liver imag workshop ver imagin orkshop liv imaging workshop liver imag workshop April 19–20, 2012 | Porto/PT November 8–9, 2012 | Athens/GR www.esgar.org liver imaging workshops
liver imag workshop liver imaging workshop liver imaging workshop liver imag workshopApril 19–20, 2012 | Porto/PT
November 8–9, 2012 | Athens/GR
www.esgar.org
liver imaging workshops
This educational activity of ESGAR is exclusively sponsored by an educational grant of BAYER HEALTHCARE.
While the information provided in this publication was assembled with great dilligence, the publishers assume no liability for printing errors or incompletion.Date of printing: January 2012
3
introduct
ion
IntroductIon
Liver imaging has evolved into one of the main fields of application in our discipline thanks to the impressive technological evolution of all modalities and the development of new contrast media in particular tissue specific agents.The aim of the workshop is to provide a comprehensive coverage of all the main liver pathologies that will be presented by means of an integrated multimodality approach. Imaging findings will be analysed on the basis of their pathological correlations.The format of the workshop will include formal lectures that have been assigned to expert colleagues able to thoroughly discuss each topic. Moreover, an interactive discussion on real clinical cases will be led – in additional “slots” – by the faculty members who will help to define the state-of-the-art in the diagnosis of liver diseases.A specific aim of the workshop is to provide practical suggestions on how to manage the diagnostic work-up of liver diseases in the daily practice.
LearnIng objectIves
To describe the most relevant technological advances of different modalities and contrast media applied to liver imaging
To equip delegates with an improved understanding of segmental anatomy of the liver in order to share a standard radiological and surgical terminology
To discuss the main liver pathologies based on structured multi-modality orientated lectures and interactive case presentations
To give practical suggestions on the diagnostic work-up of liver diseases in the daily practice
To understand the imaging features on the basis of pathological correlations
4
Registration
regIstratIon
Please use the online registration system on the ESGAR website www.esgar.org.
regIstratIon Fees:
radiologists, PhysiciansESGAR Members ..........................€ 400.00Non Members .................................€ 550.00
radiologists in training (residents)ESGAR Members ..........................€ 250.00Non Members .................................€ 350.00
regIstratIon Fee IncLudes:
access to lectures and interactive case discussions
final programme/syllabus coffee breaks lunches or lunchbox certificate of attendance
The number of participants per workshop is limited and registrations will be accepted on a first come first served basis. Together with the registration payment is necessary.
Registrations as radiologist in training (Residents) must be accompanied by a confirmation of the head of the department confirming the status as Resident.
registratio
n
regIstratIon deadLInes
Registration Deadline for the Porto Workshop is March 21, 2012.
Registration Deadline for the Athens Workshop is october 8, 2012.
Insurance
Participants have the opportunity to take out insurance for the registration fee. This insurance applies in case of an unforeseen cancellation of participation in the ESGAR Liver Imaging Workshops and can be taken out together with the online registration. Details can be found on the ESGAR website.
accredItatIon
ESGAR, the European Society of Gastrointestinal and Abdominal Radiology is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to provide the following CME activities for medical specialists. The EACCME is an institution of the UEMS (www.uems.net).The number of CME credits awarded to the 10th and 11th ESGAR Liver Imaging Workshop is pending and will be announced on the ESGAR website!
introduct
ion
5
PortoApril 19-20, 2012
6
General Information
WorKsHoP organIsers
Prof. Filipe Caseiro AlvesFaculdade Medicina CoimbraHospital da Universidade de CoimbraDepartment of RadiologyPraceta Mota PintoPT — 3030 Coimbra, Portugal
Dr. Manuela FrancaGeneral Hospital Santo António Largo Prof. Abel Salazar PT — 4099-001 Porto, Portugal
WorKsHoP venue
„Centro Hospitalar do Porto Hospital de Santo António“ Largo Prof. Abel Salazar PT — 4099-001 Porto, Portugal
FacuLtY
C. Bartolozzi, Pisa/ITG. Brancatelli, Palermo/ITF. Caseiro Alves, Coimbra/PTD.A. Clevert, Munich/DEL. Guimaraes, Porto/PTL. Martí-Bonmatí, Valencia/ESC. Matos, Brussels/BEL.H. Ros Mendoza, Zaragoza/ES S. Skehan, Dublin/IEV. Vilgrain, Clichy/FRC.J. Zech, Munich/DE
organIsIng secretarIat
Central ESGAR Office Neutorgasse 9 AT — 1010 Vienna, AustriaPhone: +43 1 535 89 27Fax: +43 1 535 70 37E-Mail: [email protected]: www.esgar.org
WorKsHoP Language
The workshop will be held in English.
