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Double-Dose Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Patients With Chronic Liver Disease

Motosugi, Utaroh MD, PhD*; Ichikawa, Tomoaki MD, PhD*; Sano, Katsuhiro MD, PhD*; Sou, Hironobu MD*; Onohara, Kojiro MD*; Muhi, Ali MB, ChB*; Kitamura, Takatoshi MD, PhD; Amemiya, Fumitake MD, PhD; Enomoto, Nobuyuki MD, PhD; Matsuda, Masanori MD, PhD; Asakawa, Masami MD, PhD; Fujii, Hideki MD, PhD; Araki, Tsutomu MD, PhD*

doi: 10.1097/RLI.0b013e3181f9c487
Original Article

Objectives: To determine the effect of double-dose gadoxetic-acid (Gd-EOB-DTPA) on lesion-liver contrast ratio in arterial- and hepatocyte-phase images and arterial-phase image quality in patients with chronic liver disease.

Materials and Methods: The ethics committee at our institute approved this study. This study included 28 patients (13 with Child-Pugh class A and 15 with class B) with 54 hepatocellular carcinomas. All patients received the standard Gd-EOB-DTPA dose (0.025 mmol/kg bodyweight) and double dose (0.050 mmol/kg bodyweight). The lesion-liver contrast ratio was evaluated in arterial- and hepatocyte-phase images. The artifacts in arterial-phase images were evaluated with a 4-point scale. Wilcoxon signed-rank test were used for comparisons.

Results: The hepatocyte-phase lesion-liver contrast ratio after the double dose was significantly higher than that after the standard dose in patients with Child-Pugh class B disease(standard dose vs. double dose; 0.20 ± 0.16 vs. 0.25 ± 0.17; P < 0.0001); however, the ratio after both the standard and double doses was equivalent in patients with Child-Pugh class A disease (0.35 ± 0.18 vs. 0.35 ± 0.14; P = 0.3038). The double dose significantly increased the arterial-phase lesion-liver contrast ratio (0.34 ± 0.19 vs. 0.58 ± 0.33; P < 0.0001). The artifacts in the arterial-phase images were more prominent after the standard dose (2.7 vs. 2.4 for reader 1, 2.8 vs. 2.4 for reader 2; P = 0.0195 and 0.0010).

Conclusions: Administration of double dose of Gd-EOB-DTPA provided better arterial enhancement of hepatocellular carcinomas in patients with chronic liver disease, and also improved the lesion-liver contrast in hepatocyte-phase images in patients with Child-Pugh class B disease.

From the *Department of Radiology, University of Yamanashi, Yamanashi, Japan; and First Departments of †Internal Medicine and ‡Surgery, University of Yamanashi, Yamanashi, Japan.

Received June 22, 2010; accepted for publication (after revision) August 1, 2010.

Reprints: Tomoaki Ichikawa, MD, PhD, Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi-ken 409–3898, Japan. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.