Gadoxetic acid-enhanced MRI: a method for the detection of hepatic metastases

Ali Muhi, Tomoaki Ichikawa and Utaroh Motosugi

Staging of malignant tumors is increasingly important as new therapeutic strategies develop. The presence of liver metastasis significantly changes the therapeutic approach; therefore, it is important to exclude metastasis with high confidence. Moreover, the proportion of patients with hepatic metastasis considered amenable to resection is increasing with improvements in surgical treatment. With improvements in surgical and medical management of hepatic metastasis comes an increasing need to provide accurate assessment of the exact number, size and location of metastases using imaging. The differentiation of liver metastases from benign lesions, such as hemangioma, focal nodular hyperplasia or adenoma, is very important. Gadoxetic acid is a liver-specific MR contrast agent that has both dynamic and hepatocytespecific properties. Once taken up by functioning hepatocytes, gadoxetic acid enhances hepatic parenchyma, whereas lesions with no hepatocytes or hepatocyte dysfunction, such as metastases, and most hepatocellular carcinomas, remain unenhanced.