Role of gadoxetate DCE-MRI in radiation therapy of liver cancers

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the liver is commonly performed using extracellular contrast agents. Different versions of the Tofts/Kety models are used to derive perfusion parameters such as K^trans (transfer rate), K^ep (efflux rate) and plasma volume fraction as biomarkers of liver function. It is possible to obtain a more direct measurement of liver function using hepatobiliary contrast agents such as gadoxetic acid/ gadoxetate (Gd-EOB-DTPA; Primovist®, Bayer Healthcare). DCE-MRI performed using gadoxetate has been used to assess liver function in chronic liver disease [1], prediction of treatment response of hepatocellular carcinoma (HCC) [2], drug-induced liver injury [3] and for preoperative assessment of future liver remnant in patients undergoing liver resection [4]. We propose that gadoxetate DCE-MRI can be similarly applied in the area of radiation therapy of the liver, particularly stereotactic ablative radiotherapy (SABR). (author)