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Liver-fat and liver-function indices derived from Gd-EOB-DTPA-enhanced liver MRI for prediction of future liver remnant growth after portal vein occlusion.
- Source :
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European Journal of Radiology . Apr2016, Vol. 85 Issue 4, p843-849. 7p. - Publication Year :
- 2016
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Abstract
- <bold>Objectives: </bold>To evaluate the use of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI)-derived fat- and liver function-measurements for prediction of future liver remnant (FLR) growth after portal vein occlusion (PVO) in patients scheduled for major liver resection.<bold>Methods: </bold>Forty-five patients (age, 59 ± 13.9 y) who underwent Gd-EOB-DTPA-enhanced liver MRI within 24 ± 18 days prior to PVO were included in this study. Fat-Signal-Fraction (FSF), relative liver enhancement (RLE) and corrected liver-to-spleen ratio (corrLSR) of the FLR were calculated from in- and out-of-phase (n=42) as well as from unenhanced T1-weighted, and hepatocyte-phase images (n=35), respectively. Kinetic growth rate (KGR, volume increase/week) of the FLR after PVO was the primary endpoint. Receiver operating characteristics analysis was used to determine cutoff values for prediction of impaired FLR-growth.<bold>Results: </bold>FSF (%) showed significant inverse correlation with KGR (r=-0.41, p=0.008), whereas no significant correlation was found with RLE and corrLSR. FSF was significantly higher in patients with impaired FLR-growth than in those with normal growth (%FSF, 8.1 ± 9.3 vs. 3.0 ± 5.9, p=0.02). ROC-analysis revealed a cutoff-FSF of 4.9% for identification of patients with impaired FLR-growth with a specificity of 82% and sensitivity of 47% (AUC 0.71 [95%CI:0.54-0.87]). Patients with impaired FLR-growth according to the FSF-cutoff showed a tendency towards higher postoperative complication rates (posthepatectomy liver failure in 50% vs. 19%).<bold>Conclusions: </bold>Liver fat-content, but not liver function derived from Gd-EOB-DTPA-enhanced MRI is a predictor of FLR-growth after PVO. Thus, liver MRI could help in identifying patients at risk for insufficient FLR-growth, who may need re-evaluation of the therapeutic strategy. [ABSTRACT FROM AUTHOR]
- Subjects :
- *FATTY liver
*GADOLINIUM
*DIETHYLENETRIAMINEPENTAACETIC acid
*LIVER
*LIVER surgery
*MAGNETIC resonance imaging
*ADIPOSE tissues
*DIAGNOSTIC imaging
*EPITHELIAL cells
*FORECASTING
*HEPATECTOMY
*HYPERTROPHY
*LIGATURE (Surgery)
*LIVER diseases
*PORTAL vein
*SPLEEN
*SURGICAL complications
*THERAPEUTIC embolization
*CONTRAST media
*RETROSPECTIVE studies
*RECEIVER operating characteristic curves
PORTAL vein diseases
Subjects
Details
- Language :
- English
- ISSN :
- 0720048X
- Volume :
- 85
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- European Journal of Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 113666846
- Full Text :
- https://doi.org/10.1016/j.ejrad.2016.02.008