Comparison of 10- and 20-min hepatobiliary phase images on Gd-EOB-DTPA-enhanced MRI T1 mapping for liver function assessment in clinic

Background: In recent years, T1 mapping imaging based on Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) has resulted in new research and clinical applications in hepatic diseases. Objective: The objective of the study is to analyze, prospect, and summarize the Gd-EOB-DTPA-enhanced MRI T1 mapping technology in hepatic diseases in recent years. Main Findings: Gd-EOB-DTPA-enhanced T1 mapping has been used more frequently in liver diseases regardless of 1.5T or 3.0T MRI equipment. Volume interpolated body examination (VIBE) mapping sequence seems to be the recommended MRI scan sequence. In the evaluation of T1 value on liver function, the hepatobiliary phase 10 minutes after enhancement is the recommended time point. The fat fraction and hepatic steatosis grade based on MRI-derived biomarkers are easier to implement and popularize than a liver biopsy. Gd-EOB-DTPA-enhanced MRI T1 mapping can not only be used to evaluate the degree of liver injury, the stage of liver fibrosis, and the liver reserve function of patients with liver cirrhosis but also to distinguish focal liver lesions and predict the differentiation degree of hepatocellular carcinoma. At the same time, it has some value in predicting tumor immunohistochemical indexes, such as Ki67, CD34. Conclusion : Gd-EOB-DTPA-enhanced MRI T1 mapping has great potential in the application of diffuse and focal liver lesions. It is a quantitative study, trying to select homogeneous research objects and try to use the same standards in scanning sequence and scanning time, especially for the study of liver function, which is a focus of future research. The research on the relationship between T1 value and tumor immunohistochemical indexes is worth consideration.

Download Full-text

Intrahepatic periportal high intensity on hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI: imaging findings and prevalence in various hepatobiliary diseases

Japanese Journal of Radiology ◽

10.1007/s11604-012-0136-x ◽

2012 ◽

Vol 31 (1) ◽

pp. 9-15 ◽

Cited By ~ 10

Author(s):

Satoshi Kobayashi ◽

Osamu Matsui ◽

Toshifumi Gabata ◽

Wataru Koda ◽

Tetsuya Minami ◽

...

Keyword(s):

High Intensity ◽

Hepatobiliary Phase ◽

Imaging Findings ◽

Mri Imaging ◽

Enhanced Mri ◽

Phase Images ◽

Hepatobiliary Diseases

Download Full-text

Hepatobiliary phase images using gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI as an imaging surrogate for the albumin–bilirubin grading system

European Journal of Radiology ◽

10.1016/j.ejrad.2016.10.010 ◽

2016 ◽

Vol 85 (12) ◽

pp. 2206-2210 ◽

Cited By ~ 4

Author(s):

Yasuo Takatsu ◽

Satoshi Kobayashi ◽

Tosiaki Miyati ◽

Toshiki Shiozaki

Keyword(s):

Acetic Acid ◽

Grading System ◽

Hepatobiliary Phase ◽

Enhanced Mri ◽

Phase Images

Download Full-text

Higher Enhancement Intrahepatic Nodules on the Hepatobiliary Phase of Gd-EOB-DTPA-Enhanced MRI as a Poor Responsive Marker of Anti-PD-1/PD-L1 Monotherapy for Unresectable Hepatocellular Carcinoma

Liver Cancer ◽

10.1159/000518048 ◽

2021 ◽

pp. 1-14

Author(s):

Tomoko Aoki ◽

Naoshi Nishida ◽

Kazuomi Ueshima ◽

Masahiro Morita ◽

Hirokazu Chishina ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Checkpoint Inhibitors ◽

Objective Response ◽

Evaluation Criteria ◽

Progression Free Survival ◽

Imaging Biomarker ◽

Hepatobiliary Phase ◽

Enhanced Mri ◽

Phase Images ◽

Magnetic Resonance Imaging Mri

Introduction: Immune checkpoint inhibitors (ICIs) are promising agents for the treatment of hepatocellular carcinoma (HCC). However, the establishment of noninvasive measure that could predict the response to ICIs is challenging. This study aimed to evaluate tumor responses to ICIs using the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI), which was shown to reflect Wnt/β-catenin activating mutation. Methods: A total of 68 intrahepatic HCC nodules from 18 patients with unresectable HCC and Child-Pugh class A liver function who received anti-programmed cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1) monotherapy were enrolled in this study. All patients had viable intrahepatic lesions evaluable using the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI within the 6 months prior to the treatment. The relative enhancement ratio was calculated, and the time to nodular progression (TTnP) defined as 20% or more increase in each nodule was compared between higher or hypo-enhancement HCC nodules. Then, the progression-free survival (PFS) and objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) were compared between patients with and without HCC nodules with higher enhancement on hepatobiliary phase images. Results: The median PFS was 2.7 (95% confidence interval [CI]: 1.4–4.0) months in patients with HCC nodules with higher enhancement (n = 8) and 5.8 (95% CI: 0.0–18.9) months in patients with hypointense HCC nodules (n = 10) (p = 0.007). The median TTnP of HCC nodules with higher enhancement (n = 23) was 1.97 (95% CI: 1.86–2.07) months and that of hypointense HCC nodules (n = 45) was not reached (p = 0.003). The ORR was 12.5% (1/8) versus 30.0% (3/10); the disease control rate was 37.5% (3/8) versus 70.0% (7/10), respectively, in patients with or without higher enhancement intrahepatic HCC nodules. Conclusion: The TTnP on HCC nodules with higher enhancement and the median PFS in patients who carried higher enhancement intrahepatic HCC nodules were significantly shorter than those in hypointense HCC nodules with anti-PD-1/PD-L1 monotherapy. The intensity of the nodule on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI is a promising imaging biomarker for predicting unfavorable response with anti-PD-1/PD-L1 monotherapy in patients with HCC.

