Expert Consensus on the Role of Hepato-Biliary Specific Contrast Agents in the Diagnosis of Hepatocellular Carcinoma

Abstract

Hepatocellular carcinoma (HCC) remains a major health burden worldwide, including in Vietnam. Current national guidelines rely on dynamic imaging with CT, MRI, or ultrasound for diagnosis; however, detecting early-stage HCC and lesions with atypical imaging features remains challenging. Gadoxetic acid–enhanced MRI (EOB-MRI) offers advantages by combining dynamic vascular assessment with hepatocyte-specific uptake. During the hepatobiliary phase (15–20 minutes post-injection), lesions with impaired transporter function fail to retain contrast and appear hypointense compared with surrounding parenchyma, thereby improving sensitivity for the detection and characterization of early HCC.
On January 26, 2024, a scientific workshop on the use of EOB-MRI in HCC diagnosis was held in Hanoi, organized by the Vietnamese Society of Radiology and Nuclear Medicine with participation from leading experts from Korea and major hospitals across Vietnam. Presentations from radiology, hepatology, and hepatobiliary surgery specialists reached a shared recognition of the clinical value of EOB-MRI. Based on the workshop and supporting international evidence, a draft consensus statement was developed. This document was subsequently revised and finalized at the Society’s Annual Scientific Meeting in August 2024, with contributions from both domestic and international experts. The consensus highlights the pivotal role of EOB-MRI in the diagnosis of HCC and provides recommendations for its clinical application.