HoteL accoMModatIon
Special room rates at the 4* hotel „Eurostars Das Artes“ are available for participants of the ESGAR Liver Imaging Workshop. Please book early in order to ensure availability.
Daily room rates (incl. breakfast and VAT): Single Room € 70.00 Twin Room € 79.00
Reservation can be done until one month prior to the event (March 18, 2012).For your room reservation and other hotel suggestions please visit the ESGAR website for further information.p
orto
- gen
eral info
rmatio
n
7
Porto, PortugaL
Porto is the second largest city in Portugal located along the river banks of the Douro River in northern Portugal. Porto is one of the oldest European cities, and is labelled as a World Heritage Site due to its history as a vital Roman outpost. Historically known for their export of wine, Porto has many cultural and historical attractions due to its long European history. Porto has numerous cathedrals and museums, most notably the Renaissance Church of Santa Clara and Porto Cathedral. Porto also has long strip of beaches and restaurants with Portuguese cuisines along the Douro River.
currencY
The Euro (€) is the offical currency in Portugal.
eLectrIcItY
230V/50Hz (European plug)
Language
The official language is Portuguese.
tIMeZone
GMT
HoW to reacH Porto
bY PLaneAeroporto do Porto or Aeroporto de Pedras Rubras is the third busiest airport in the country and is about 15 km from the city centre. Just outside of the airport is the AeroBus which takes you to Praça da Liberdade (city center) or will drop you off at the Pousada da Juventude. A taxi trip will cost approx. € 20.00. The Metro line connects the Airport to the city centre, offering a fast and peaceful ride into the heart of the city. At night, between 01:30 and 06:00, there is no regular connection, so using a taxi is the only possibility.
bY traInThe city is served by two major train stations, the “São Bento” (Saint Benedict) station which is located in the city centre and the “Campanhã” station. Trains from and to Madrid and Paris are regular, other non-domestic destinations vary according to demand and time of year. Domestic trains are very frequent and usually on time.
PubLIc transPort
Campanhã has the light railway and the suburban railway, both services connect to the central station of São Bento Station.
por
to -
gen
eral info
rmatio
n
por
to -
pro
gra
mm
e
8
Thursday, April 19
08:45 registration
09:15 oPenIng reMarKs
IMagIng ModaLItIes09:20 us technique including ceus D.A. Clevert, Munich/DE 09:45 Mdct of the Liver L. Guimaraes, Porto/PT 10:10 Liver MrI: advanced techniques, dWI and hepatocyte-specific
contrast agents L. Martí-Bonmatí, Valencia/ES 10:35 Q&a
10:50 coFFee breaK
vascuLar and bILIarY anatoMY and dIseases11:20 Functional anatomy of the liver and biliary tract: clinical implications L.H. Ros Mendoza, Zaragoza/ES 11:55 vascular diseases F. Caseiro Alves, Coimbra/PT 12:20 biliary diseases C. Matos, Brussels/BE 12:45 Q&a
12:55 LuncH
non-cIrrHotIc LIver13:45 Focal lesions in the non-cirrhotic liver C.J. Zech, Munich/DE 14:10 Focal lesions too small to characterise: what to do? G. Brancatelli, Palermo/IT 14:35 Imaging of metastases – diagnostic approach to the
oncological patient S. Skehan, Dublin/IE 15:00 Q&a
15:15 coFFee breaK
15:30 InteractIve case dIscussIons, 3 x 40MIn the incidental focal liver nodule F. Caseiro Alves, Coimbra/PT How MrI can help to characterise a lesion in the non-cirrhotic liver C.J. Zech, Munich/DE Liver Imaging: cases with dual energy ct L. Guimaraes, Porto/PT
17:45 adjourn
por
to -
pro
gra
mm
e
9
Friday, April 20
dIFFuse dIseases and Hcc 08:30 diffuse liver diseases L. Martí-Bonmatí, Valencia/ES 08:50 diagnosis and staging of Hcc: current guidelines C. Bartolozzi, Pisa/IT 09:15 Focal lesions in cirrhosis: not always Hcc G. Brancatelli, Palermo/IT 09:35 Imaging in liver transplantation V. Vilgrain, Clichy/FR 10:00 Q&a
