gadoxetic-acid-disodium and Hyperplasia

Peri-tumoral hyperintensity (P-hyperintensity) is occasionally seen in hepatocellular carcinoma (HCC) on the hepatobiliary (HB) phase of gadoxetic acid-enhanced MRI (EOB-MRI). A recent study reported peri-tumoral hyperplasia (P-hyperplasia) associated with over-expression of glutamine synthetase (GS) in HCC or metastatic carcinoma. The aim of this study was to analyze the correlation between P-hyperintensity on the HB phase and GS expression indicating P-hyperplasia and reveal its pathological features.. Seventy-seven surgically resected HCCs from 68 patients were analyzed. The grade of P-hyperintensity on HB phase was divided according to the degree of the peri-tumoral hyperintense signal: grade 0 (no P-hyperintensity), grade 1 (less than 50% of the tumor border), grade 2 (50%-80%), grade 3 (80%-100%). Immunohistochemical staining for GS and organic anion transporter polypeptides (OATP)1B3 was performed. The relationships among P-hyperplasia (peri-tumoral GS expression) and OATP1B3 expression, P-hyperintensity, and pathological features of the tumor were analyzed.. Thirty-four HCCs were classified as P-hyperintensity grade 0, 29 HCCs as grade 1,10 nodules as grade 2, and 4 HCCs as grade 3. P-hyperplasia was observed in 3/34 (8.8%) P-hyperintensity grade 0, 16/29 (55.2%) grade 1, 9/10 (90%) grade 2, and 4/4 (100%) grade 3. The incidence of P-hyperplasia was significantly increased in P-hyperintensity grades 1-3 compared with grade 0 (p < 0.0001). Hepatocytes in all P-hyperplasia sites demonstrated definite OATP1B3 expression. Microscopic hepatic venous invasion was significantly increased in P-hyperintensity-positive HCCs compared with negative HCCs (p = 0.0017).. P-hyperintensity on HB phase in HCC may indicate p-hyperplasia with GS and OATP1B3 expression and a higher incidence of microscopic hepatic venous invasion.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Hepatocellular; Contrast Media; Female; Gadolinium DTPA; Humans; Hyperplasia; Image Enhancement; Liver; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies

To analyze the difference in signal intensity on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) among various hepatocellular nodules during hepatocarcinogenesis as correlated with the expressions of the transporters of Gd-EOB-DTPA.. We received institutional animal review board approval prior to the commencement of all studies. Forty rats were divided into three groups. The rats in the tumor groups received N-nitrosomorpholine solution (n = 16), and rats in the cirrhosis group (thioacetamide [TAA] group) received thioacetamide solution (n = 12). As a control, the remaining 12 rats were fed normal water. Each group was divided into two sub-groups: Group 1 for Gd-EOB-DTPA-enhanced MRI (0.025 mmol Gd/kg, n =7) and Group 2 for reverse transcription-polymerase chain reaction to compare transporter (oatp1 and mrp2) expressions (n = 5 for control and TAA groups, n = 9 for tumor groups).. Signal enhancement of tumors decreased according to the progress of hepatocarcinogenesis. Although the relative enhancement of each tumor group was significantly lower than that of the control group (P < 0.01), and there was no significant difference between TAA, hyperplastic nodules (HPN), and HCC(well) groups. The relative enhancement of the HCC(mod) group was significantly lower than the other groups (P < 0.01). The oatp1 expression of HPN tended to be higher than those of HCC(well) and HCC(mod). The mrp2 expression of TAA was significantly higher than those of HCC(well), HCC(mod), HPN and control (P < 0.01). The mrp2 expression of HPN tended to be higher than those of HCC(well ) and HCC(mod).. It was suggested that the signal enhancement on Gd-EOB-DTPA-enhanced MRI would correlate with the transporter expression in various hepatocellular nodules during hepatocarcinogenesis.

Topics: Analysis of Variance; Animals; ATP-Binding Cassette Transporters; Contrast Media; Disease Progression; Gadolinium DTPA; Hyperplasia; Lasers; Liver; Liver Cirrhosis, Experimental; Liver Neoplasms, Experimental; Magnetic Resonance Imaging; Male; Microdissection; Nitrosamines; Organic Anion Transporters, Sodium-Independent; Rats; Rats, Wistar; Reverse Transcriptase Polymerase Chain Reaction; Thioacetamide; Time Factors

To illustrate the unusual enhancement pattern of the focal nodular hyperplasia central scar using Gadoxetate Disodium.. Over a 10-month period, six patients, with a total of seven focal nodular hyperplasia lesions with typical central scar, had MRI of the liver using Gadoxetate Disodium (Eovist, Bayer HealthCare Pharmaceuticals Inc., Wayne, NJ). Four of the six patients had a prior Gadobenate Dimeglumine (Multihance, Bracco Diagnostics Inc., Princeton, NJ) -enhanced MRI of the liver performed within the previous year. The dynamic enhancement pattern of the central scar on the 10 liver MRIs was independently analyzed by two abdominal imaging radiologists who were blinded to the contrast agent used.. On the Gadoxetate Disodium-enhanced MRIs and during the arterial phase, 1-min, 2-min, and 3-min delay, none of the central scars demonstrated enhancement. However, all four of the lesions that were previously scanned using Gadobenate Dimeglumine demonstrated typical enhancement after a 3-min delay.. On Gadoxetate Disodium-enhanced MRIs of the liver, the central scar of focal nodular hyperplasia lesions does not typically demonstrate delayed enhancement.

Topics: Adult; Contrast Media; Female; Focal Nodular Hyperplasia; Gadolinium DTPA; Humans; Hyperplasia; Image Processing, Computer-Assisted; Liver; Magnetic Resonance Imaging; Meglumine; Middle Aged; Time Factors