Consensus report from the 8th International Forum for Liver Magnetic Resonance Imaging

Objectives The 8th International Forum for Liver Magnetic Resonance Imaging (MRI), held in Basel, Switzerland, in October 2017, brought together clinical and academic radiologists from around the world to discuss developments in and reach consensus on key issues in the field of gadoxetic acid–enhanc...

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Bibliographic Details
Published in:European radiology 2020-01, Vol.30 (1), p.370-382
Main Authors: Zech, Christoph J., Ba-Ssalamah, Ahmed, Berg, Thomas, Chandarana, Hersh, Chau, Gar-Yang, Grazioli, Luigi, Kim, Myeong-Jin, Lee, Jeong Min, Merkle, Elmar M., Murakami, Takamichi, Ricke, Jens, B. Sirlin, Claude, Song, Bin, Taouli, Bachir, Yoshimitsu, Kengo, Koh, Dow-Mu
Format: Article
Language:English
Subjects:
Acids
Breathing
Carcinoma, Hepatocellular - diagnostic imaging
Carcinoma, Hepatocellular - pathology
Cirrhosis
Computed tomography
Contrast Media
Diagnosis
Diagnostic Radiology
Diagnostic systems
Female
Gadolinium DTPA
Hepatocellular carcinoma
Humans
Imaging
Internal Medicine
Interventional Radiology
Liver
Liver - diagnostic imaging
Liver - pathology
Liver cancer
Liver cirrhosis
Liver Cirrhosis - diagnostic imaging
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - pathology
Magnetic Resonance
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Medical imaging
Medicine
Medicine & Public Health
Microvasculature
Monitoring
Multidetector Computed Tomography
Neuroradiology
NMR
Nuclear magnetic resonance
Phase transitions
Radiology
Resonance
Respiration
Sensitivity
Switzerland
Ultrasound
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Summary:Objectives The 8th International Forum for Liver Magnetic Resonance Imaging (MRI), held in Basel, Switzerland, in October 2017, brought together clinical and academic radiologists from around the world to discuss developments in and reach consensus on key issues in the field of gadoxetic acid–enhanced liver MRI since the previous Forum held in 2013. Methods Two main themes in liver MRI were considered in detail at the Forum: the use of gadoxetic acid for contrast-enhanced MRI in patients with liver cirrhosis and the technical performance of gadoxetic acid–enhanced liver MRI, both opportunities and challenges. This article summarises the expert presentations and the delegate voting on consensus statements discussed at the Forum. Results and conclusions It was concluded that gadoxetic acid–enhanced MRI has higher sensitivity for the diagnosis of hepatocellular carcinoma (HCC), when compared with multidetector CT, by utilising features of hyperenhancement in the arterial phase and hypointensity in the hepatobiliary phase (HBP). Recent HCC management guidelines recognise an increasing role for gadoxetic acid–enhanced MRI in early diagnosis and monitoring post-resection. Additional research is needed to define the role of HBP in predicting microvascular invasion, to better define washout during the transitional phase in gadoxetic acid–enhanced MRI for HCC diagnosis, and to reduce the artefacts encountered in the arterial phase. Technical developments are being directed to shortening the MRI protocol for reducing time and patient discomfort and toward utilising faster imaging and non-Cartesian free-breathing approaches that have the potential to improve multiphasic dynamic imaging. Key Points • Gadoxetic acid–enhanced MRI provides higher diagnostic sensitivity than CT for diagnosing HCC. • Gadoxetic acid–enhanced MRI has roles in early-HCC diagnosis and monitoring post-resection response. • Faster imaging and free-breathing approaches have potential to improve multiphasic dynamic imaging.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-019-06369-4