10:10 coFFee breaK
10:30 InteractIve case dIscussIons, 3 x 40MIn How MrI can help to characterise a lesion in the cirrhotic liver G. Brancatelli, Palermo/IT differential diagnosis Hcc – regenerative nodule C. Bartolozzi, Pisa/IT vascular diseases V. Vilgrain, Clichy/FR
12:45 LuncH
assessIng tuMour resPonse13:45 evaluation of tumour response: recIst and more S. Skehan, Dublin/IE 14:15 tumour ablation: indications, results and F/u C. Bartolozzi, Pisa/IT 14:45 dce Mr-Perfusion in the liver: feasibility and potential benefits C.J. Zech, Munich/DE
15:05 coFFee breaK
15:30 InteractIve case dIscussIons, 3 x 40 MIn ce-us: selected cases of focal liver lesions D.A. Clevert, Munich/DE Liver tumours: assessment of treatment response S. Skehan, Dublin/IE biliary disease C. Matos, Brussels/BE
17:45 dIscussIon oF QuIZ cases F. Caseiro Alves, Coimbra/PT
18:00 adjourn
10
www.esgar.org
gen
eral info
rmatio
n
11
AthensNovember 8-9, 2012
12
ath
ens - g
ener
al info
rmatio
n General Information
WorKsHoP organIser
Dr. Charina TriantopoulouKonstantopoulio Agia Olga HospitalRadiology and CT DepartmentAgias olgas 3-5GR — 14233 N.Ionia, Athens, Greece
WorKsHoP venue
Divani Caravel Hotel2, Vas. Alexandrou Avenue,GR — 16121 Athens, Greece
FacuLtY
C. Bartolozzi, Pisa/ITG. Brancatelli, Palermo/ITF. Caseiro Alves, Coimbra/PTC. Dervenis, Athens/GRS. Efremidis, Ioannina/GRS. Gourtsoyianni, Athens/GRN. Gourtsoyiannis, Athens/GRC. Matos, Brussels/BEY. Menu, Paris/FRN. Papanikolaou, Athens/GRP. Prassopoulos, Alexandroupolis/GRC. Stoupis, Maennedorf/CHC. Triantopoulou, Athens/GRV. Vilgrain, Clichy/FRS. Yarmenitis, Maroussi/GR
organIsIng secretarIat
Central ESGAR OfficeNeutorgasse 9AT — 1010 Vienna, Austria Phone: +43 1 535 89 27Fax: +43 1 535 70 37E-Mail: [email protected]: www.esgar.org
WorKsHoP Language
The workshop will be held in English.
HoteL accoMModatIon
Special room rates at the workshop hotel “Divani Caravel” are available for participants of the ESGAR Liver Imaging Workshop. Please book early in order to ensure availability.
Daily room rates(incl. American buffet breakfast, services and VAT):Single Room € 150.00Double Room € 170.00
In order to secure space, reservation forms should be sent to the reservation department till September 25, 2012.For your room reservation please visit the ESGAR website for further information.
13
ath
ens - g
ener
al info
rmatio
n
atHens, greece
Athens is the capital of Greece, with a population of 750,000. As the city where democracy was born and the most important civilization of the ancient world flourished, Athens is one of the world’s main centres of archaeological research. It lives on through some of the world’s most formidable edifices, with the Acropolis belonging to the Seven Wonders of the World. Today, a walk around the famous historic sites and the old neighbourhoods reveals the coexistence of different eras. Old mansions, luxurious department stores and small intimate shops, fancy restaurants and traditional taverns. All have their place in this city.
currencY
The Euro (€) is the official currency in Greece.
eLectrIcItY
220V/50Hz (European plug)
Language
The official language is Greek.
tIMeZone
GMT +2
HoW to reacH atHens
bY PLaneThe new Athens Eleftherios Venizelos International Airport 27 km east of the city centre, near the suburb of Spáta, opened in 2001 and is now an attractive and efficient major European airport. The airport has excellent public transit connections to the city. From the airport you can reach the city by metro, taxi, bus and suburban railway.
bY traInThe national rail service, Trainose, connects Athens to other cities in Greece.
