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Monitoring Liver Function of Patients Undergoing Transarterial Chemoembolization (TACE) by a 13C Breath Test (LiMAx)

  • Clinical Investigation
  • Interventional Oncology
  • Published:
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Abstract

Purpose

Transarterial chemoembolization (TACE) is associated with the risk of deteriorating liver function, especially in patients with preexisting liver damage. Current liver function tests may fail to accurately predict the functional liver reserve. Aim of this study was to investigate whether changes of liver function caused by TACE are associated with detectable changes of LiMAx values.

Methods and Materials

Forty patients with primary or secondary liver cancer underwent TACE and LiMAx test on the day before, the day after, and 4 weeks after TACE. LiMAx results were evaluated, referenced to liver volume (CT/MR volumetry), correlated with the respective TACE volume (subsegmental vs. segmental vs. lobar), established liver function tests, and Child–Pugh and ALBI scores.

Results

The individual LiMAx values were significantly reduced by 10% (p = 0.01) on the day after TACE and fully recovered to baseline 1 month after treatment. Similar changes were observed regarding levels of bilirubin, transaminases, albumin, INR, and creatinine. LiMAx did not correlate significantly with the treated liver volume, but did correlate with the baseline liver volume (< 1200 ml vs. > 1200 ml; p < 0.01). No significant changes were observed in the Child–Pugh score or ALBI score.

Conclusion

LiMAx is capable of detecting changes in liver function, even modulations caused by superselective TACE procedures. Accordingly, it could be used as a tool for patient selection and monitoring of transarterial therapy. In comparison, Child–Pugh and ALBI scores did not reflect any of these changes. Some biochemical parameters also changed significantly after TACE, but they tend to be less specific in providing sufficient information on actual cellular dysfunction.

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Funding

This study was not supported by any funding.

Author information

Author notes

  1. Emona S. Barzakova and Maximilian Schulze-Hagen have contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstreet 30, 52074, Aachen, Germany

    Emona S. Barzakova, Maximilian Schulze-Hagen, Markus Zimmermann, Federico Pedersoli, Peter Isfort, Christiane Kuhl & Philipp Bruners

  2. Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany

    Georg Lurje & Jan Bednarsch

Authors
  1. Emona S. Barzakova
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  2. Maximilian Schulze-Hagen
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Correspondence to Emona S. Barzakova.

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Barzakova, E.S., Schulze-Hagen, M., Zimmermann, M. et al. Monitoring Liver Function of Patients Undergoing Transarterial Chemoembolization (TACE) by a 13C Breath Test (LiMAx). Cardiovasc Intervent Radiol 42, 1702–1708 (2019). https://doi.org/10.1007/s00270-019-02325-3

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