Dynamic MR imaging of liver metastases with Gd-EOB-DTPA

Purpose: To assess liver and lesion enhancements by dynamic MR imaging afte r bolus injection of the hepatobiliary contrast agent gadolinium ethoxybenz yldiet- hylenetriamine-pentaacetic acid (Gd-EOB-DTPA) in patients with live r metastases and to compare the effect of different doses. Material and Method's: A randomized double-blinded trial with doses of 12.5 , 25 and 50 mu mol/kg Gd-EOB-DTPA was performed in 35 patients with liver m etastases. Liver enhancement, tumor enhancement and liver lesion contrast-t o-noise (C/N) ratios were calculated from breath-hold gradient echo images (100/5/80 degrees) recorded precontrast and at different times up to 10 min postcontrast. Results: Normal liver showed a characteristic enhancement pattern, with a r apid enhancement in the first 45 s postcontrast and a slight but significan t further increase up to 600 s. The initial enhancement in the lesions was also pronounced, but the enhancement was slightly decreased after 240 s pos tcontrast. At dose levels of 12.5 and 25 mu mol/kg Gd-EOB-DTPA, C/N ratios significantly increased compared to baseline from 90 to 600 s. Postcontrast C/N-values obtained using 50 mu mol/kg Cd-EOB-DTPA were not significantly increased, except for the examinations 480 s postcontrast. Conclusion: In liver metastases, CIN ratios obtained with doses of 12.5 and 25 mu mol/kg Gd-EOB-DTPA were slightly superior to 50 mu mol/kg Gd-EOB-DTP A. This finding is probably due to a more pronounced extracellular effect o f the contrast medium at higher doses.