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T2 mapping in gadoxetic acid-enhanced MRI: utility for predicting decompensation and death in cirrhosis

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

An Editorial Comment to this article was published on 23 August 2021

Abstract

Objectives

To determine whether T2 mapping in liver MRI can predict decompensation and death in cirrhotic patients.

Methods

This retrospective study included 292 cirrhotic patients who underwent gadoxetic acid-enhanced MRI, including T1 and T2 mapping at 10-min hepatobiliary phase by using the Look-Locker and radial turbo spin-echo sequences, respectively. T1 and T2 values of the liver and spleen were measured. The association of MR parameters and serum markers with decompensation and death was investigated. Risk models combining T2Liver, serum albumin level, and Model for End-Stage Liver Disease (MELD) score were created for predicting decompensation (T2Liver, < 49.3 versus ≥ 49.3 ms) and death (< 57.4 versus ≥ 57.4 ms).

Results

In patients with compensated cirrhosis at baseline and in the full patient cohort, 9.6% (19 of 197) and 5.1% (15 of 292) developed decompensation and died during the mean follow-up periods of 18.7 and 19.2 months, respectively. A prolonged T2Liver (hazard ratio (HR), 2.59; 95% confidence interval (CI), 1.26, 5.31) was independently predictive of decompensation along with the serum albumin level (HR, 0.28; 95% CI, 0.12, 0.68) and MELD score (HR, 1.34; 95% CI, 1.08, 1.66). T2Liver (HR, 2.61; 95% CI, 1.19, 5.72) and serum albumin level (HR, 0.46; 95% CI, 0.19, 1.14) were independent predictors of death. The mean times to decompensation (12.9 versus 29.2 months) and death (16.5 versus 29.6 months) were significantly different between the high- and low-risk groups (p < 0.001).

Conclusion

T2Liver from T2 mapping can predict decompensation and death in patients with cirrhosis.

Key Points

• Liver T2 values from the radial turbo spin-echo (TSE) T2 mapping sequence with tiered echo sharing and pseudo golden-angle (pGA) reordering were significantly higher in decompensated cirrhosis than compensated cirrhosis.

• Liver T2 values from the radial TSE T2 mapping sequence with tiered echo sharing and pGA reordering can predict decompensation and death in patients with cirrhosis.

• T2 mapping is recommended as part of liver MRI examinations for cirrhotic patients because it can provide a noninvasive prognostic marker for the development of decompensation and death.

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Abbreviations

AIC:

Akaike information criterion

CI:

Confidence interval

CV:

Coefficient of variation

ETL:

Echo train length

HBP:

Hepatobiliary phase

HR:

Hazard ratio

ICC:

Intraclass correlation coefficient

MELD:

Model for End-Stage Liver Disease

pGA:

Pseudo golden-angle

TE:

Echo time

TR:

Repetition time

TSE:

Turbo spin-echo

VB:

Variceal bleeding

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Acknowledgements

We acknowledge Professor Rock Bum Kim in Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju, Republic of Korea, for statistical advice for this manuscript.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju, 52727, Republic of Korea

    Wonjeong Yang, Ji Eun Kim, Ho Cheol Choi, Mi Jung Park, Hye Young Choi, Hwa Seon Shin & Jeong Ho Won

  2. Siemens Healthcare USA, Los Angeles, CA, USA

    Fei Han

  3. Siemens Healthcare GmbH, Erlangen, Germany

    Marcel Dominik Nickel

  4. Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea

    Hyun Chin Cho

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  1. Wonjeong Yang
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Correspondence to Ji Eun Kim.

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Guarantor

The scientific guarantor of this publication is Professor Ji Eun Kim in Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.

Conflict of interest

Two of the authors (Fei Han, Marcel Dominik Nickel) are employees of Siemens Healthcare. The rest of 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.

Statistics and biometry

Professor Rock Bum Kim in Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju, Republic of Korea, kindly provided statistical advice for this manuscript.

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Written informed consent was waived by the Institutional Review Board.

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• Retrospective

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• Performed at one institution

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Yang, W., Kim, J.E., Choi, H.C. et al. T2 mapping in gadoxetic acid-enhanced MRI: utility for predicting decompensation and death in cirrhosis. Eur Radiol 31, 8376–8387 (2021). https://doi.org/10.1007/s00330-021-07805-0

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