PubLIc transPort
Public transport in Athens has improved by leaps and bounds in the last ten years. The simple ticket lets you travel on any means of transport — metro, suburban trains, trams, trolleybuses, buses — with unlimited transfers anywhere within Athens.
ath
ens - p
rogra
mm
e
14
Thursday, November 8
08:30 registration
09:00 oPenIng reMarKs C. Triantopoulou, Athens/GR
09:05 KeY note Lecture What will be the challenges for
abdominal imaging in the next decade? N. Gourtsoyiannis, Athens/GR
IMagIng ModaLItIes 09:20 us technique including ceus S. Yarmenitis, Maroussi/GR 09:45 Mdct of the liver C. Stoupis, Maennedorf/CH 10:10 Liver MrI: advanced techniques, dWI and hepatocyte-specific
contrast agents S. Gourtsoyianni, Athens/GR 10:35 Q&a
10:45 coFFee breaK
vascuLar and bILIarY anatoMY and dIseases 11:15 Functional anatomy of the liver and biliary tract: clinical implications F. Caseiro Alves, Coimbra/PT 11:45 vascular diseases of the liver V. Vilgrain, Clichy/FR 12:15 benign and malignant biliary diseases C. Matos, Brussels/BE 12:40 Q&a
12:50 LuncH
IncIdentaL LIver LesIons and InFectIons13:50 acute hepatobiliary infections and complications P. Prassopoulos, Alexandroupolis/GR 14:15 Incidental liver lesions in non-cirrhotic liver C. Stoupis, Maennedorf/CH 14:40 the hypointense liver lesion on t2w MrI and what it means F. Caseiro Alves, Coimbra/PT 15:05 Q&a
15:15 coFFee breaK
15:30 InteractIve case dIscussIons, 3 x 40MIn the incidental focal liver nodule F. Caseiro Alves, Coimbra/PT vascular diseases V. Vilgrain, Clichy/FR biliary diseases C. Matos, Brussels/BE
17:45 adjourn
ath
ens - p
rogra
mm
e
15
Friday, November 9 cIrrHosIs and Hcc08:30 From regenerative nodule to Hcc S. Efremidis, Ioannina/GR 08:50 diagnosis and staging of Hcc: current guidelines C. Bartolozzi, Pisa/IT 09:10 Focal lesions in cirrhosis: not always Hcc G. Brancatelli, Palermo/IT 09:30 Imaging in liver transplantation V. Vilgrain, Clichy/FR 09:50 Q&a
10:00 coFFee breaK
10:30 InteractIve case dIscussIons, 3 x 40MIn How MrI can help to characterise a lesion in the cirrhotic liver G. Brancatelli, Palermo/IT differential diagnosis Hcc – regenerative nodule C. Bartolozzi, Pisa/IT cad post processing of liver MrI N. Papanikolaou, Athens/GR
12:45 LuncH
MetastatIc LIver dIsease13:45 What the radiologist needs to learn from a liver surgeon C. Dervenis, Athens/GR 14:05 Liver metastases detection: dWI or hepatobiliary MrI or both? S. Gourtsoyianni, Athens/GR 14:25 Focal lesions too small to characterise: what to do? G. Brancatelli, Palermo/IT 14:45 evaluation of tumour response: recIst and more Y. Menu, Paris/FR 15:05 Q&a
15:15 coFFee breaK
15:45 InteractIve case dIscussIons, 3 x 40 MIn ce-us: selected cases of focal liver lesions S. Yarmenitis, Maroussi/GR evaluation of tumour response: recIst and more Y. Menu, Paris/FR How MrI can help to characterise a lesion in the non-cirrhotic liver S. Gourtsoyianni, Athens/GR
17:45 dIscussIon oF QuIZ cases C. Triantopoulou, Athens/GR
18:15 adjourn
Prim
ovis
t® 0
.25
mm
ol/m
L so
luti
on f
or in
ject
ion
. Com
posi
tion
1 m
L so
luti
on f
or in
ject
ion
con
tain
s 18
1.4
3 m
g ga
doxe
tic
acid
, Gd-
EOB
DTP
A di
sodi
um, e
quiv
alen
t to
0.2
5 m
mol
Gd-
EOB-
DTP
A di
sodi
um. I
ndi
cati
ons
Prim
ovis
t® is
indi
cate
d fo
r th
e de
tect
ion
of f
ocal
live
r le
sion
s an
d pr
ovid
es in
form
atio
n on
th
e ch
arac
ter o
f les
ion
s in
T1-
wei
ghte
d m
agn
etic
res
onan
ce im
agin
g (M
RI).
