Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla
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The purpose of this study was to evaluate the usefulness of Gd-EOB-DTPA-enhanced 3-T MRI to determine the hepatic functional reserve expressed by the model for end-stage liver disease (MELD) score.
A total of 121 patients with normal liver function (NLF; MELD score ≤ 10) and 29 patients with impaired liver function (ILF; MELD score > 10) underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 min after contrast injection. Relative enhancement (RE) between plain signal intensity and contrast-enhanced signal intensity was calculated and was used to determine Gd-EOB-DTPA uptake into the liver parenchyma for patients with different MELD scores.
RE differed significantly (p ≤ 0.001) between patients with NLF (87.2 ± 29.5 %) and patients with ILF (45.4 ± 26.5 %). The optimal cut-off value for RE to differentiate NLF from ILF was 47.7 % (AUC 0.87). This cut-off value showed a sensitivity of 82.8 % and a specificity of 92.7 % for the differentiation of the analysed groups.
Gd-EOB-DTPA uptake in hepatocytes is strongly affected by liver function. Gd-EOB-DTPA-enhanced MRI and assessment of RE during the hepatobiliary phase (HBP) may serve as a useful image-based test in liver imaging for determining regional and global liver function.
Hepatic uptake of Gd-EOB-DTPA is strongly affected by liver function.
Relative enhancement during HBP in GD-EOB-DTPA MRI correlates with the MELD score.
Assessment of relative enhancement may help improve treatment in routine clinical practice.
KeywordsMagnetic resonance imaging Gd-EOB-DTPA Abdomen Liver Model for end-stage liver disease (MELD)
Abbreviations and acronyms
Area under the curve
Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid
Impaired liver function
Model for end-stage liver disease
Magnetic resonance imaging
Normal liver function
Volume interpolated breath-hold examination
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. Mr. Florian Zeman kindly provided statistical advice for this manuscript and is one of the authors of this manuscript. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic or prognostic study, performed at one institution.
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