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Volume-assisted estimation of liver function based on Gd-EOB-DTPA–enhanced MR relaxometry

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To determine whether liver function as determined by indocyanine green (ICG) clearance can be estimated quantitatively from hepatic magnetic resonance (MR) relaxometry with gadoxetic acid (Gd-EOB-DTPA).

Methods

One hundred and seven patients underwent an ICG clearance test and Gd-EOB-DTPA–enhanced MRI, including MR relaxometry at 3 Tesla. A transverse 3D VIBE sequence with an inline T1 calculation was acquired prior to and 20 minutes post-Gd-EOB-DTPA administration. The reduction rate of T1 relaxation time (rrT1) between pre- and post-contrast images and the liver volume-assisted index of T1 reduction rate (LVrrT1) were evaluated. The plasma disappearance rate of ICG (ICG-PDR) was correlated with the liver volume (LV), rrT1 and LVrrT1, providing an MRI-based estimated ICG-PDR value (ICG-PDRest).

Results

Simple linear regression model showed a significant correlation of ICG-PDR with LV (r = 0.32; p = 0.001), T1post (r = 0.65; p < 0.001) and rrT1 (r = 0.86; p < 0.001). Assessment of LV and consecutive evaluation of multiple linear regression model revealed a stronger correlation of ICG-PDR with LVrrT1 (r = 0.92; p < 0.001), allowing for the calculation of ICG-PDRest.

Conclusions

Liver function as determined using ICG-PDR can be estimated quantitatively from Gd-EOB-DTPA–enhanced MR relaxometry. Volume-assisted MR relaxometry has a stronger correlation with liver function than does MR relaxometry.

Key Points

• Measurement of T1 relaxation times in Gd-EOB-DTPA–enhanced MR imaging quantifies liver function.

• Volume-assisted Gd-EOB-DTPA–enhanced MR relaxometry has stronger correlation with ICG-PDR than does Gd-EOB-DTPA–enhanced MR relaxometry.

• Gd-EOB-DTPA–enhanced MR relaxometry may provide robust parameters for detecting and characterizing liver disease.

• Gd-EOB-DTPA–enhanced MR relaxometry may be useful for monitoring liver disease progression.

• Gd-EOB-DTPA–enhanced MR relaxometry has the potential to become a novel liver function index.

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Abbreviations

ICG:

Indocyanine green

Gd-EOB-DTPA:

Gadoxetic acid

LV:

Liver volume

ROI:

Regions of interest

rrT1:

Reduction rate of T1 relaxation times

LVrrT1:

Volume-assisted index of the reduction rate of T1 relaxation times

ICG-PDRest :

Estimated ICG-PDR value

PDR:

Plasma disappearance rate

T1post :

T1 relaxometry measurements 20 min after Gd-EOB-DTPA administration

CPA:

Child-Pugh A

CPB:

Child-Pugh B

CPC:

Child-Pugh C

NLF:

Normal liver function

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Acknowledgments

The scientific guarantor of this publication is PD Dr. Philipp Wiggermann. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise (Florian Zeman). Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic or prognostic study / experimental, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany

    Michael Haimerl, Mona Schlabeck, Niklas Verloh, Claudia Fellner, Christian Stroszczynski & Philipp Wiggermann

  2. Center for Clinical Trials, University Hospital Regensburg, Regensburg, Germany

    Florian Zeman

  3. MR Applications Development, Siemens AG, Healthcare Sector, Erlangen, Germany

    Dominik Nickel

  4. Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany

    Ana Paula Barreiros

  5. Department of Surgery, University Hospital Regensburg, Regensburg, Germany

    Martin Loss

Authors
  1. Michael Haimerl
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  2. Mona Schlabeck
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  3. Niklas Verloh
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  4. Florian Zeman
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  5. Claudia Fellner
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  6. Dominik Nickel
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  7. Ana Paula Barreiros
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  8. Martin Loss
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  9. Christian Stroszczynski
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  10. Philipp Wiggermann
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Correspondence to Michael Haimerl.

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Haimerl, M., Schlabeck, M., Verloh, N. et al. Volume-assisted estimation of liver function based on Gd-EOB-DTPA–enhanced MR relaxometry. Eur Radiol 26, 1125–1133 (2016). https://doi.org/10.1007/s00330-015-3919-5

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  • DOI: https://doi.org/10.1007/s00330-015-3919-5

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