FAQ

Question 1: In what concentration is Primovist^® applied? How is the application of Primovist^® compared to other contrast agents containing gadolinium (Gd)?: Answer: Primovist^® concentration (0.25 mmol/mL) is only quarter that of unspecific extracellular Gd containing contrast media (e.g. Magnevist^®, Omniscan, Multihance^®). Osmolarity is thus diminished, thereby further reducing the potentially painful reactions in cases of inadvertent, perivascular application. Despite the lower dose concentration the mean application volume amounts to only 7.5mL (for a 75-kg patient) allowing a convenient administration for the patient.
Question 2: When does the liver-specific phase commence, when should a measurement be started?: Answer: From a pharmacological point of view, the liver-specific phase commences immediately after CM application. Significant enhancement due to uptake in the hepatocytes can be observed approximately five minutes after injection (depending on the metabolic status of the individual patient). Due to gadolinium (Gd), dynamic information is similar to dynamic information with ECCM-MRI and CT. The recommended time for liver-specific imaging is 10-20 minutes after administration. According to preliminary results, an earlier time point ten minutes post injection can be used, but it was shown that the highest level of liver-specific enhancement occurs ~20 minutes after contrast medium administration, especially in patients with liver cirrhosis.
Question 3: Adenoma/FNH: can they be differentiated based on Primovist^® administration?: Answer: Primovist^® provides more information compared to extracellular contrast media. In addition to the information from precontrast sequences and the dynamic phase imaging Primovist^® adds information about liver-specific uptake and biliary excretion. Thus, according to the scientific data available, the differentiation between adenoma and FNH seems possible.
Question 4: HCC: Is there a liver-specific enhancement in HCC?: Answer: Liver-specific enhancement of well-differentiated (G1) HCC was reported in rare cases.
Question 5: Is metastases liver-specific enhancement possible during the liver-specific phase?: Answer: If the liver-specific imaging is performed at the recommended time point 10-20 minutes after Primovist^® administration, metastases show no relevant enhancement.