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Gadoxetic acid (marketed as Eovist in the US and Primovist in Europe) is a gadolinium-based, hepatocyte-specific paramagnetic contrast agent used in magnetic resonance imaging (MRI) of the liver. It combines the properties of a conventional extracellular fluid contrast agent with those of a hepatobiliary agent. Gadoxetic acid is selectively taken up by functioning hepatocytes via organic anion transporting polypeptides (OATP1B1 and OATP1B3) and subsequently excreted into the bile via multidrug resistance-associated protein 2 (MRP2). This dual-phase enhancement allows for both dynamic perfusion imaging and delayed hepatobiliary phase imaging, significantly improving the detection, characterization, and differentiation of focal liver lesions, such as hepatocellular carcinoma (HCC) and liver metastases, from non-hepatocellular lesions.
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