Editorial Type:
Diagnostic Imaging

Hepatic computed tomography and cholangiography by use of gadoxetic acid in healthy cats

Joanna L. Pilton 1Unit of Diagnostic Imaging, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia.

Search for other papers by Joanna L. Pilton in
Current site
Google Scholar
PubMed Close
 BVSc
,
Jennifer Chau 1Unit of Diagnostic Imaging, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia.

Search for other papers by Jennifer Chau in
Current site
Google Scholar
PubMed Close
 BVSc
,
Timothy S. Foo 1Unit of Diagnostic Imaging, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia.

Search for other papers by Timothy S. Foo in
Current site
Google Scholar
PubMed Close
 BVMS
,
Evelyn J. Hall 3Unit of Environmental Sciences, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia.

Search for other papers by Evelyn J. Hall in
Current site
Google Scholar
PubMed Close
 BSCAGR, PhD
,
Fernando Martinez-Taboada 2Unit of Anaesthesia, School of Veterinary Science, Faculty of Science, and School of Life, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia.

Search for other papers by Fernando Martinez-Taboada in
Current site
Google Scholar
PubMed Close
 LV
,
Juan M. Podadera 1Unit of Diagnostic Imaging, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia.

Search for other papers by Juan M. Podadera in
Current site
Google Scholar
PubMed Close
 Dr Med Vet
, and
Mariano A. Makara 1Unit of Diagnostic Imaging, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia.

Search for other papers by Mariano A. Makara in
Current site
Google Scholar
PubMed Close
 Dr Med Vet
DOI:
https://doi.org/10.2460/ajvr.80.4.385
Volume/Issue:
Volume 80: Issue 4
Online Publication Date:
01 Apr 2019
Restricted access
Sign In Reprints and Permissions Purchase Article

Abstract

OBJECTIVE

To evaluate 3 doses of gadoxetic acid (Gd-EOB-DPTA) for hepatic CT and cholangiography in cats and to determine optimal timing for hepatobiliary image acquisition and evaluation of the contrast-enhanced hepatobiliary anatomy.

ANIMALS

6 healthy cats.

PROCEDURES

Cats were anesthetized; sequential CT scans were performed 0, 5, 25, 45, 65, and 85 minutes after IV administration of Gd-EOB-DTPA at low (0.0125 mmol/kg), medium (0.1 mmol/kg), and high (0.3 mmol/kg) doses. Hepatobiliary enhancement for each dose was objectively assessed over time and by use of a subjective semiquantitative visual assessment score.

RESULTS

No contrast-related adverse effects were detected. Each increase in dose of contrast medium resulted in a significant increase in HU across the hepatobiliary system. The liver had a significantly higher number of HU at 45 minutes, with homogenous enhancement at all doses of contrast medium. Contrast-enhanced cystic and bile duct HU were significantly higher and maximal at 65 minutes. Contrast-enhanced gallbladder HU did not plateau by 85 minutes. At a high dose of contrast medium, 12 of 60 (20%) biliary tract scores indicated no enhancement, 34 (57%) indicated poor enhancement, and 14 (23%) indicated moderate enhancement. No cat had excellent enhancement of the biliary tract at any dose.

CONCLUSIONS AND CLINICAL RELEVANCE

Gd-EOB-DTPA–enhanced hepatic CT and cholangiography in cats were safely performed and provided good hepatic enhancement but poor to moderate enhancement of the biliary tract. This technique may be useful for assessing the liver parenchyma in cats, but its value for assessing the biliary tract is questionable.

Abstract

OBJECTIVE

To evaluate 3 doses of gadoxetic acid (Gd-EOB-DPTA) for hepatic CT and cholangiography in cats and to determine optimal timing for hepatobiliary image acquisition and evaluation of the contrast-enhanced hepatobiliary anatomy.

ANIMALS

6 healthy cats.

PROCEDURES

Cats were anesthetized; sequential CT scans were performed 0, 5, 25, 45, 65, and 85 minutes after IV administration of Gd-EOB-DTPA at low (0.0125 mmol/kg), medium (0.1 mmol/kg), and high (0.3 mmol/kg) doses. Hepatobiliary enhancement for each dose was objectively assessed over time and by use of a subjective semiquantitative visual assessment score.