Th
is m
edic
al p
rodu
ct is
for
dia
gnos
tic
use
onl
y. D
osag
e an
d A
dmin
istr
atio
n: P
rim
ovis
t is
a re
ady-
to-u
se a
queo
us
solu
tion
to
be a
dmin
iste
red
undi
lute
d as
an
intr
aven
ous
bolu
s in
ject
ion
. Th
e re
com
men
ded
dose
of
Prim
ovis
t fo
r ad
ults
is 0
.1 m
l/kg
bod
y w
eigh
t Pr
imov
ist.
Con
trai
ndi
cati
ons
Hyp
erse
nsi
tivi
ty t
o th
e ac
tive
sub
stan
ce o
r to
an
y of
th
e ex
cipi
ents
. Un
desi
rabl
e ef
fect
s D
urin
g th
e cl
inic
al d
evel
opm
ent
phas
e th
e ov
eral
l in
cide
nce
of
adve
rse
reac
tion
s w
hic
h w
ere
clas
sifi
ed a
s re
late
d w
as b
elow
5 %
. Mos
t of
th
e un
desi
rabl
e ef
fect
s w
ere
tran
sien
t an
d of
mil
d to
mod
erat
e in
ten
sity
. No
indi
vidu
al a
dver
se r
eact
ion
reac
hed
a f
requ
ency
gre
ater
tha
n 1
/10
0 Q
Ner
vous
sys
tem
dis
orde
rs h
eada
che,
diz
zin
ess,
pa
rest
hes
ia, t
aste
dis
turb
ance
, ver
tigo
, aka
this
ia, t
rem
or, p
aros
mia
QCa
rdia
c di
sord
ers
bun
dle
bran
ch b
lock
, pal
pita
tion
QVa
scul
ar d
isor
ders
fl u
shin
g, h
yper
ten
sion
QRe
spir
ator
y, t
hora
cic
and
med
iast
inal
dis
orde
rs d
yspn
ea, r
espi
rato
ry d
istr
ess
QG
astr
oint
esti
nal d
isor
ders
vo
mit
ing,
nau
sea,
dry
mou
th, o
ral d
isco
mfo
rt, s
aliv
ary
hyp
erse
cret
ion
QSk
in a
nd s
ubcu
tane
ous
tiss
ue d
isor
ders
ras
h, p
ruri
tus,
mac
ulop
apul
ar r
ash
, hyp
erh
idro
sis
QG
ener
al d
isor
ders
and
adm
inis
trat
ion
site
con
diti
ons
ches
t pa
in, i
nje
ctio
n si
te r
eact
ion
s, f
eeli
ng
hot
, ch
ills
, di
scom
fort
fat
igu
e,m
alai
se, f
eeli
ng
abn
orm
al. L
abor
ator
y ch
ange
s as
ele
vate
d se
rum
iron
, ele
vate
d bi
liru
bin
, in
crea
ses
in l
iver
tra
nsa
min
ases
, dec
reas
e of
hem
oglo
bin
, ele
vati
on o
f am
ylas
e, l
euco
cytu
ria,
hyp
ergl
ycem
ia, e
leva
ted
urin
e al
bum
in, h
ypon
atre
mia
, ele
vate
d in
orga
nic
ph
osph
ate,
dec
reas
e of
ser
um p
rote
ine,
leu
cocy
tosi
s, h
ypok
alem
ia, e
leva
ted
LDH
wer
e re
port
ed in
cli
nic
al t
rial
s. E
CGs
wer
e re
gula
rly
mon
itor
ed d
urin
g cl
inic
al s
tudi
es a
nd
tran
sien
t Q
T pr
olon
gati
on w
as o
bser
ved
in s
ome
pati
ents
wit
hou
t an
y as
soci
ated
adv
erse
cl
inic
al e
ven
ts. I
n ve
ry r
are
case
s an
aph
ylac
toid
rea
ctio
ns
lead
ing
to s
hoc
k m
ay o
ccur
. Pre
cau
tion
s G
ener
al in
form
atio
n Th
e u
sual
saf
ety
prec
auti
ons
for
MRI
mu
st b
