![]() ![]() This monograph summarizes the presentations, conclusions, and recommendations of a panel of experts who reviewed the safety, efficacy, and use of GBCAs for several MRI applications. However, while gadopiclenol may fulfill many, if not all, of the requirements of an ideal MR contrast agent, this agent has not entered clinical practice as of this writing (October 2022), and radiologists must still choose between high-relaxivity and high-stability agents. Food and Drug Administration (FDA) for a wide range of MR imaging applications at reduced dose. Recently, a highly stable, high-relaxivity GBCA, gadopiclenol (Vueway™ Bracco Diagnostics Inc.), 2 was approved by the U.S. 1 Such an agent would potentially permit a reduction in contrast dose, resulting in lower Gd exposure, without sacrificing image quality or diagnostic performance. Ideally, an MR contrast agent would possess both high relaxivity and high stability, rendering moot the need to choose between these two properties for a given MRI application. ![]() For example, more stable macrocyclic GBCAs may be better suited to younger patients or those requiring serial MRI examinations, whereas higher-relaxivity agents may be more appropriate in cases where better diagnostic performance has the potential to impact the diagnosis, prognosis, and/or treatment plan. To this end, risk-benefit analyses should be tailored to each patient. GBCA relaxivity and stability are the key properties to consider when selecting a contrast agent for MRI, and achieving the correct balance between high-quality images and low Gd exposure is a primary aim of radiologists. However, while reducing Gd exposure may decrease the levels of retained Gd, it may also lead to less-than-optimal contrast enhancement and thus sub-optimal diagnostic performance. Although no clinical sequelae resulting from Gd retention have been reported, GBCA guidelines recommend taking measures to reduce patient Gd exposure during MRI examinations. Unfortunately, the discovery that gadolinium (Gd) can be retained in the brain and bodily tissues in patients who have been administered GBCAs has led to widespread concern over their safety. In this perspective article, we will discuss the various intravenous contrast agents used for liver MRI and their ideal utilization.īiliary tree Extracellular contrast agents Gadobenate dimeglumine Gadolinium-based contrast agents Gadoxetate disodium Hepatobiliary contrast agents.Gadolinium-based contrast agents (GBCAs) have been used for decades to enhance the diagnostic performance of magnetic resonance imaging (MRI). Gadoxetate, however, provides less satisfactory dynamic phase images compared to ECAs, particularly during the arterial phase. In the last decade, HBAs, particularly Gadoxetate, have been found useful for characterizing lesions with functioning hepatocytes and more importantly in evaluating the biliary tree. ECAs have been used for decades since their introduction into clinical practice and provide excellent dynamic phase information that is useful in characterizing focal liver lesions. The use of appropriate contrast agents for liver MRI requires knowledge of the clinical situation and question to be answered. Currently, two classes of MRI contrast agents are available for clinical use, namely the extracellular contrast agent (ECA) and the hepatobiliary agent (HBA). Contrast enhanced MRI of the liver provides valuable information in the evaluation of both chronic liver disease and focal liver lesions. ![]()
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