Impaired lesion detectability on gadoxetic acid-enhanced MR imaging in indocyanine green excretory defect: case series of three patients

Indocyanine green (ICG) excretory defect is characterized by an ICG retention rate of more than 50% at 15 min without any other abnormal liver functions. The incidence of ICG excretory defect is 0.007% in the Japanese population. Due to its rarity, the imaging characteristics associated with ICG exc...

Full description

Saved in:
Bibliographic Details
Published in:Japanese journal of radiology 2020-10, Vol.38 (10), p.997-1003
Main Authors: Masuoka, Sota, Nasu, Katsuhiro, Takahashi, Hiroaki, Kitao, Azusa, Sakai, Masafumi, Ishiguro, Toshitaka, Saida, Tsukasa, Minami, Manabu
Format: Article
Language:English
Subjects:
Acids
Aged
Bile ducts
Bile Ducts - diagnostic imaging
Coloring Agents - pharmacokinetics
Contrast Media
Defects
Gadolinium DTPA
Hepatocytes
Hepatocytes - metabolism
Humans
Imaging
Indocyanine Green - pharmacokinetics
Lesions
Liver
Liver - diagnostic imaging
Liver - metabolism
Liver-Specific Organic Anion Transporter 1 - metabolism
Magnetic Resonance Imaging
Male
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Nuclear Medicine
Organic anion transporting polypeptide
Parenchyma
Polypeptides
Radiology
Radiotherapy
Solute Carrier Organic Anion Transporter Family Member 1B3 - metabolism
Special Report
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Indocyanine green (ICG) excretory defect is characterized by an ICG retention rate of more than 50% at 15 min without any other abnormal liver functions. The incidence of ICG excretory defect is 0.007% in the Japanese population. Due to its rarity, the imaging characteristics associated with ICG excretory defect remain unclear. Herein, we present three cases of ICG excretory defect, which showed impaired lesion detectability on gadoxetic acid-enhanced MR imaging (EOB-MRI). In the hepatobiliary phase (HBP) of EOB-MRI, diminished enhancement of the liver parenchyma, prolonged intravascular enhancement, and attenuated gadoxetic acid excretion to the bile duct were observed. Our study also investigated the expression level of organic anion transporting polypeptide (OATP) 1B3 and OATP1B1/1B3, which is related to the uptake of ICG and gadoxetic acid into hepatocytes. All cases showed decreased expression of OATP1B3, which was assumed to be characteristic of ICG excretory defect. The present study indicates that, when patients with ICG excretory defect are evaluated using EOB-MRI, attention should be paid to the impaired lesion detectability in the HBP due to the attenuated gadoxetic acid uptake into the liver parenchyma.
ISSN:1867-1071
1867-108X
DOI:10.1007/s11604-020-00991-9