Consensus report from the 9 <sup>th</sup> International Forum for Liver Magnetic Resonance Imaging: applications of gadoxetic acid-enhanced imaging

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Abstract

Objectives

The 9th International Forum for Liver Magnetic Resonance Imaging (MRI) was held in Singapore in September 2019, bringing together radiologists and allied specialists to discuss the latest developments in and formulate consensus statements for liver MRI, including the applications of gadoxetic acid–enhanced imaging.

Methods

As at previous Liver Forums, the meeting was held over 2 days. Presentations by the faculty on days 1 and 2 and breakout group discussions on day 1 were followed by delegate voting on consensus statements presented on day 2. Presentations and discussions centered on two main meeting themes relating to the use of gadoxetic acid–enhanced MRI in primary liver cancer and metastatic liver disease.

Results and conclusions

Gadoxetic acid–enhanced MRI offers the ability to monitor response to systemic therapy and to assist in pre-surgical/pre-interventional planning in liver metastases. In hepatocellular carcinoma, gadoxetic acid–enhanced MRI provides precise staging information for accurate treatment decision-making and follow-up post therapy. Gadoxetic acid–enhanced MRI also has potential, currently investigational, indications for the functional assessment of the liver and the biliary system. Additional voting sessions at the Liver Forum debated the role of multidisciplinary care in the management of patients with liver disease, evidence to support the use of abbreviated imaging protocols, and the importance of standardizing nomenclature in international guidelines in order to increase the sharing of scientific data and improve the communication between centers.

Key Points

• Gadoxetic acid– enhanced MRI is the preferred imaging method for pre-surgical or pre-interventional planning for liver metastases after systemic therapy.

• Gadoxetic acid– enhanced MRI provides accurate staging of HCC before and after treatment with locoregional/biologic therapies.

• Abbreviated protocols for gadoxetic acid–enhanced MRI offer potential time and cost savings, but more evidence is necessary. The use of gadoxetic acid–enhanced MRI for the assessment of liver and biliary function is under active investigation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00330-020-07637-4.

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Author and article information

Contributors

Dow-Mu Koh:

ORCID: http://orcid.org/0000-0001-7654-8011

Mu.Koh@icr.ac.uk , dowmukoh@icr.ac.uk

Journal

Journal ID (nlm-ta): Eur Radiol

Journal ID (iso-abbrev): Eur Radiol

Title: European Radiology

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0938-7994

ISSN (Electronic): 1432-1084

Publication date (Electronic): 1 February 2021

Publication date PMC-release: 1 February 2021

Publication date (Print): 2021

Volume: 31

Issue: 8

Pages: 5615-5628

Affiliations

[1 ]GRID grid.424926.f, ISNI 0000 0004 0417 0461, Department of Diagnostic Radiology, , Royal Marsden Hospital, ; Sutton, UK

[2 ]GRID grid.22937.3d, ISNI 0000 0000 9259 8492, Department of Biomedical Imaging and Image-Guided Therapy, , Medical University of Vienna, ; Vienna, Austria

[3 ]GRID grid.10776.37, ISNI 0000 0004 1762 5517, Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BiND), , University of Palermo, ; Palermo, Italy

[4 ]GRID grid.417468.8, ISNI 0000 0000 8875 6339, Department of Radiology, Mayo Clinic Arizona, ; Phoenix, AZ USA

[5 ]GRID grid.59734.3c, ISNI 0000 0001 0670 2351, Department of Pathology, Molecular and Cell Medicine, , Icahn School of Medicine at Mount Sinai, ; New York, NY USA

[6 ]GRID grid.505613.4, Department of Diagnostic Radiology & Nuclear Medicine, , Hamamatsu University School of Medicine, ; Hamamatsu, Japan

[7 ]GRID grid.263826.b, ISNI 0000 0004 1761 0489, Department of Radiology, Zhongda Hospital, , Southeast University, ; Nanjing, People’s Republic of China

[8 ]GRID grid.24381.3c, ISNI 0000 0000 9241 5705, Department of Radiology Huddinge, , Karolinska University Hospital, ; Stockholm, Sweden

[9 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Division of Radiology, , CLINTEC, Karolinska Institutet, ; Stockholm, Sweden

[10 ]GRID grid.258622.9, ISNI 0000 0004 1936 9967, Department of Hepatology and Gastroenterology, , Kindai University Faculty of Medicine, ; Osaka, Japan

[11 ]GRID grid.31501.36, ISNI 0000 0004 0470 5905, Department of Radiology, College of Medicine, , Seoul National University, ; Seoul, South Korea

[12 ]GRID grid.31432.37, ISNI 0000 0001 1092 3077, Department of Radiology, , Kobe University Graduate School of Medicine, ; Kobe, Japan

[13 ]GRID grid.411095.8, ISNI 0000 0004 0477 2585, Klinik und Poliklinik für Radiologie, , Klinikum der Universität München, ; Munich, Germany

[14 ]GRID grid.266100.3, ISNI 0000 0001 2107 4242, Department of Radiology, , University of California San Diego, ; San Diego, CA USA

[15 ]GRID grid.59025.3b, ISNI 0000 0001 2224 0361, Department of Diagnostic Radiology, Tan Tock Seng Hospital, , Lee Kong Chian School of Medicine, ; Singapore, Singapore

[16 ]GRID grid.412558.f, ISNI 0000 0004 1762 1794, Department of Radiology, , Third Affiliated Hospital of Sun Yat Sen University, ; Guangzhou, People’s Republic of China

[17 ]GRID grid.8547.e, ISNI 0000 0001 0125 2443, Department of Radiology, Zhongshan Hospital, , Fudan University, ; Shanghai, People’s Republic of China

[18 ]GRID grid.8547.e, ISNI 0000 0001 0125 2443, Liver Cancer Institute, Zhongshan Hospital, , Fudan University, ; Shanghai, People’s Republic of China

[19 ]GRID grid.59734.3c, ISNI 0000 0001 0670 2351, Department of Diagnostic, Molecular, and Interventional Radiology, , BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, ; New York, NY USA

Author information

Dow-Mu Koh http://orcid.org/0000-0001-7654-8011

Article

Publisher ID: 7637

DOI: 10.1007/s00330-020-07637-4

PMC ID: 8270799

PubMed ID: 33523304

SO-VID: 05eea4b8-7b46-4b29-9e28-26a7641e3c51

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 3 August 2020

Date revision received : 17 November 2020

Date accepted : 16 December 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100004326, Bayer;

Award ID: This study received funding from Bayer AG. No complex statistical methods were necessary for this paper. Institutional Review Board approval was not required because this is a review paper. Medical writing assistance was provided by Bill Wolvey at Parexel, and was funded by Bayer AG

Custom metadata

ScienceOpen disciplines: Radiology & Imaging

Keywords: gadoxetic acid,hepatocellular carcinoma,magnetic resonance imaging,metastatic liver disease

Data availability:

ScienceOpen disciplines: Radiology & Imaging

Keywords: gadoxetic acid, hepatocellular carcinoma, magnetic resonance imaging, metastatic liver disease