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

Christoph J. Zech, Ahmed Ba-Ssalamah, Thomas Berg, Hersh Chandarana, Gar Yang Chau, Luigi Grazioli, Myeong Jin Kim, Jeong Min Lee, Elmar M. Merkle, Takamichi Murakami, Jens Ricke, Claude B. Sirlin, Bin Song, Bachir Taouli, Kengo Yoshimitsu, Dow Mu Koh

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish
Pages (from-to)370-382
Number of pages13
JournalEuropean Radiology
Volume30
Issue number1
DOIs
StatePublished - 1 Jan 2020

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Magnetic Resonance Imaging
Liver
Hepatocellular Carcinoma
Respiration
Politics
Switzerland
Liver Cirrhosis
Artifacts
Early Diagnosis
Guidelines
Research

Keywords

  • Gadoxetic acid
  • Hepatocellular carcinoma
  • Magnetic resonance imaging

Cite this

Zech, C. J., Ba-Ssalamah, A., Berg, T., Chandarana, H., Chau, G. Y., Grazioli, L., ... Koh, D. M. (2020). Consensus report from the 8th International Forum for Liver Magnetic Resonance Imaging. European Radiology, 30(1), 370-382. https://doi.org/10.1007/s00330-019-06369-4
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. / Consensus report from the 8th International Forum for Liver Magnetic Resonance Imaging. In: European Radiology. 2020 ; Vol. 30, No. 1. pp. 370-382.
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abstract = "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.",
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Zech, CJ, Ba-Ssalamah, A, Berg, T, Chandarana, H, Chau, GY, Grazioli, L, Kim, MJ, Lee, JM, Merkle, EM, Murakami, T, Ricke, J, B. Sirlin, C, Song, B, Taouli, B, Yoshimitsu, K & Koh, DM 2020, 'Consensus report from the 8th International Forum for Liver Magnetic Resonance Imaging', European Radiology, vol. 30, no. 1, pp. 370-382. https://doi.org/10.1007/s00330-019-06369-4

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

In: European Radiology, Vol. 30, No. 1, 01.01.2020, p. 370-382.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Consensus report from the 8th International Forum for Liver Magnetic Resonance Imaging

AU - Zech, Christoph J.

AU - Ba-Ssalamah, Ahmed

AU - Berg, Thomas

AU - Chandarana, Hersh

AU - Chau, Gar Yang

AU - Grazioli, Luigi

AU - Kim, Myeong Jin

AU - Lee, Jeong Min

AU - Merkle, Elmar M.

AU - Murakami, Takamichi

AU - Ricke, Jens

AU - B. Sirlin, Claude

AU - Song, Bin

AU - Taouli, Bachir

AU - Yoshimitsu, Kengo

AU - Koh, Dow Mu

PY - 2020/1/1

Y1 - 2020/1/1

N2 - 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.

AB - 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.

KW - Gadoxetic acid

KW - Hepatocellular carcinoma

KW - Magnetic resonance imaging

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Zech CJ, Ba-Ssalamah A, Berg T, Chandarana H, Chau GY, Grazioli L et al. Consensus report from the 8th International Forum for Liver Magnetic Resonance Imaging. European Radiology. 2020 Jan 1;30(1):370-382. https://doi.org/10.1007/s00330-019-06369-4