Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla

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.

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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.

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Assessing liver function: diagnostic efficacy of parenchymal enhancement and liver volume ratio of Gd-EOB-DTPA-enhanced MRI study during interstitial and hepatobiliary phase

Abdominal Radiology ◽

10.1007/s00261-018-1812-9 ◽

2018 ◽

Vol 44 (4) ◽

pp. 1340-1349 ◽

Cited By ~ 3

Author(s):

Davide Ippolito ◽

Anna Pecorelli ◽

Simone Famularo ◽

Davide Bernasconi ◽

Eleonora Benedetta Orsini ◽

...

Keyword(s):

Liver Function ◽

Liver Volume ◽

Volume Ratio ◽

Hepatobiliary Phase ◽

Diagnostic Efficacy ◽

Enhanced Mri ◽

Mri Study ◽

Parenchymal Enhancement

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Correlation of liver enhancement in gadoxetic acid–enhanced MRI with liver functions: a multicenter-multivendor analysis of hepatocellular carcinoma patients from SORAMIC trial

European Radiology ◽

10.1007/s00330-021-08218-9 ◽

2021 ◽

Author(s):

Osman Öcal ◽

Bora Peynircioglu ◽

Christian Loewe ◽

Otto van Delden ◽

Vincent Vandecaveye ◽

...

Keyword(s):

Liver Function ◽

Total Bilirubin ◽

Clinical Findings ◽

Gadoxetic Acid ◽

Imaging Biomarker ◽

Hepatobiliary Phase ◽

Platelet Counts ◽

Enhanced Mri ◽

Grading Systems ◽

Liver Functions

Abstract Objectives To evaluate the correlation between liver enhancement on hepatobiliary phase and liver function parameters in a multicenter, multivendor study. Methods A total of 359 patients who underwent gadoxetic acid–enhanced MRI using a standardized protocol with various scanners within a prospective multicenter phase II trial (SORAMIC) were evaluated. The correlation between liver enhancement on hepatobiliary phase normalized to the spleen (liver-to-spleen ratio, LSR) and biochemical laboratory parameters, clinical findings related to liver functions, liver function grading systems (Child-Pugh and Albumin-Bilirubin [ALBI]), and scanner characteristics were analyzed using uni- and multivariate analyses. Results There was a significant positive correlation between LSR and albumin (rho = 0.193; p < 0.001), platelet counts (rho = 0.148; p = 0.004), and sodium (rho = 0.161; p = 0.002); and a negative correlation between LSR and total bilirubin (rho = −0.215; p < 0.001) and AST (rho = −0.191; p < 0.001). Multivariate analysis confirmed independent significance for each of albumin (p = 0.022), total bilirubin (p = 0.045), AST (p = 0.031), platelet counts (p = 0.012), and sodium (p = 0.006). The presence of ascites (1.47 vs. 1.69, p < 0.001) and varices (1.55 vs. 1.69, p = 0.006) was related to significantly lower LSR. Similarly, patients with ALBI grade 1 had significantly higher LSR than patients with grade 2 (1.74 ± 0.447 vs. 1.56 ± 0.408, p < 0.001); and Child-Pugh A patients had a significantly higher LSR than Child-Pugh B (1.67 ± 0.44 vs. 1.49 ± 0.33, p = 0.021). Also, LSR was negatively correlated with MELD-Na scores (rho = −0.137; p = 0.013). However, one scanner brand was significantly associated with lower LSR (p < 0.001). Conclusions The liver enhancement on the hepatobiliary phase of gadoxetic acid–enhanced MRI is correlated with biomarkers of liver functions in a multicenter cohort. However, this correlation shows variations between scanner brands. Key Points • The correlation between liver enhancement on the hepatobiliary phase of gadoxetic acid–enhanced MRI and liver function is consistent in a multicenter-multivendor cohort. • Signal intensity–based indices (liver-to-spleen ratio) can be used as an imaging biomarker of liver function. • However, absolute values might change between vendors.

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Liver function correlates with liver-to-portal vein contrast ratio during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MR at 3 Tesla

Abdominal Radiology ◽

10.1007/s00261-018-1462-y ◽

2018 ◽

Vol 43 (9) ◽

pp. 2262-2269 ◽

Cited By ~ 3

Author(s):

Weiguo Zhang ◽

Xiao Wang ◽

Youhan Miao ◽

Chunhong Hu ◽

Weifeng Zhao

Keyword(s):

Liver Function ◽

Portal Vein ◽

Contrast Ratio ◽

3 Tesla ◽

Hepatobiliary Phase

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

Abdominal Radiology ◽

10.1007/s00261-017-1143-2 ◽

2017 ◽

Vol 42 (9) ◽

pp. 2272-2278 ◽

Cited By ~ 5

Author(s):

Zhi-Peng Zhou ◽

Li-Ling Long ◽

Wei-Jia Qiu ◽

Ge Cheng ◽

Li-Juan Huang ◽

...

Keyword(s):

Liver Function ◽

T1 Mapping ◽

Hepatobiliary Phase ◽

Enhanced Mri ◽

Phase Images ◽

Function Assessment

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Gd-EOB-DTPA-enhanced MRI T1 mapping for assessment of liver function in rabbit fibrosis model: comparison of hepatobiliary phase images obtained at 10 and 20 min

La radiologia medica ◽

10.1007/s11547-016-0719-1 ◽

2017 ◽

Vol 122 (4) ◽

pp. 239-247 ◽

Cited By ~ 2

Author(s):

Zhi-Peng Zhou ◽

Li-Ling Long ◽

Li-Juan Huang ◽

Teng-Fei Yang ◽

Zhong-Kui Huang

Keyword(s):

Liver Function ◽

Model Comparison ◽

T1 Mapping ◽

Hepatobiliary Phase ◽

Enhanced Mri ◽

Phase Images

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Application Progress of Gd-EOB-DTPA-Enhanced MRI T1 Mapping in Hepatic Diffuse Diseases

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666211130153450 ◽

2021 ◽

Vol 17 ◽

Author(s):

Xing Wen ◽

Xu Feng ◽

Yao Kang ◽

Long Xu

Keyword(s):

Liver Function ◽

T1 Mapping ◽

Future Research ◽

Focal Liver Lesions ◽

Hepatobiliary Phase ◽

Liver Lesions ◽

Scanning Time ◽

Hepatic Diseases ◽

Enhanced Mri ◽

New Research

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.

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

BMC Medical Imaging ◽

10.1186/s12880-020-00519-7 ◽

2020 ◽

Vol 20 (1) ◽

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.

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