Examination of the Means of Measuring Liver Function in the Hepatobiliary Phase

Abstract Previous studies have shown gadoxetate disodium’s potential to represent liver function by its retention in the hepatobiliary phase. Additionally, in cardiac imaging, quantitative characterization of altered parenchyma is established by extracellular volume (ECV) calculation with extracellular contrast agents. Therefore, the purpose of our study was to evaluate whether intracellular accumulation capacity (IAC) of gadoxetate disodium derived from ECV calculation provides added scientific value in terms of liver function compared to the established parameter reduction rate (RR). After local review board approval, 105 patients undergoing standard MR examination with gadoxetate disodium were included. Modified Look-Locker sequences were obtained before and 20 min after contrast agent administration. RR and IAC were calculated and correlated with serum albumin, as a marker of synthetic liver function. Correlation was higher between IAC and albumin, than between RR and albumin. Additionally, capacity of both RR and IAC to distinguish between patients with or without liver cirrhosis was investigated, and differed significantly in their respective means between patients with cirrhosis and those without. We concluded, that the formula to calculate ECV can be transferred to calculate IAC of gadoxetate disodium in hepatocytes, and, thereby, IAC may possibly qualify as an imaging-based parameter to estimate synthetic liver function.

Download Full-text

MR liver imaging with Gd-EOB-DTPA: The need for different delay times of the hepatobiliary phase in patients with different liver function

European Journal of Radiology ◽

10.1016/j.ejrad.2015.12.015 ◽

2016 ◽

Vol 85 (3) ◽

pp. 546-552 ◽

Cited By ~ 10

Author(s):

Minglong Liang ◽

Jun Zhao ◽

Bing Xie ◽

Chuanming Li ◽

Xuntao Yin ◽

...

Keyword(s):

Liver Function ◽

Liver Imaging ◽

Hepatobiliary Phase ◽

Delay Times

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

Gadoxetic Acid-Enhanced Hepatobiliary-Phase Magnetic Resonance Imaging for Pyrrolizidine Alkaloid-Induced Hepatic Sinusoidal Obstruction Syndrome and Association with Liver Function

Scientific Reports ◽

10.1038/s41598-018-37775-1 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 7

Author(s):

Tingting Guo ◽

Xin Li ◽

Xiaoqian Yang ◽

Xiangquan Kong ◽

Hui Liu ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Liver Function ◽

Pyrrolizidine Alkaloid ◽

Gadoxetic Acid ◽

Sinusoidal Obstruction Syndrome ◽

Hepatobiliary Phase ◽

Resonance Imaging ◽

Hepatic Sinusoidal Obstruction Syndrome

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

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

Download Full-text

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.

Download Full-text