 Hello everyone, Myself Dr. Akansha working as a senior resident in Department of Radio Diagnosis at Tata Memorial Hospital, Mumbai. The title of my paper presentation is Hepatobiliary Phase MRI as a problem-solving sequence for evaluating potentially metastatic liver lesions a case series. In reduction, Hepatobiliary Phase improves the diagnostic accuracy of MRI through its functional role that is Hepatobiliary Contrast Agent are extruded by functional hepatocytes into bile ducts enabling differentiation from liver lesions which contain non-functional hepatocytes like metastasis. Key is to have both functional hepatocytes as well as bile ducts. Iso or hyper intense appearance on hepatobiliary phase in a lesion detected in oncology patients usually indicates benign etiology. Reduces the number of non-specific and indeterminate lesions also reduces usage of invasive tests like biopsy and aspiration for characterization of these lesions. Ames and methods we present three cases with a known malignancy who presented with indeterminate liver lesions on follow-up or baseline imaging. All three cases underwent dynamic liver MRI. This hepatobiliary phase was obtained as a problem solving sequence for the liver lesion characterization. MRI sequence were obtained at our institution using Philips Ingenia 1.5 Tesla MRI with the prefix standard protocol for liver imaging using sequences. Axial and coronal T2 weighted fat suppressed. Axial T1 weighted in an opposed phase. Diffusion weighted in corresponding apparent diffusion coefficient. MRCP sequence. Post contrast T1 weighted fat suppressed arterial portal venous delayed with hepatobiliary phase was taken at two hours. Contrast agent used was gadobinate dimeglumine also known as gadolinium bobtor multi-hands with a dosage of 0.1 millimoles per kg or 0.2 ml per kg. Patient 1. A 51-year-old female with history of carcinoma breast operated 17 years back with complete response and on regular follow-up now presented with complaint of fever since 10 days ultrasound done was normal however contrast enhanced CT showed multiple tiny hypodinflation scattered in both lobes of liver. Restore organs were unremarkable lab parameters were also unremarkable. In the CT images taken at portal venous phase we can see multiple tiny hypodinflation scattered in both lobes of liver a dynamic phase MRI with a patobiliary phase was done next to it. We can see in diffusion weighted images tiny areas of diffusion restriction in both lobes of liver which are not well appreciated on T2 weighted fat suppressed portal venous phase and a patobiliary phase taken at two hours. Imaging diagnosis was given as pseudo lesions and follow-up MRI was suggested after two to three months. Liver biopsy revealed benign liver parenchyma with periportal inflammation also follow-up MRI done at three months after the scan did not reveal any lesions. Patient 2. A 39-year-old male diagnosed with carcinoma rectum during baseline evaluation was detected with solitary liver lesion of size 15 to 12 mm in segment 8. Multidisciplinary team advised dynamic liver MRI with a patobiliary phase. In these MRI sequences we can see a tiny area of diffusion restriction on DWI image in segment 8 with corresponding ISO to hypo intense signal on ADC and this observation also appeared hyper intense on T2. In post contrast arterial phase it was not well appreciated. In portal venous phase the observation appeared slightly hypo intense and became more hypo intense in the hepatobiliary phase imaging in comparison to the background liver parenchyma. Imaging diagnosis given was a T2 weighted hyper intense DWI restricting hypo enhancing observation with no uptake on hepatobiliary phase. Possibility of metastasis could not be ruled out. Patient was started on adjuvant chemotherapy for primary and the liver lesion underwent radio frequency ablation or RFA. Patient is on regular follow-up with no evidence of any new lesion or recurrence in ablated lesion. Patient 3, a 48-year-old female post-TAH with bilaterals helping oophorectomy and adjuvant chemotherapy two years back for serious ovarian cancer now presented with a marginal increase in CA125 levels. Outside contrast enhanced CT revealed two hypo dense liver lesions in segment 4A and 8. Multidisciplinary team advised dynamic liver MRI with hepatobiliary phase. In the corresponding MRI sequences we can see two observations in segment 4A and adjoining segment 4A8. The observation which has been outlined by the blue arrow appears hyper intense on DWI with facilitated diffusion on ADC, hyper intense signal on T2 and completely hyper intense in comparison to the background liver parankymen all the post contrast phases including the hepatobiliary phase which suggested a simple hepatic cyst. Another observation is seen adjacent to this in segment 4A8 which appears patchy diffusion restriction with ISO to hyper intense signal on ADC and slightly hyper intense on T2 weighted images in comparison to the background liver parankyma in post contrast arterial phase it was not very very much appreciated in portal venous phase it appeared slightly hyper intense and in hepatobiliary phase it was again not delineated in comparison to the hepatic parankyma. Imaging diagnosis was of a simple cyst in segment 4A with an ill-defined hepatic lesion in segment 4A8 which appears ISO intense on hepatobiliary phase suggestive of benign etiology. Patient is on regular follow-up with stable segment 4A8 benign lesion on follow-up MRI. Results and discussion one out of three patients in our case series was imagine wise suspicious for metastasis and underwent RFA that is radiofrequency ablation two out of three patients had benign or pseudo-level lesions and were hence managed conservatively. Hepatocyte specific contrast agents are initially distributed in extracellular space followed by their uptake in normal hepatocytes and subsequently released into bile ducts thus enabling comprehensive evaluation in both dynamic and hepatocyte phase. A protocol based approach using hepatobiliary phase while performing dynamic liver MRI in oncology patients with indeterminate lesions acts as an adjuvant tool for deciding appropriate treatment strategies. Hepatobiliary phase is also useful as a follow-up imaging sequence in oncology patients with previously known benign hepatic lesions. The references for my paper presentation are given as below. Thank you