Radiology Rounds - October 2010 - Gadoxetic Acid (Eovist) and Hepatobiliary MR Imaging

Gadolinium-ethoxybenzyl-diethylene triamine penta-acetic acid (Gd-EOB-DTPA), which is marketed as Eovist® (gadoxetic acid disodium), is a new hepatobiliary imaging agent that was approved for clinical use by the U.S. Food and Drug Administration in 2008. Gadoxetic acid is specifically taken up by hepatocytes using the same molecular mechanism as bile acid. It is eliminated from the body in equal quantities by the biliary and urinary systems. Unlike the standard extracellular gadolinium contrast agents, gadoxetic acid binds weakly to plasma proteins. As a result, T1 relaxivity is greater and enhancement is more intense. For this reason, the dose of gadoxetic acid (0.025 mmol/ kg body weight) is one fourth that of conventional MR contrast agents. Gadoxetic acid is well tolerated, and drugrelated adverse events are uncommon and mild or moderate in severity. However, there is a small risk of developing nephrogenic systemic fibrosis (NSF) in patients with poor kidney function (see Radiology Rounds, June 2007). Therefore, all patients must have kidney function tests prior to imaging.