RESULTS

No contrast-related adverse effects were detected. Each increase in dose of contrast medium resulted in a significant increase in HU across the hepatobiliary system. The liver had a significantly higher number of HU at 45 minutes, with homogenous enhancement at all doses of contrast medium. Contrast-enhanced cystic and bile duct HU were significantly higher and maximal at 65 minutes. Contrast-enhanced gallbladder HU did not plateau by 85 minutes. At a high dose of contrast medium, 12 of 60 (20%) biliary tract scores indicated no enhancement, 34 (57%) indicated poor enhancement, and 14 (23%) indicated moderate enhancement. No cat had excellent enhancement of the biliary tract at any dose.

CONCLUSIONS AND CLINICAL RELEVANCE

Gd-EOB-DTPA–enhanced hepatic CT and cholangiography in cats were safely performed and provided good hepatic enhancement but poor to moderate enhancement of the biliary tract. This technique may be useful for assessing the liver parenchyma in cats, but its value for assessing the biliary tract is questionable.

Contributor Notes

Address correspondence to Dr. Pilton (joanna.pilton@sydney.edu.au).
Cover American Journal of Veterinary Research
American Journal of Veterinary Research
Publication Date:
01 Apr 2019

  • 1. Marolf AJ, Stewart JA, Dunphy TR, et al. Hepatic and pancreaticobiliary MRI and MR cholangiopancreatography with and without secretin stimulation in normal cats. Vet Radiol Ultrasound 2011;52:415–421.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 2. Center SA. Diseases of the gallbladder and biliary tree. Vet Clin North Am Small Anim Pract 2009;39:543–598.

  • 3. Smallwood JE. Digestive system. In: Hudson L, Hamilton W, eds. Atlas of feline anatomy for veterinarians. Philadelphia: WB Saunders Co, 1993;166–167.

    • Search Google Scholar
    • Export Citation

  • 4. Neer TM. A review of disorders of the gallbladder and extrahepatic biliary tract in the dog and cat. J Vet Intern Med 1992;6:186–192.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 5. Brain PH, Barrs VR, Martin P, et al. Feline cholecystitis and acute neutrophilic cholangitis: clinical findings, bacterial isolates and response to treatment in six cases. J Feline Med Surg 2006;8:91–103.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 6. Boland L, Beatty J. Feline cholangitis. Vet Clin North Am Small Anim Pract 2017;47:703–724.

  • 7. Weiss DJ, Gagne JM, Armstrong PJ. Relationship between inflammatory hepatic disease and inflammatory bowel disease, pancreatitis, and nephritis in cats. J Am Vet Med Assoc 1996;209:1114–1116.

    • Search Google Scholar
    • Export Citation

  • 8. Cullen JM. Summary of the World Small Animal Veterinary Association Standardization Committee Guide to Classification of Liver Disease in Dogs and Cats. Vet Clin North Am Small Anim Pract 2009;39:395–418.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 9. Selmic LE. Hepatobiliary neoplasia. Vet Clin North Am Small Anim Pract 2017;47:725–735.

  • 10. Bennett SL, Milne M, Slocombe RF, et al. Gallbladder mucocoele and concurrent hepatic lipidosis in a cat. Aust Vet J 2007;85:397–400.

  • 11. Woods KS, Brisson BA, Defarges AM, et al. Congenital duplex gallbladder and biliary mucocele associated with partial hepatic cholestasis and cholelithiasis in a cat. Can Vet J 2012;53:269–273.

    • Search Google Scholar
    • Export Citation

  • 12. Furneaux RW. A series of six cases of sphincter of Oddi pathology in the cat (2008–2009). J Feline Med Surg 2010;12:794–801.

  • 13. Della Santa D, Schweighauser A, Forterre F, et al. Imaging diagnosis—extrahepatic biliary tract obstruction secondary to a duodenal foreign body in a cat. Vet Radiol Ultrasound 2007;48:448–450.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 14. Brioschi V, Rousset N, Ladlow JF. Imaging diagnosis—extrahepatic biliary tract obstruction secondary to a biliary foreign body in a cat. Vet Radiol Ultrasound 2014;55:628–631.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 15. Linton M, Buffa E, Simon A, et al. Extrahepatic biliary duct obstruction as a result of involuntary transcavitary implantation of hair in a cat. JFMS Open Rep 2015;1:2055116915610359.