Download Full-text

Evaluation of liver function using liver parenchyma, spleen and portal vein signal intensities during the hepatobiliary phase in Gd-EOB-DTPA-enhanced MRI

10.21203/rs.3.rs-17044/v3 ◽

2020 ◽

Author(s):

Ming Yang ◽

Yue Zhang ◽

Wenlu Zhao ◽

Wen Cheng ◽

Han Wang ◽

...

Keyword(s):

Liver Function ◽

Portal Vein ◽

Contrast Ratio ◽

Liver Parenchyma ◽

International Normalized Ratio ◽

Imaging Biomarkers ◽

Hepatobiliary Phase ◽

Enhanced Mri ◽

Pugh Class ◽

Class C

Abstract Background: Previous studies have used signal intensity (SI) to reflect liver function. However, few studies have evaluated liver function via the portal vein. Regarding the SI of the liver, spleen, and portal vein, no study has indicated which can best reflect liver function. Therefore, the aim of this study is to investigate whether these parameters can evaluate liver function in patients with cirrhosis and determine which is the best parameter.Methods: 120 patients with normal livers (n = 41) or Child–Pugh class A (n = 50), B (n = 21) or C (n = 8) disease who had undergone Gd-EOB-DTPA-enhanced MRI were retrospectively reviewed. Comparisons of the MRI data (liver parenchyma SI, portal vein SI, and spleen SI and liver-to-portal vein contrast ratio (LPC), liver-to-spleen contrast ratio (LSC), and portal vein-to-spleen contrast ratio (PSC)) in the 15-min hepatobiliary phase images were performed among the groups, and the correlations among the liver function parameters (total bilirubin, direct bilirubin, indirect bilirubin, aspartate aminotransferase, alanine aminotransferase, albumin, creatinine, platelet count, prothrombin time and international normalized ratio), liver function scores and MRI data were also quantitatively analysed.Results: Significant differences were observed in the liver parenchyma SI, LPC and LSC among the groups. These values all decreased gradually from normal livers to Child–Pugh class C cirrhotic livers (P < 0.001). The portal vein SI constantly and slightly increased from normal livers to Child–Pugh class C cirrhotic livers, but no differences were found among the groups in the portal vein SI and PSC (P > 0.05). LPC showed a stronger correlation with the Child–Pugh score and MELD score than LSC and the liver parenchyma SI. The order of the AUCs of these parameters, from largest to smallest, was as follows: LPC, LSC, and liver parenchyma SI (P > 0.05).Conclusion: The liver parenchyma SI, LSC and LPC may be used as alternative imaging biomarkers to assess liver function, while the portal vein SI and PSC do not reflect liver function. Furthermore, LPC values can more effectively distinguish severity among patients with cirrhosis than the liver parenchyma SI and LSC.

Download Full-text

Evaluation of the liver function by the liver parenchyma, spleen and portal vein signal intensity during the hepatobiliary phase in Gd-EOB-DTPA-enhanced MRI

10.21203/rs.3.rs-17044/v2 ◽

2020 ◽

Author(s):

Ming Yang ◽

Yue Zhang ◽

Wenlu Zhao ◽

Wen Cheng ◽

Han Wang ◽

...

Keyword(s):

