast between CHD and liver continued to increase for Gd-EOB-DTPA, whereas it decreased for Gd-BOPTA. CONCLUSION: The earlier onset and longer duration of a high contrast between CHD and liver for Gd-EOB-DTPA facilitates examination of hepatobiliary excretion. Therefore, Gd-EOB-DTPA may provide adequate hepatobiliary imaging within a shorter time span than Gd-BOPTA and facilitate scheduling at the MR unit. Further studies in patients are required to compare the imaging advantages of Gd-EOB-DTPA and Gd-BOPTA in clinical practice.

Place, publisher, year, edition, pages
Informa Healthcare , 2007. Vol. 48, no 4, 362-368 p.
Keyword [en]
Bile ducts; biliary; comparative studies; intravenous contrast agents; liver; MR imaging
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-17916DOI: 10.1080/02841850701196922ISI: 000246782700002OAI: oai:DiVA.org:liu-17916DiVA: diva2:212860
Note

This is an electronic version of an article published in: Nils Dahlström, Anders Persson, Nils Albiin, Örjan Smedby and Torkel Brismar, Contrast-enhanced magnetic resonance cholangiography with Gd-BOPTA and Gd-EOB-DTPA in healthy subjects, 2007, Acta Radiologica, (48), 4, 362-368. Acta Radiologica is available online at informaworldTM: http://dx.doi.org/10.1080/02841850701196922 Copyright: Taylor & Francis http://www.tandf.co.uk/journals/default.asp

Available from: 2009-04-24 Created: 2009-04-24 Last updated: 2015-10-08Bibliographically approved
In thesis
1. Magnetic Resonance Imaging of the Hepatobiliary System Using Hepatocyte-Specific Contrast Media
Open this publication in new window or tab >>Magnetic Resonance Imaging of the Hepatobiliary System Using Hepatocyte-Specific Contrast Media
2009 (English)Licentiate thesis, comprehensive summary (Other academic)
Alternative title[sv]
Magnetresonanstomografi av lever och gallvägar med levercellsspecifika kontrastmedel
Abstract [en]

There are two Gadolinium-based liver-specific contrast media for Magnetic Resonance Imaging on the market, Gd-BOPTA (MultiHance®, Bracco Imaging, Milan, Italy) and Gd-EOB-DTPA (Primovist®, Bayer Schering Pharma, Berlin, Germany). The aim of this study in two parts was to evaluate the dynamics of biliary, parenchymal and vascular enhancement using these contrast media in healthy subjects. Ten healthy volunteers were examined in a 1.5 T magnetic resonance system using three-dimensional Volumetric Interpolated Breath-Hold (VIBE) sequences for dynamic imaging with both contrast media – at two different occasions – until five hours after injection. The doses given were 0.025 mmol/kg for Gd-EOB-DTPA and 0.1 mmol/kg for Gd-BOPTA. The enhancement over time of the common biliary duct in contrast to the liver parenchyma was analyzed in the first study. This was followed by a study of the image contrasts of the hepatic artery, portal vein and middle hepatic vein versus the liver parenchyma.While Gd-EOB-DTPA gave an earlier and more prolonged enhancement of the biliary duct, Gd-BOPTA achieved higher image contrast for all vessels studied, during the arterial and portal venous phases. There was no significant difference in the maximal enhancement obtained in the liver parenchyma.At the obtained time-points and at the dosage used, the high contrast between the common biliary duct and liver parenchyma had an earlier onset and longer duration for Gd-EOB-DTPA, while Gd-BOPTA achieved higher maximal enhancement of the hepatic artery, portal vein and middle hepatic vein than Gd-EOB-DTPA. Diseases of the liver and biliary system may affect the vasculature, parenchyma, biliary excretion or a combination of these. The clinical context regarding the relative importance of vascular, hepatic parenchymal and biliary processes should determine the choice of contrast media for each patient and examination.

 

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 36 p.
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 95
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-17918 (URN)978-91-7393-653-8 (ISBN)
Presentation
2009-05-18, Wrannesalen, CMIV, Campus US, Linköpings Universitet, Linköping, 10:15 (English)
Opponent
Supervisors
Available from: 2009-04-24 Created: 2009-04-24 Last updated: 2015-09-22Bibliographically approved
2. Quantitative Evaluation of Contrast Agent Dynamics in Liver MRI
Open this publication in new window or tab >>Quantitative Evaluation of Contrast Agent Dynamics in Liver MRI
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The studies presented here evaluate the biliary, parenchymal and vascular enhancement effects of two T1-shortening liver-specific contrast agents, Gd-BOPTA and Gd-EOB-DTPA, in Magnetic Resonance Imaging (MRI) of healthy subjects and of patients.

Ten healthy volunteers were examined with both contrast agents in a 1.5 T MRI system using three-dimensional gradient echo sequences for dynamic imaging until five hours after injection. The enhancement of the common hepatic duct in contrast to the liver parenchyma was analyzed in the first study. This was followed by a study of the image contrasts of the hepatic artery, portal vein and middle hepatic vein versus the liver parenchyma.

While Gd-EOB-DTPA gave an earlier and more prolonged enhancement and image contrast of the bile duct, Gd-BOPTA achieved higher maximal enhancement and higher image contrast for all vessels studied during the arterial and portal venous phases. There was no significant difference in the maximal enhancement obtained in the liver parenchyma.

In a third study, another 10 healthy volunteers were examined with the same protocol in another 1.5 T MRI system. Using signal normalization and a more quantitative, pharmacokinetic analysis, the hepatocyte-specific uptake of Gd-EOB-DTPA and Gd-BOPTA was calculated. A significant between-subjects correlation of the uptake estimates was found and the ratio of these uptake rates was of the same magnitude as has been reported in pre-clinical studies. The procedure also enabled quantitative analysis of vascular enhancement properties of these agents. Gd-BOPTA was found to give higher vessel-to-liver contrast than Gd-EOB-DTPA when recommended doses were given.

In the final study, retrospectively gathered datasets from patients with hepatobiliary disease were analyzed using the quantitative estimation of hepatic uptake of Gd-EOB-DTPA described in the third study. The uptake rate estimate provided significant predictive ability in separating normal from disturbed hepatobiliary function, which is promising for future evaluations of regional and global liver disease.

In conclusion, the differing dynamic enhancement profiles of the liver-specific contrast agents presented here can be beneficial in one context and challenging in another. Diseases of the liver and biliary system may affect the vasculature, parenchyma or biliary excretion, or a combination of these. The clinical context in terms of the relative importance of vascular, hepatic parenchymal and biliary processes should therefore determine the contrast agent for each patient and examination. A quantitative approach to analysis of contrast-enhanced liver MRI examinations is feasible and may prove valuable for their interpretation.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2010. 93 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1196
Keyword
Liver, spleen, hepatobiliary system, liver function, MRI, DCE-MRI, Gd-EOBDTPA, Gd-BOPTA, pharmacokinetic, hepatocyte, relaxivity.
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-60264 (URN)978-91-7393-338-4 (ISBN)
Public defence
2010-11-05, Elsa Brändströmsalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2010-10-08 Created: 2010-10-08 Last updated: 2017-01-31Bibliographically approved

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Dahlström, NilsPersson, AndersSmedby, Örjan

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