Gadoxetate disodium

Yang J, et al. European Journal of Radiology, 2022, 154, 110397.

In a comparative intra-individual study, gadoxetate disodium (EOB)-enhanced MRI was applied alongside contrast-enhanced ultrasound (CEUS) to evaluate hepatocellular carcinoma (HCC) aggressiveness using the Liver Imaging Reporting and Data System (LI-RADS). A total of 140 patients with surgically confirmed HCC underwent both preoperative CEUS and EOB-MRI. Imaging assessments were independently performed by blinded radiologists, and diagnostic accuracy for macrovascular invasion was statistically compared with pathology. While CEUS exhibited higher specificity for macrovascular invasion, EOB-MRI with LR-M features provided enhanced detection of high Edmondson-Steiner grades and microvascular invasion. This experimental application demonstrated that gadoxetate disodium-enhanced MRI not only complements CEUS but also delivers critical prognostic insights, particularly for tumor differentiation and microvascular pathology, thereby underscoring its diagnostic value in preoperative HCC evaluation.

Lauscher JC, et al. HPB, 2024, 26(6), 782-788.

A retrospective cohort study investigated the utility of gadoxetate disodium-enhanced magnetic resonance imaging (MRI) in predicting post-hepatectomy liver failure (PHLF). Patients undergoing major hepatectomy (≥3 segments) received preoperative MRI scans with gadoxetate disodium as the hepatocyte-specific contrast agent. Liver signal intensity was quantified by normalizing to splenic signal intensity, and functional liver remnant (FLR) was calculated. Logistic regression revealed that low standardized liver signal intensity significantly correlated with PHLF risk (OR 0.112; 95% CI 0.023-0.551). In patients with small FLR volumes, receiver operating characteristic analysis demonstrated high predictive accuracy (AUC 0.857), with a defined cutoff offering 80% sensitivity and 89.3% specificity. These findings highlight the experimental application of gadoxetate disodium-enhanced MRI as a non-invasive method to quantify hepatocyte function, supporting surgical decision-making and reducing postoperative morbidity and mortality.