Liver Function ◽

Portal Vein ◽

Signal Intensity ◽

Liver Parenchyma ◽

International Normalized Ratio ◽

Imaging Biomarkers ◽

Hepatobiliary Phase ◽

Enhanced Mri ◽

Pugh Class ◽

Class C

Abstract Background: Previous studies used the signal intensity (SI) to reflect liver function. However, there are still few studies on the assessment of liver function via the portal vein, and no study has pointed out that in terms of SI (liver, spleen, portal vein), which one can better reflect liver function. Therefore, the aim of this study is to investigate whether these parameters can be used to evaluate liver function in patients with cirrhosis and determine which parameter is best.Methods: A total of 120 patients with normal livers (n = 41) or Child–Pugh class A (n = 50), B (n = 21) or C (n = 8) disease who underwent Gd-EOB-DTPA-enhanced MRI were retrospectively reviewed. Comparisons of the SI of the liver parenchyma, portal vein, and spleen and liver-to-portal vein (LPC), liver-to-spleen (LSC), and portal vein-to-spleen (PSC) contrast ratios on the 15-min hepatobiliary phase images were performed among groups, and the correlations among liver function parameters (total bilirubin, direct bilirubin, indirect bilirubin, aspartate aminotransferase, alanine aminotransferase, albumin, creatinine, platelet count, prothrombin time and international normalized ratio), liver function scores and MRI date were also quantitatively analyzed.Results: Significant differences were observed in the SI of the liver parenchyma, LPC and LSC among groups. These values all decreased gradually from normal livers to Child–Pugh class C cirrhotic livers (P < 0.001). The SI of the portal vein constantly and slightly increased from normal livers to Child–Pugh class C cirrhotic livers, but there were no differences among groups in portal vein signal and PSC (P > 0.05). LPC had a stronger correlation with Child-Pugh score and MELD score than LSC and liver parenchyma SI. The order of the AUCs of these parameters, from largest to smallest, was as follows: LPC, LSC, and liver parenchyma SI (P > 0.05).Conclusion: Liver parenchyma SI, LSC and LPC may be used as alternative imaging biomarkers for assessing liver function, while the portal vein signal and PSC could not reflect liver function. Furthermore, LPC values can more effectively distinguish severity among patients with cirrhosis than liver parenchyma SI and LSC.

Download Full-text

A 3D Deep Neural Network for Liver Volumetry in 3T Contrast-Enhanced MRI

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/a-1238-2887 ◽

2020 ◽

Author(s):

Hinrich Winther ◽

Christian Hundt ◽

Kristina Imeen Ringe ◽

Frank K. Wacker ◽

Bertil Schmidt ◽

...

Keyword(s):

Neural Network ◽

Intraclass Correlation ◽

Ground Truth ◽

Hepatobiliary Phase ◽

Dice Coefficient ◽

Enhanced Mri ◽

The Neural Network ◽

Liver Volumetry ◽

Phase Images ◽

Mri Scans

Purpose To create a fully automated, reliable, and fast segmentation tool for Gd-EOB-DTPA-enhanced MRI scans using deep learning. Materials and Methods Datasets of Gd-EOB-DTPA-enhanced liver MR images of 100 patients were assembled. Ground truth segmentation of the hepatobiliary phase images was performed manually. Automatic image segmentation was achieved with a deep convolutional neural network. Results Our neural network achieves an intraclass correlation coefficient (ICC) of 0.987, a Sørensen–Dice coefficient of 96.7 ± 1.9 % (mean ± std), an overlap of 92 ± 3.5 %, and a Hausdorff distance of 24.9 ± 14.7 mm compared with two expert readers who corresponded to an ICC of 0.973, a Sørensen–Dice coefficient of 95.2 ± 2.8 %, and an overlap of 90.9 ± 4.9 %. A second human reader achieved a Sørensen–Dice coefficient of 95 % on a subset of the test set. Conclusion Our study introduces a fully automated liver volumetry scheme for Gd-EOB-DTPA-enhanced MR imaging. The neural network achieves competitive concordance with the ground truth regarding ICC, Sørensen–Dice, and overlap compared with manual segmentation. The neural network performs the task in just 60 seconds. Key Points: Citation Format

Download Full-text

Comparison of Liver Scintigraphy and the Liver-Spleen Contrast in Gd-EOB-DTPA-Enhanced MRI on Liver Function Tests

10.21203/rs.3.rs-879858/v1 ◽

2021 ◽

Author(s):

Hiroshige Mori ◽

Hanaka Machimura ◽

Amika Iwaya ◽

Masaru Baba ◽

Ken Furuya

Keyword(s):

Liver Function ◽

Total Bilirubin ◽

Clinical Stage ◽

Correlation Coefficients ◽

Liver Function Tests ◽

Coefficient Of Determination ◽

Hepatobiliary Phase ◽

Biochemical Tests ◽

Liver Scintigraphy ◽

Phase Images

Abstract The liver-spleen contrast (LSC) using hepatobiliary-phase images could replace the receptor index (LHL15) in liver scintigraphy; however, few comparative studies exist. This study aimed to verify the convertibility from LSC into LHL15. In 136 patients, the LSC, not at 20 min, but at 60 min after injecting gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid was compared with the LHL15, albumin–bilirubin (ALBI) score, and the related laboratory parameters. The LHL15 was also compared with their biochemical tests. The correlation coefficients of LSC with LHL15, ALBI score, total bilirubin, and albumin were 0.740, − 0.624, − 0.606, and 0.523 (P < 0.00001), respectively. The correlation coefficients of LHL15 with ALBI score, total bilirubin, and albumin were − 0.647, − 0.553, and 0.569 (P < 0.00001), respectively. The linear regression equation on the estimated LHL15 (eLHL15) from LSC was eLHL15 = 0.460 • LSC + 0.727 (P < 0.00001) and the coefficient of determination was 0.548. Regarding a contingency table using imaging-based clinical stage classification, the degree of agreement between eLHL15 and LHL15 was 65.4 %, and Cramer's V was 0.568 (P < 0.00001). Therefore, although the LSC may be influenced by high total bilirubin, the eLHL15 can replace the LSC as an index to evaluate liver function.

Download Full-text