e ob
serv
ed, e
.g. e
xclu
sion
of
card
iac
pace
mak
ers
and
ferr
omag
net
ic im
plan
ts. D
iagn
osti
c pr
oced
ures
tha
t in
volv
e th
e u
se o
f co
ntr
ast
agen
ts s
hou
ld b
e ca
rrie
d ou
t un
der
the
dire
ctio
n of
a p
hys
icia
n w
ith
the
prer
equi
site
tra
inin
g an
d a
thor
ough
kn
owle
dge
of t
he
proc
edur
e to
be
perf
orm
ed. T
he
pati
ent
shou
ld r
efra
in f
rom
eat
ing
for
two
hou
rs p
rior
to
exam
inat
ion
to r
edu
ce t
he
risk
of
aspi
rati
on, a
s na
use
a an
d vo
mit
ing
are
know
n po
ssib
le a
dver
se r
eact
ion
s. W
hen
ever
pos
sibl
e, t
he
con
tras
t ag
ent
shou
ld b
e ad
min
iste
red
wit
h th
e pa
tien
t ly
ing
dow
n. A
fter
th
e in
ject
ion
, th
e pa
tien
t sh
ould
be
kept
un
der
obse
rvat
ion
for
at l
east
30
min
ute
s, s
ince
ex
peri
ence
wit
h co
ntr
ast
med
ia s
how
s th
at t
he
maj
orit
y of
un
desi
rabl
e ef
fect
s oc
cur
wit
hin
th
is t
ime.
Cau
tion
sh
ould
be
exer
cise
d in
pat
ien
ts w
ith
seve
re r
enal
impa
irm
ent
due
to r
edu
ced
elim
inat
ion
capa
city
of
Gd-
EOB-
DTP
A. P
atie
nts
wit
h re
nal
impa
irm
ent:
Th
ere
have
be
en r
epor
ts o
f N
ephr
ogen
ic S
yste
mic
Fib
rosi
s (N
SF) a
ssoc
iate
d w
ith
use
of
som
e ga
doli
niu
m-c
onta
inin
g co
ntr
ast
agen
ts in
pat
ien
ts w
ith
- ac
ute
or
chro
nic
sev
ere
rena
l im
pair
men
t (G
FR<
30m
l/m
in /
1.7
3 m
2) o
r -
acu
te r
enal
insu
ffi c
ien
cy o
f an
y se
veri
ty d
ue
to t
he
hep
ato-
rena
l syn
drom
e or
in t
he
peri
oper
ativ
e li
ver
tran
spla
nta
tion
per
iod.
As
ther
e is
a p
ossi
bili
ty t
hat
NSF
may
occ
ur w
ith
Prim
ovis
t®, i
t sh
ould
th
eref
ore
only
be
use
d in
th
ese
pati
ents
aft
er c
aref
ul r
isk/
ben
efi t
ass
essm
ent
and
if t
he
diag
nos
tic
info
rmat
ion
is e
ssen
tial
an
d n
ot
avai
labl
e w
ith
non
-con
tras
t en
han
ced
mag
net
ic r
eson
ance
imag
ing
(MRI
). A
ll p
atie
nts
sh
ould
be
scre
ened
, in
part
icul
ar p
atie
nts
ove
r th
e ag
e of
65,
for
ren
al d
ysfu
nct
ion
by o
btai
nin
g a
his
tory
an
d/o
r la
bora
tory
tes
ts. H
aem
odia
lysi
s sh
ortl
y af
ter
Prim
ovis
t® a
dmin
istr
atio
n in
pat
ien
ts c
urre
ntl
y re
ceiv
ing
haem
odia
lysi
s m
ay b
e u
sefu
l at
rem
ovin
g Pr
imov
ist®
fro
m t
he
body
. Th
ere
is n
o ev
iden
ce t
o su
ppor
t th
e in
itia
tion
of
haem
odia
lysi
s fo
r pr
even
tion
or
trea
tmen
t of
NSF
in p
atie
nts
not
alr
eady
un
derg
oin
g ha
emod
ialy
sis.