    • Search Google Scholar
    • Export Citation

  • 16. Léveille R, Biller DS, Shiroma JT. Sonographic evaluation of the common bile duct in cats. J Vet Intern Med 1996;10:296–299.

  • 17. Sherding RG. Feline jaundice. J Feline Med Surg 2000;2:165–169.

  • 18. Newell SM, Selcer BA, Roberts RE, et al. Hepatobiliary scintigraphy in the evaluation of feline liver disease. J Vet Intern Med 1996;10:308–315.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 19. Newell SM, Graham JP, Roberts GD, et al. Quantitative hepatobiliary scintigraphy in normal cats and in cats with experimental cholangiohepatitis. Vet Radiol Ultrasound 2001;42:70–76.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 20. Head LL, Daniel GB. Correlation between hepatobiliary scintigraphy and surgery or postmortem examination findings in dogs and cats with extrahepatic biliary obstruction, partial obstruction, or patency of the biliary system: 18 cases (1995–2004). J Am Vet Med Assoc 2005;227:1618–1624.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 21. Carlisle C. A comparison of technics for cholecystography in the cat. Vet Radiol 1977;18:173–176.

  • 22. Larson MM. Ultrasound imaging of the hepatobiliary system and pancreas. Vet Clin North Am Small Anim Pract 2016;46:453–480, v–vi.

  • 23. Marolf AJ, Leach L, Gibbons DS, et al. Ultrasonographic findings of feline cholangitis. J Am Anim Hosp Assoc 2012;48:36–42.

  • 24. Gaillot HA, Penninck DG, Webster CRL, et al. Ultrasonographic features of extrahepatic biliary obstruction in 30 cats. Vet Radiol Ultrasound 2007;48:439–447.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 25. Policelli Smith R, Gookin JL, Smolski W, et al. Association between gallbladder ultrasound findings and bacterial culture of bile in 70 cats and 202 dogs. J Vet Intern Med 2017;31:1451–1458.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 26. Spillmann T, Willard MD, Ruhnke I, et al. Feasibility of endoscopic retrograde cholangiopancreatography in healthy cats. Vet Radiol Ultrasound 2014;55:85–91.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 27. Marolf AJ. Computed tomography and MRI of the hepatobiliary system and pancreas. Vet Clin North Am Small Anim Pract 2016;46:481–497 (vi.).

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 28. Rosenberg FJ, Ackerman JH, Nickel AR. Iosulamide: a new intravenous cholangiocholecystographic medium. Invest Radiol 1980;15:S142–S147.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 29. Marolf AJ, Kraft SL, Dunphy TR, et al. Magnetic resonance (MR) imaging and MR cholangiopancreatography findings in cats with cholangitis and pancreatitis. J Feline Med Surg 2013;15:285–294.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 30. Marolf AJ. Diagnostic imaging of the hepatobiliary system: an update. Vet Clin North Am Small Anim Pract 2017;47:555–568.

  • 31. Schindera ST, Nelson RC, Paulson EK, et al. Assessment of the optimal temporal window for intravenous CT cholangiography. Eur Radiol 2007;17:2531–2537.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 32. Spillmann T, Schnell-Kretschmer H, Dick M, et al. Endoscopic retrograde cholangio-pancreatography in dogs with chronic gastrointestinal problems. Vet Radiol Ultrasound 2005;46:293–299.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 33. O'Connor OJ, O'Neill S, Maher MM. Imaging of biliary tract disease. AJR Am J Roentgen 2011;197:W551–W558.

  • 34. Maccioni F, Martinelli M, Al Ansari N, et al. Magnetic resonance cholangiography: past, present and future: a review. Eur Rev Med Pharmacol Sci 2010;14:721–725.

