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  • Introduction to liver disease management
  • Module 1: Hepatocellular carcinoma (HCC)
  • Module 2: Hepatic metastases
    • ConclusionsLexicon

Introduction to liver disease management

2. Primovist
®
-enhanced MRI

2.2
Primovist®
studies

  • Comprehensive liver imaging with Primovist® in a patient with chronic hepatitis B. Typical imaging features of HCC in segment VI/VII (Fig 2.1a; white arrow) with strong arterial phase hyperenhancement, washout, and enhancing capsule. Due to the lost function of the de-differentiated hepatocytes to take up Primovist®, the tumor appears hypointense (dark) in the HBP.
  • In addition, the HBP reveals a geographic area around the tumor (Fig 2.1b; red arrow) that also shows reduced hepatocellular uptake of Primovist® due to concomitant inflammation. Information on reduced cell function can be of high clinical relevance and help guide therapy planning before interventions.

 

Fig. 2.1a

Vascular perfusion imaging

Early arterial phase

Early arterial phase

Late arterial phase

Late arterial phase

Portovenous phase

Portovenous phase

Fig 2.1b

Hepatocyte-selective imaging

Hepatocyte-selective imaging

20 min, hepatobillary phase

Image courtesy of Professor Jin Wang, Third Affiliated Hospital, Sun Yat-Sen University (SYSU) and Liver Disease Hospital, Sun Yat-Sen University (SYSU), Guangzhou, China.

  • European Association for the Study of the Liver (EASL) Clinical Practice Guidelines

    “Gadoxetic acid is unique in that approximately 50% of the administrated dose is taken up by the hepatocytes and excreted into the bile ducts, while the other half is excreted by the kidneys”

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    • 1
      European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182-236.