Magnetic resonance imaging of hepatocellular carcinoma using contrast media

Magnetic resonance imaging (MRI) has been widely used for evaluation of focal lesions associated with hepatic carcinogenesis including hepatocellular carcinoma (HCC). By providing better tissue contrast compared to ultrasonography and computed tomography, MRI is considered the most sensitive modality for diagnosis of HCC. Dynamic MRI using gadolinium-based extracellular fluid (ECF) agents is useful for detection of hypervascular tumors and lesion characterization but has limitations in the diagnosis of hypovascular HCCs and lesion characterization of nonhypervascular tumors. MRI using superparamagnetic iron oxide agents may be useful for detecting and characterizing lesions that were not seen on dynamic MRI using ECF agents, but finding well-differentiated HCC and differentiating it from a dysplastic nodule can be difficult in some cases. Hepatobiliary agents that can be used in both dynamic MRI and delayed hepatobiliary phase imaging have great potential for improving characterization of focal lesions associated with hepatic carcinogenesis. Further studies are necessary to determine their roles in evaluation and management of HCCs.