    • Search Google Scholar
    • Export Citation

  • 35. Lee NK, Kim S, Lee JW, et al. Biliary MR imaging with Gd-EOB-DTPA and its clinical applications. Radiographics 2009;29:1707–1724.

  • 36. Burke C, Alexander Grant L, Goh V, et al. The role of hepatocyte-specific contrast agents in hepatobiliary magnetic resonance imaging. Semin Ultrasound CT MR 2013;34:44–53.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 37. Van Beers BE, Pastor CM, Hussain HK. Primovist, Eovist: what to expect? J Hepatol 2012;57:421–429.

  • 38. Schmitz SA, Häberle J, Balzer T, et al. Detection of focal liver lesions: CT of the hepatobiliary system with gadoxetic acid disodium, or Gd-EOB-DTPA. Radiology 1997;202:399–405.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 39. Yonetomi D, Kadosawa T, Miyoshi K, et al. Contrast agent Gd-EOB-DTPA (EOB.Primovist®) for low-field magnetic resonance imaging of canine focal liver lesions. Vet Radiol Ultrasound 2012;53:371–380.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 40. Constant C, Hecht S, Craig LE, et al. Gadoxetate disodium (Gd-EOB-DTPA) contrast enhanced magnetic resonance imaging characteristics of hepatocellular carcinoma in dogs. Vet Radiol Ultrasound 2016;57:594–600.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 41. Chau J, Podadera J, Young A, et al. Use of gadoxetic acid for computed tomographic cholangiography in healthy dogs. Am J Vet Res 2017;78:828–839.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 42. Schmitz SA, Wagner S, Schuhmann-Giampieri G, et al. A prototype liver-specific contrast medium for CT: preclinical evaluation of gadoxetic acid disodium, or Gd-EOB-DTPA. Radiology 1997;202:407–412.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 43. Schmitz SA, Wagner S, Schuhmann-Giampieri G, et al. Gd-EOB-DTPA and Yb-EOB-DTPA: two prototypic contrast media for CT detection of liver lesions in dogs. Radiology 1997;205:361–366.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 44. Shanaman MM, Hartman SK, O'Brien RT. Feasibility for using dual-phase contrast-enhanced multi-detector helical computed tomography to evaluate awake and sedated dogs with acute abdominal signs. Vet Radiol Ultrasound 2012;53:605–612.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 45. Patel NB, Oto A, Thomas S. Multidetector CT of emergent biliary pathologic conditions. Radiographics 2013;33:1867–1888.

  • 46. Eovist (gadoxetate disodium) prescribing information, 2010. Wayne, NJ: Bayer HealthCare Pharmaceuticals Inc. Available at: www.accessdata.fda.gov/drugsatfda_docs/label/2010/022090s004lbl.pdf. Accessed Jun 5, 2017.

    • Search Google Scholar
    • Export Citation

  • 47. Mendichovszky IA, Marks SD, Simcock CM, et al. Gadolinium and nephrogenic systemic fibrosis: time to tighten practice. Pediatr Radiol 2008;38:489–496.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 48. Hamm B, Staks T, Mühler A, et al. Phase I clinical evaluation of Gd-EOB-DTPA as a hepatobiliary MR contrast agent: safety, pharmacokinetics, and MR imaging. Radiology 1995;195:785–792.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 49. Louvet A, Duconseille A-C. Feasibility for detecting liver metastases in dogs using gadobenate dimeglumine-enhanced magnetic resonance imaging. Vet Radiol Ultrasound 2015;56:286–295.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 50. Abou-El-Makarem MM, Millburn P, Smith RL, et al. Biliary excretion in foreign compounds. Species difference in biliary excretion. Biochem J 1967;105:1289–1293.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 51. Marks AL, Hecht S, Stokes JE, et al. Effects of gadoxetate disodium (EOVIST®) contrast on magnetic resonance imaging characteristics of the liver in clinically healthy dogs. Vet Radiol Ultrasound 2014;55:286–291.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 52. Choi IY, Yeom SK, Cha SH, et al. Diagnosis of biliary stone disease: T1-weighted magnetic resonance cholangiography with Gd-EOB-DTPA versus T2-weighted magnetic resonance cholangiography. Clin Imaging 2014;38:164–169.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement