caa a22 4500 605493901 CHVBK 20210128100523.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00261-014-0227-5 doi (NATIONALLICENCE)springer-10.1007/s00261-014-0227-5 Hepatobiliary agents and their role in LI-RADS [Elektronische Daten] [Thomas Hope, Kathryn Fowler, Claude Sirlin, Eduardo Costa, Judy Yee, Benjamin Yeh, Jay Heiken] The Liver Imaging Reporting and Data System (LI-RADS) was introduced with the goal of standardizing the diagnosis of hepatocellular carcinoma. The 2014 version of LI-RADS incorporates the use of hepatobiliary contrast agents (HBAs) into the diagnostic algorithm, including gadoxetate disodium and gadobenate dimeglumine. Three new ancillary features are introduced: hepatobiliary phase (HBP) hypointensity and HBP hypointense rim favor malignancy, while HBP isointensity favors benignity. HBP hyperintensity favors neither malignancy nor benignity. In this review, we describe how to use these new features as well as numerous pitfalls associated with the use ofHBAs, including hemangiomas, cholangiocarcinomas, and focal confluent fibrosis. Importantly, findings on the HBP are not included as major criteria and therefore the criteria for the diagnosis of LI-RADS 5 observations remain unchanged, and so congruence with the Organ Procurement Transplant Network system remains intact. Additionally, we review how the major features in LI-RADS, arterial phase hyperenhancement, threshold growth, and washout and capsule appearance, may be affected with HBAs. Notably with HBAs, hypointensity on the delayed phase, termed the transitional phase, does not qualify as washout appearance due to the possibility of early parenchymal enhancement. It is hoped that the incorporation of HBAs into LI-RADS will help create consistency when interpreting HBA enhanced MRIs. Springer Science+Business Media New York (outside the USA), 2014 Hepatocellular carcinoma nationallicence Hepatobiliary agents nationallicence Liver nationallicence LI-RADS nationallicence Gadoxetate nationallicence Gadobenate dimeglumine nationallicence Hope Thomas Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue - 0628, 94143-0628, San Francisco, CA, USA aut Fowler Kathryn Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA aut Sirlin Claude Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA aut Costa Eduardo Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA aut Yee Judy Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue - 0628, 94143-0628, San Francisco, CA, USA aut Yeh Benjamin Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue - 0628, 94143-0628, San Francisco, CA, USA aut Heiken Jay Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/3(2015-03-01), 613-625 0942-8925 40:3<613 2015 40 261 https://doi.org/10.1007/s00261-014-0227-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0227-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hope Thomas Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue - 0628, 94143-0628, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Fowler Kathryn Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Sirlin Claude Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA aut NATIONALLICENCE 700 1- Costa Eduardo Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA aut NATIONALLICENCE 700 1- Yee Judy Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue - 0628, 94143-0628, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Yeh Benjamin Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue - 0628, 94143-0628, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Heiken Jay Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/3(2015-03-01), 613-625 0942-8925 40:3<613 2015 40 261