Dow-Mu Koh1, Ahmed Ba-Ssalamah2, Giuseppe Brancatelli3, Ghaneh Fananapazir4, M Isabel Fiel5, Satoshi Goshima6, Sheng-Hong Ju7, Nikolaos Kartalis8,9, Masatoshi Kudo10, Jeong Min Lee11, Takamichi Murakami12, Max Seidensticker13, Claude B Sirlin14, Cher Heng Tan15, Jin Wang16, Jeong Hee Yoon11, Mengsu Zeng17, Jian Zhou18, Bachir Taouli19. 1. Department of Diagnostic Radiology, Royal Marsden Hospital, Sutton, UK. Mu.Koh@icr.ac.uk. 2. Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria. 3. Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BiND), University of Palermo, Palermo, Italy. 4. Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA. 5. Department of Pathology, Molecular and Cell Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 6. Department of Diagnostic Radiology & Nuclear Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan. 7. Department of Radiology, Zhongda Hospital, Southeast University, Nanjing, People's Republic of China. 8. Department of Radiology Huddinge, Karolinska University Hospital, Stockholm, Sweden. 9. Division of Radiology, CLINTEC, Karolinska Institutet, Stockholm, Sweden. 10. Department of Hepatology and Gastroenterology, Kindai University Faculty of Medicine, Osaka, Japan. 11. Department of Radiology, College of Medicine, Seoul National University, Seoul, South Korea. 12. Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan. 13. Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Munich, Germany. 14. Department of Radiology, University of California San Diego, San Diego, CA, USA. 15. Department of Diagnostic Radiology, Tan Tock Seng Hospital, Lee Kong Chian School of Medicine, Singapore, Singapore. 16. Department of Radiology, Third Affiliated Hospital of Sun Yat Sen University, Guangzhou, People's Republic of China. 17. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China. 18. Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China. 19. Department of Diagnostic, Molecular, and Interventional Radiology, BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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.
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.
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