European Radiology

, Volume 26, Issue 4, pp 1125–1133 | Cite as

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

  • Michael Haimerl
  • Mona Schlabeck
  • Niklas Verloh
  • Florian Zeman
  • Claudia Fellner
  • Dominik Nickel
  • Ana Paula Barreiros
  • Martin Loss
  • Christian Stroszczynski
  • Philipp Wiggermann
Hepatobiliary-Pancreas

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.

Keywords

Liver function Magnetic resonance imaging T1 relaxometry Indocyanine green clearance Gd-EOB-DTPA–enhanced imaging 

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

Notes

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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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Michael Haimerl
    • 1
  • Mona Schlabeck
    • 1
  • Niklas Verloh
    • 1
  • Florian Zeman
    • 2
  • Claudia Fellner
    • 1
  • Dominik Nickel
    • 3
  • Ana Paula Barreiros
    • 4
  • Martin Loss
    • 5
  • Christian Stroszczynski
    • 1
  • Philipp Wiggermann
    • 1
  1. 1.Department of RadiologyUniversity Hospital RegensburgRegensburgGermany
  2. 2.Center for Clinical TrialsUniversity Hospital RegensburgRegensburgGermany
  3. 3.MR Applications Development, Siemens AG, Healthcare SectorErlangenGermany
  4. 4.Department of Internal Medicine IUniversity Hospital RegensburgRegensburgGermany
  5. 5.Department of SurgeryUniversity Hospital RegensburgRegensburgGermany

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