Imaging-based evaluation of liver function: comparison of 99mTc-mebrofenin hepatobiliary scintigraphy and Gd-EOB-DTPA-enhanced MRI

Abstract Objectives Effective and non-invasive biomarkers to predict and avoid posthepatectomy liver failure (PHLF) are urgently needed. This systematic review aims to evaluate the efficacy of gadoxetic acid–enhanced MRI-derived parameters as an imaging biomarker in preoperative prediction of PHLF. Methods A systematic literature search was performed in the databases of PubMed/Medline, Web of Science, Embase, and Cochrane Library up to 11 December 2020. Studies evaluating the incidence of PHLF on patients who underwent hepatectomy with preoperative liver function assessment using gadoxetic acid–enhanced MRI were included. Data was extracted using pre-designed tables. The Quality In Prognostic Studies (QUIPS) tool was adopted to evaluate the risk of bias. Results A total of 15 studies were identified for qualitative synthesis and most studies were marked as low to moderate risk of bias in each domain of QUIPS. The most commonly used parameter was relative liver enhancement or its related parameters. The reported incidence of PHLF ranged from 3.9 to 40%. The predictive sensitivity and specificity of gadoxetic acid–enhanced MRI parameters varied from 75 to 100% and from 54 to 93% in ten reported studies. A majority of the studies revealed that the gadoxetic acid–enhanced MRI parameter was a predictor for PHLF. Conclusions Gadoxetic acid–enhanced MRI showed a high predictive capacity for PHLF and represents a promising imaging biomarker in prediction of PHLF. Multicenter, prospective trials with large sample size and reliable, unified liver function parameters are required to validate the efficacy of individual liver function parameters. Key Points • There is an obvious heterogeneity of the published studies, not only in variance of MRI liver function parameters but also in indication and extent of the liver resection. • Signal intensity (SI)–based parameters derived from gadoxetic acid–enhanced MRI are the commonly used method for PHLF prediction. • Gadoxetic acid–enhanced MRI-derived parameters showed high predictive efficacy for PHLF and can potentially serve as a predictor for the incidence of PHLF.

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Stress test of liver function using 99mTc-mebrofenin Hepatobiliary Scintigraphy (HBS)

HPB ◽

10.1016/j.hpb.2019.10.782 ◽

2019 ◽

Vol 21 ◽

pp. S809

Author(s):

F. Rassam ◽

K. Cieslak ◽

P. Olthof ◽

T. van Gulik ◽

R. Bennink

Keyword(s):

Liver Function ◽

Stress Test ◽

Hepatobiliary Scintigraphy

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A Pilot Study on Hepatobiliary Scintigraphy to Monitor Regional Liver Function in 90Y Radioembolization

Journal of Nuclear Medicine ◽

10.2967/jnumed.118.224394 ◽

2019 ◽

Vol 60 (10) ◽

pp. 1430-1436 ◽

Cited By ~ 2

Author(s):

Sandra van der Velden ◽

Manon N.G.J.A. Braat ◽

Tim A. Labeur ◽

Mike V. Scholten ◽

Otto M. van Delden ◽

...

Keyword(s):

Pilot Study ◽

Liver Function ◽

Hepatobiliary Scintigraphy ◽

90Y Radioembolization

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Quantification of liver function using gadoxetic acid-enhanced MRI

Abdominal Radiology ◽

10.1007/s00261-020-02779-x ◽

2020 ◽

Vol 45 (11) ◽

pp. 3532-3544

Author(s):

Sarah Poetter-Lang ◽

Nina Bastati ◽

Alina Messner ◽

Antonia Kristic ◽

Alexander Herold ◽

...

Keyword(s):

Liver Function ◽

Liver Diseases ◽

Organic Anion ◽

Liver Perfusion ◽

Dynamic Imaging ◽

Gadoxetic Acid ◽

Functional Evaluation ◽

Nonalcoholic Fatty Liver ◽

Enhanced Mri

Abstract The introduction of hepatobiliary contrast agents, most notably gadoxetic acid (GA), has expanded the role of MRI, allowing not only a morphologic but also a functional evaluation of the hepatobiliary system. The mechanism of uptake and excretion of gadoxetic acid via transporters, such as organic anion transporting polypeptides (OATP1,3), multidrug resistance-associated protein 2 (MRP2) and MRP3, has been elucidated in the literature. Furthermore, GA uptake can be estimated on either static images or on dynamic imaging, for example, the hepatic extraction fraction (HEF) and liver perfusion. GA-enhanced MRI has achieved an important role in evaluating morphology and function in chronic liver diseases (CLD), allowing to distinguish between the two subgroups of nonalcoholic fatty liver diseases (NAFLD), simple steatosis and nonalcoholic steatohepatitis (NASH), and help to stage fibrosis and cirrhosis, predict liver transplant graft survival, and preoperatively evaluate the risk of liver failure if major resection is planned. Finally, because of its noninvasive nature, GA-enhanced MRI can be used for long-term follow-up and post-treatment monitoring. This review article aims to describe the current role of GA-enhanced MRI in quantifying liver function in a variety of hepatobiliary disorders.

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