Cau
tion
sh
ould
be
exer
cise
d in
pat
ien
ts w
ith
seve
re r
enal
impa
irm
ent
due
to r
edu
ced
elim
inat
ion
capa
city
of
Gd-
EOB-
DTP
A. P
rior
to
adm
inis
trat
ion
of P
rim
ovis
t, it
is r
ecom
men
ded
that
all
pat
ien
ts a
re s
cree
ned
for
ren
al d
ysfu
nct
ion
by o
btai
nin
g la
bora
tory
tes
ts. C
auti
on s
hou
ld b
e ex
erci
sed
wh
en P
rim
ovis
t® is
adm
inis
tere
d to
pat
ien
ts w
ith
seve
re c
ardi
ovas
cula
r pro
blem
s be
cau
se o
nly
lim
ited
dat
a ar
e av
aila
ble
so fa
r. It
can
not
be
excl
ude
d th
at G
d-EO
B-D
TPA
may
cau
se t
orsa
de d
e po
ints
arr
hyt
hmia
s in
an
indi
vidu
al p
atie
nt.
Hyp
erse
nsit
ivit
y Al
lerg
y-li
ke r
eact
ion
s,
incl
udi
ng
shoc
k, a
re k
now
n to
be
rare
eve
nts
aft
er a
dmin
istr
atio
n of
gad
olin
ium
-bas
ed M
RI c
ontr
ast
med
ia. P
atie
nts
wit
h a
his
tory
of
alle
rgic
/all
ergo
id r
eact
ion
s or
bro
nch
ial a
sthm
a m
igh
t be
at
hig
her
ris
k fo
r se
vere
rea
ctio
ns.
Mos
t of
th
ese
reac
tion
s oc
cur
wit
hin
hal
f an
h
our
afte
r ad
min
istr
atio
n of
con
tras
t m
edia
. How
ever
, as
wit
h ot
her
con
tras
t m
edia
of t
his
cla
ss, d
elay
ed r
eact
ion
s m
ay o
ccur
aft
er h
ours
to
days
in r
are
case
s. A
dequ
ate
mea
sure
s fo
r re
susc
itat
ion
shou
ld b
e m
ade
read
ily
avai
labl
e pr
ior
to a
dmin
istr
atio
n of
con
tras
t ag
ents
. H
yper
sen
siti
vity
rea
ctio
ns
can
be m
ore
inte
nse
in p
atie
nts
on
beta
-blo
cker
s, p
arti
cula
rly
in t
he
pres
ence
of b
ron
chia
l ast
hma.
It s
hou
ld b
e co
nsi
dere
d th
at p
atie
nts
on
beta
-blo
cker
s m
ay b
e re
frac
tory
to
stan
dard
tre
atm
ent o
f hyp
erse
nsi
tivi
ty r
eact
ion
s w
ith
beta
-ago
nis
ts. I
f h
yper
sen
siti
vity
rea
ctio
ns
occu
r, in
ject
ion
of t
he
con
tras
t med
ium
mu
st b
e di
scon
tin
ued
imm
edia
tely
. Loc
al in
tole
ranc
e In
tram
usc
ular
adm
inis
trat
ion
may
cau
se lo
cal i
nto
lera
nce
rea
ctio
ns
incl
udi
ng
foca
l nec
rosi
s an
d sh
ould
th
eref
ore
be s
tric
tly
avoi
ded.
Dat
e of
pre
para
tion
of
th
e te
xt O
ctob
er 2
007
. Ple
ase
not
e! F
or c
urre
nt
pres
crib
ing
info
rmat
ion
refe
r to
th
e pa
ckag
e in
sert
an
d/o
r co
nta
ct y
our
loca
l Ba
yer
Hea
lth
Care
org
anis
atio
n. B
ayer
Pha
rma
AG, 1
3342
Ber
lin
, Ger
man
y. A
dver
se r
eact
ion
s ca
n be
rep
orte
d to
GPV
.Cas
ePro
cess
ing@
baye
rhea
lth
care
.com
The Fine Art of Liver Imaging
Defi ning Liver Imaging
EU.D
I.05.
2009
.009
1 N
ovem
ber 2
009
Q Mastership 1 in detection, delineation and characterization
Q Masterpieces of clear imaging support clear diagnosis and treatment
Q Master’s degree 2 in tolerability
12816_bay_pv_anz_A5_la_02_bl.indd 1 23.12.11 11:48