Uptake of Gd-EOB-DTPA by hepatocellular carcinoma: radiologic-pathologic correlation with special reference to bile production

Purpose: The aim of this study was to reveal the relationship between intratumoral uptake of gadoliniumethoxylbenzyldiethylenetriaminepentaacetic acid (Gd-EOB-DTPA) of hepatocellular carcinoma (HCC) in the hepatobiliary phase and pathological features.

Materials and methods: Sixty HCC nodules were confirmed at pathology in 56 patients who had undergone dynamic MRI. T1-weighted 3D gradient echo sequences before and 20 min (hepatobiliary phase) after the injection of Gd-EOB-DTPA were performed. Uptake of Gd-EOB-DTPA was defined as an increase in signal intensity in the hepatobiliary phase compared with the precontrast scan. All surgical specimens were fixed with formalin and then digitally photographed. The relationship between Gd-EOB-DTPA uptake and histological findings, including a macroscopic greenish area, was examined.

Results: MR images showed uptake of Gd-EOB-DTPA in twenty-two nodules. Histological findings indicated twenty-six nodules contained a greenish area. There is a significant correlation between HCC showing Gd-EOB-DTPA uptake and the presence of a greenish area (p<0.001). On a nodule-by-nodule basis, more than two-thirds of the area of Gd-EOB DTPA uptake coincides with the greenish part in only 12 of 22 lesions (54.5%). More than two-thirds of the greenish area coincided with that of Gd-EOB-DTPA uptake in only 10 of 26 cases (38.5%).

Conclusion: The area of Gd-EOB-DTPA uptake does not always match the greenish part, but HCC with uptake of Gd-EOB-DTPA significantly correlated with green HCC.