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CardioVascular and Interventional Radiology

, Volume 42, Issue 12, pp 1702–1708 | Cite as

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

  • Emona S. BarzakovaEmail author
  • Maximilian Schulze-Hagen
  • Markus Zimmermann
  • Georg Lurje
  • Jan Bednarsch
  • Federico Pedersoli
  • Peter Isfort
  • Christiane Kuhl
  • Philipp Bruners
Clinical Investigation Interventional Oncology
  • 88 Downloads
Part of the following topical collections:
  1. Interventional Oncology

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.

Keywords

TACE Transarterial chemoembolization Liver function LiMAx 

Notes

Funding

This study was not supported by any funding.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

For this type of study, formal consent is not required. Consent for publication was obtained for every individual person’s data included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  • Emona S. Barzakova
    • 1
    Email author
  • Maximilian Schulze-Hagen
    • 1
  • Markus Zimmermann
    • 1
  • Georg Lurje
    • 2
  • Jan Bednarsch
    • 2
  • Federico Pedersoli
    • 1
  • Peter Isfort
    • 1
  • Christiane Kuhl
    • 1
  • Philipp Bruners
    • 1
  1. 1.Department of Diagnostic and Interventional RadiologyUniversity Hospital RWTH AachenAachenGermany
  2. 2.Department of Surgery and TransplantationUniversity Hospital RWTH AachenAachenGermany

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