Elsevier

Journal of Hepatology

Volume 57, Issue 2, August 2012, Pages 421-429
Journal of Hepatology

Review
Primovist, Eovist: What to expect?

https://doi.org/10.1016/j.jhep.2012.01.031Get rights and content
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Summary

Gadolinium ethoxybenzyl dimeglumine (Gd-EOB-DTPA, Primovist® in Europe and Eovist® in the USA) is a liver-specific magnetic resonance imaging contrast agent that has up to 50% hepatobiliary excretion in the normal liver. After intravenous injection, Gd-EOB-DTPA distributes into the vascular and extravascular spaces during the arterial, portal venous and late dynamic phases, and progressively into the hepatocytes and bile ducts during the hepatobiliary phase. The hepatocyte uptake of Gd-EOB-DTPA mainly occurs via the organic anion transporter polypeptides OATP1B1 and B3 located at the sinusoidal membrane and biliary excretion via the multidrug resistance-associated proteins MRP2 at the canalicular membrane. Because of these characteristics, Gd-EOB-DTPA behaves similarly to non-specific gadolinium chelates during the dynamic phases, and adds substantial information during the hepatobiliary phase, improving the detection and characterization of focal liver lesions and diffuse liver disease. This information is particularly relevant for the detection of metastases, and for the detection and characterization of nodular lesions in liver cirrhosis, including early hepatocellular carcinomas. Finally, GD-EOB-DTPA-enhanced magnetic resonance imaging may provide quantitative assessment regarding liver perfusion and hepatocyte function in diffuse liver diseases. The full potential of GD-EOB-DTPA-enhanced magnetic resonance imaging has to be established further. It is already clear that GD-EOB-DTPA-enhanced magnetic resonance imaging provides anatomic and functional information in the setting of focal and diffuse liver disease that is unattainable with magnetic resonance imaging enhanced with non-specific contrast agents.

Abbreviations

ABC
ATP-binding cassette
CCC
cholangiocarcinoma
CT
computed tomography
FNH
focal nodular hyperplasia
Gd-BOPTA
gadobenate dimeglumine
Gd-DO3A-butrol
gadobutrol
Gd-DOTA
gadoterate dimeglumine
Gd-EOB-DTPA
gadolinium ethoxybenzyl dimeglumine
Gd-DTPA
gadopentetate dimeglumine
HA
hepatocellular adenoma
HCC
hepatocellular carcinoma
ICG
indocyanin green
MELD
Mayo end-stage liver disease
MR
magnetic resonance
MRP
multidrug resistance protein
NTCP
sodium taurocholate-cotransporting polypeptide
OATP
organic anion transporter
SCTO
solute carrier transporter family of the OATPs
TIPS
transjugular intrahepatic portosystemic shunt

Keywords

Magnetic resonance imaging
Contrast media
Gadolinium ethoxybenzyl DTPA
Liver neoplasms
Liver cirrhosis
Liver function tests

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