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European Radiology

, Volume 27, Issue 7, pp 3080–3087 | Cite as

Gd-EOB-DTPA-enhanced MRI for monitoring future liver remnant function after portal vein embolization and extended hemihepatectomy: A prospective trial

  • Dominik Geisel
  • Philip Raabe
  • Lutz Lüdemann
  • Maciej Malinowski
  • Martin Stockmann
  • Daniel Seehofer
  • Johann Pratschke
  • Bernd Hamm
  • Timm Denecke
Hepatobiliary-Pancreas

Abstract

Objectives

To evaluate changes in liver function after right portal vein embolization (PVE) and extended right hemihepatectomy using gadolinium ethoxybenzyl-DTPA-enhanced (Gd-EOB-DTPA) MRI.

Methods

In this prospective trial, 37 patients undergoing PVE were examined before and 14 and 28 days after PVE and 10 days after extended hemihepatectomy using Gd-EOB-DTPA-enhanced MRI. Lobar volume, kinetic growth rate (KGR), relative enhancement (RE) as well as hepatocellular uptake index (HUI) and fat signal fraction (FSF) were calculated for each lobe.

Results

RE of the left liver lobe (LLL) was steadily increasing after PVE and decreased to 0.48 ± 0.19 10 days after surgery, which is significantly lower than 14 days and 28 days post PVE (P < 0.05). KGR was 14.06 ± 9.82%/week for the period from PVE to 14 days after PVE. HUI of the LLL increased steadily after PVE and was significantly higher at both 14 and 28 days after PVE compared to pre PVE (P < 0.05). HUI of the residual liver after surgery was lower than before.

Conclusions

Gd-EOB-DTPA-enhanced MRI may be used to monitor the functional increase in the FLR after PVE and to depict the intraoperative liver injury leading to a decrease in liver remnant function.

Key Points

• The most significant FLR volume increase happens within the first 14 days.

• No MRI parameter was able to predict the success of FLR growth.

• Our data suggest an early resection about 14 days after PVE.

• Routine Gd-EOB-DTPA-enhanced MRI might be suitable to replace ICG-test.

Keywords

Liver Portal vein embolization Gadolinium ethoxybenzyl DTPA Liver function tests Magnetic resonance imaging 

Abbreviations and acronyms

FSF

Fat signal fraction

FLR

Future liver remnant

Gd-EOB-DTPA

Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid

HUI

Hepatic uptake index

ICG

Indocyanine green

KGR

Kinetic growth rate

LiMAx

Maximum liver function capacity

LLL

Left liver lobe

PVE

Portal vein embolisation

RE

Relative enhancement

RLL

Right liver lobe

ROI

Region of interest

SI

Signal intensity

VIBE

Volume interpolated breath-hold examination

Notes

Acknowledgements

The scientific guarantor of this publication is Dominik Geisel. 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. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Some study subjects or cohorts have been previously reported in European Radiology. Methodology: prospective, observational/experimental, performed at one institution

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  1. 1.Department of Diagnostic and Interventional RadiologyCharité Campus Virchow-KlinikumBerlinGermany
  2. 2.Department of General, Visceral and Transplantation SurgeryCharité Campus Virchow-KlinikumBerlinGermany
  3. 3.Department of Medical PhysicsEssen University HospitalEssenGermany

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