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The value of gadobenate dimeglumine–enhanced biliary imaging from the hepatobiliary phase for predicting post-hepatectomy liver failure in HCC patients

  • Magnetic Resonance
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Abstract

Objectives

To determine the value of gadobenate dimeglumine–enhanced biliary imaging from the hepatobiliary phase for predicting post-hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC).

Methods

Patients with HCC who underwent gadobenate dimeglumine–enhanced hepatobiliary magnetic resonance imaging prior to hepatectomy were collected in two centers. The relative enhancement ratio of the biliary system (REB) and the liver to muscle ratio (LMR) were measured at the hepatobiliary phase. Potential risk factors for PHLF were analyzed by logistic regression. The capacity of the REB and LMR to predict PHLF was analyzed via receiver operating characteristic curve.

Results

Of the 221 patients, post-hepatectomy liver failure occurred in 60 patients (27.1%). The REB was an independent risk factor for PHLF (odds ratio [OR] = 0.127 [0.047–0.348], p < 0.001). Although the LMR tended to be associated with PHLF (p = 0.063), it was not an independent risk factor in the multivariable analysis (OR = 0.624 [0.023–16.709], p = 0.779). Moreover, the area under the receiver operating characteristic curve of the REB and LMR was 0.87 and 0.60. The most appropriate cutoff value for the REB was 2.21. The HCC patients with the REB ≤ 2.21 had a higher incidence of post-hepatectomy liver failure than those with the REB > 2.21 (60.0% versus 8.5%, p < 0.001).

Conclusions

Gadobenate dimeglumine–enhanced biliary imaging from the hepatobiliary phase was valuable in predicting post-hepatectomy liver failure in HCC patients.

Key Points

• The relative enhancement ratio of the biliary system (REB) was an independent risk factor for post-hepatectomy liver failure in HCC patients.

• HCC patients with the REB ≤ 2.21 had significantly higher incidence of post-hepatectomy liver failure than those with the REB > 2.21 (60.0% versus 8.5%).

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Abbreviations

AUC:

Area under the curve

CI:

Confidence interval

Gd-BOPTA:

Gadobenate dimeglumine

HCC:

Hepatocellular carcinoma

INR:

International normalized ratio

LMR:

Liver to muscle ratio

MRI:

Magnetic resonance imaging

OATP:

Organic anion transporting polypeptides

OR:

Odds ratio

PHLF:

Post-hepatectomy liver failure

REB:

The relative enhancement ratio of the biliary system

ROC:

Receiver operating characteristic

ROI:

Region of interest

sFLR:

The standardized future liver remnant

SI:

Signal intensity

T1-VIBE:

T1-weighted volume interpolated breath hold examination

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Acknowledgements

We would like to thank Prof. Meng Yin (Department of Radiology, Mayo Clinic, Rochester, MN, USA) for the revision of the draft.

Funding

This research was supported by The National Natural Science Foundation of China (81770607 and 82160124).

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Shandong Provincial Hospital, Shandong University, Jinan, 250021, Shandong province, China

    Dongxiao Meng & Qiang Zhu

  2. Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong province, China

    Dongxiao Meng & Qiang Zhu

  3. Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324, Jing 5 Rd, Jinan, 250021, Shandong Province, China

    Changhu Liang, Ximing Wang & Xinya Zhao

  4. Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, 250021, Shandong province, China

    Changhu Liang, Ximing Wang & Xinya Zhao

  5. Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong province, China

    Yuanwen Zheng

  6. Shandong Academy of Clinical Medicine, Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong province, China

    Keke Liu

  7. Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350004, Fujian province, China

    Zhengyu Lin

Authors
  1. Dongxiao Meng
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  7. Qiang Zhu
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  8. Xinya Zhao
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Correspondence to Xinya Zhao.

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The scientific guarantor of this publication is Prof. Xinya Zhao.

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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.

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• observational

• multicenter study

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Meng, D., Liang, C., Zheng, Y. et al. The value of gadobenate dimeglumine–enhanced biliary imaging from the hepatobiliary phase for predicting post-hepatectomy liver failure in HCC patients. Eur Radiol 32, 8608–8616 (2022). https://doi.org/10.1007/s00330-022-08874-5

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  • DOI: https://doi.org/10.1007/s00330-022-08874-5

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