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Possible utility of MRI using Gd-EOB-DTPA for estimating liver functional reserve

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Preoperative estimation of the liver functional reserve is important in liver surgery. We evaluated the role of dynamic magnetic resonance (MR) imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA), i.e., EOB-MRI, for determining liver functional reserve.

Methods

Fifty patients who underwent EOB-MRI to examine their liver tumors were included in this study. We first performed a pixel-by-pixel comparison of registered MR images and activity images with Tc-99m galactosyl human serum albumin (GSA) on each slice, and the correlation coefficient was calculated for 8 patients. We also determined the correlation coefficient between the relative signal intensity (SI) values of EOB-MRI and preoperative liver function, such as the GSA, indocyanine green dye retention at 15 min (ICGR15), and prothrombin time.

Results

The mean of the correlation coefficients for 512 × 512 matrices between the EOB-MRI and the GSA was 0.83 ± 0.05 (ranging from 0.73 to 0.87). The correlation coefficient between the relative SI of the EOB-MRI and the receptor index (LHL15) of GSA was 0.56 (P < 0.01). Better correlation coefficients were observed between the relative SI and the liver function test, including ICGR15 (r = −0.67, P < 0.01) and prothrombin time (r = 0.59, P < 0.01). In a patient with hilar cholangiocarcinoma whose right hepatic duct was obstructed, the relative SI in the right lobe (2.4 ± 0.3) was significantly lower than that in the left lobe (3.1 ± 0.1).

Conclusion

EOB-MRI represents a practical and reliable imaging technique that may be used to estimate regional liver functional reserve in the clinical setting.

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Abbreviations

ICGR15:

Indocyanine green dye retention at 15 min

Gd-EOB-DTPA:

Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid

MR:

Magnetic resonance

GSA:

Tc-99m galactosyl human serum albumin

ROI:

Regions of interest

FLIRT:

FMRIB’s linear image registration tool

FSL:

FMRIB software library

SI:

Signal intensities

ALT:

Alanine aminotransferase

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Acknowledgments

This work was supported in part by Grants-in-Aid for Scientific Research (B) (20390359) and for Scientific Research (C) (22591506), and Grants-in-Aid for Challenging Exploratory Research (22659233 and 22659243) from the Japan Society for the Promotion of Science. This work was also supported in part by the Uehara Memorial Foundation, and the Research Support Foundation of The University of Tokushima and TAIHO Pharmaceutical Co., Ltd.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, The University of Tokushima, 13-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan

    Tohru Utsunomiya, Mitsuo Shimada, Jun Hanaoka, Mami Kanamoto, Tetsuya Ikemoto, Yuji Morine & Satoru Imura

  2. Department of Radiology, The University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan

    Masafui Harada

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  1. Tohru Utsunomiya
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Correspondence to Tohru Utsunomiya.

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Utsunomiya, T., Shimada, M., Hanaoka, J. et al. Possible utility of MRI using Gd-EOB-DTPA for estimating liver functional reserve. J Gastroenterol 47, 470–476 (2012). https://doi.org/10.1007/s00535-011-0513-8

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  • DOI: https://doi.org/10.1007/s00535-011-0513-8

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