Assessment of Orthotopic Liver Transplant Graft Survival on Gadoxetic Acid–Enhanced Magnetic Resonance Imaging Using Qualitative and Quantitative Parameters

Bastati, Nina; Wibmer, Andreas G.; Tamandl, Dietmar; Einspieler, Henrik; Hodge, Jacqueline C.; Poetter-Lang, Sarah; Rockenschaub, Susanne; Berlakovich, Gabriela; Trauner, Michael; Herold, Christian; Ba‐Ssalamah, Ahmed

doi:10.1097/rli.0000000000000286

Cited by 39 publications

(40 citation statements)

References 34 publications

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“…Total bilirubin and cholinesterase showed the strongest correlation, while eGFR did not correlate with the RLE. These results were confirmed in a cohort study by Bastati et al, who also showed that the eGFR did not significantly influence the RLE on the HBP phase images …”

Section: Quantitative Methods For Evaluating Liver Function With Ga‐mrisupporting

confidence: 68%

“…Both dynamic and delayed phase imaging with this agent can be used to assess for HCC, which characteristically is hypervascular in the arterial phase, washes out in the portal venous phase, and is hypointense relative to the surrounding liver in the HBP in approximately 80–90% of cases . The degree of parenchymal uptake and biliary excretion in GA‐MRI may be useful for the evaluation of liver function as cirrhosis evolves (Figs. and ).…”

Section: Potential Clinical Uses For Ga‐enhanced Mri Measures Of Livementioning

confidence: 99%

“…As the demand for donor organs far exceeds the supply, it is critical to give each graft the best chance of survival, which includes prompt diagnosis and aggressive management of possible complications. Graft complications fall into two broad categories: the more common mechanical‐vascular complications, including arterial and venous thrombosis/stenosis; and biliary‐parenchymal complications, such as rejection, recurrent CLD, biliary obstruction, and hepatitis . In addition, parenchymal liver dysfunction may be regional, such as segmental cholangitis, or global, limiting the utility of liver biopsy.…”

Section: Potential Clinical Uses For Ga‐enhanced Mri Measures Of Livementioning

confidence: 99%

See 2 more Smart Citations

Hepatic gadoxetic acid uptake as a measure of diffuse liver disease: Where are we?

Ba‐Ssalamah

Bastati

Wibmer

et al. 2016

Magnetic Resonance Imaging

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Section: Quantitative Methods For Evaluating Liver Function With Ga‐mrisupporting

confidence: 68%

Section: Potential Clinical Uses For Ga‐enhanced Mri Measures Of Livementioning

confidence: 99%

Section: Potential Clinical Uses For Ga‐enhanced Mri Measures Of Livementioning

confidence: 99%

See 1 more Smart Citation

Hepatic gadoxetic acid uptake as a measure of diffuse liver disease: Where are we?

Ba‐Ssalamah

Bastati

Wibmer

et al. 2016

Magnetic Resonance Imaging

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“…The scientific literature is replete with articles demonstrating the importance in terms of medical diagnosis, lesion characterization, and response to therapy provided by delayed imaging with the hepatobiliary linear gadolinium chelates. [58][59][60] Renal function needs to be kept in mind in regard to the potential for long-term gadolinium deposition (and the degree thereof ) after administration of the linear chelates. It is clear from the evaluation of animals receiving such agents that renal dysfunction (with the correlate in patients being mild or moderate chronic kidney disease) potentiates deposition of gadolinium not only in the cerebellum but also in the brain and bones.…”

Section: Additional Issuesmentioning

confidence: 99%

Dechelation (Transmetalation)

Runge¹

2018

Invest Radiol

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The issue of dechelation (transmetallation) in vivo after administration of the linear gadolinium-based contrast agents, and potential safety concerns, is considered on the basis of an extensive, focused literature review. Early indications of potential problems included the high level of excess ligand used in the formulation of 2 agents (indeed the 2 least stable thermodynamically) and interference with laboratory tests when blood was drawn from patients relatively soon after administration of these same agents. The advent of nephrogenic systemic fibrosis in the late 2000s raised additional major concerns.The correlation in 2014 of dentate nucleus hyperintensity on precontrast T1-weighted scans with multiple prior injections of linear gadolinium chelates, in patients with normal renal function, has driven subsequent research concerning dechelation of these agents in vivo. Unexpectedly high levels of gadolinium in the bone, skin, and liver have been found long term after administration, in animal models and in humans, although the latter data are limited. Bone may serve as a long-term reservoir, with a residual excretion phase for gadolinium after intravenous injection of the linear agents due to a subsequent slow release from bone. Many different patient populations could be vulnerable and potentially later develop clinical symptoms, although at this stage there are only limited data and small retrospective uncontrolled studies. Possible vulnerable populations include children, menopausal women, patients with osteoporosis (who are predisposed to fractures and often slow to heal or heal poorly), those receiving multiple doses, those with proinflammatory conditions, moderate renal dysfunction, or an undefined genetic predisposition. Of particular concern would be nephrogenic systemic fibrosis-like symptoms-including particularly pain and skin/joint symptoms, or disease related to the incorporation of gadolinium in hydroxyapatite in bone, in small subgroups of patients with a not yet defined propensity and/or cofactor. These concerns have led to withdrawal of the linear agents from the largest clinical market, Europe, with the exception of the hepatobiliary agents for delayed liver imaging, an indication that cannot be fulfilled by the current macrocyclic gadolinium chelates (for which these concerns do not apply).

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“…Gadoxetate uptake and enhancement in patients with diffuse chronic liver disease is generally lower than in healthy individuals, due to differences in transporter number or activity. Therefore it allows differentiation between two subgroups of nonalcoholic fatty liver disease, plus between simple steatosis and nonalcoholic steatohepatitis [114]; and also can be used for assessment and staging of fibrosis [76] and cirrhosis [115], as well as in predicting liver transplant graft survival [116]. In addition, gadoxetate enhanced MR imaging together with T2-weighted MR cholangiography may be a useful tool in providing information about the biliary system, like biliary injury, bile duct obstruction, diagnosis of cholecystitis, and differentiation of biliary from extrabiliary lesions [117,118].…”

Section: Current Clinical Use Of Gadoxetate In Liver Disease Diagnosismentioning

confidence: 99%

Noninvasive Preclinical and Clinical Imaging of Liver Transporter Function Relevant to Drug-Induced Liver Injury

Kenna

Waterton

Baudy

et al. 2018

Methods in Pharmacology and Toxicology

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Imaging technologies can evaluate many different biological processes in vitro (in cell culture models) and in vivo (in animals and humans), and many are used routinely in investigation of human liver diseases. Some of these methods can help understand liver toxicity caused by drugs in vivo in animals, and druginduced liver injury (DILI) which arises in susceptible humans. Imaging could aid assessment of the relevance to humans in vivo of toxicity caused by drugs in animals (animal/human translation), plus toxicities observed using in vitro model systems (in vitro/in vivo translation). Technologies and probe substrates for quantitative evaluation of hepatobiliary transporter activities are of particular importance. This is due to the key role played by sinusoidal transporter mediated hepatic uptake in DILI caused by many drugs, plus the strong evidence that inhibition of the hepatic bile salt export pump (BSEP) can initiate DILI. Imaging methods for investigation of these processes are reviewed in this chapter, together with their scientific rationale, and methods of quantitative data analysis. In addition to providing biomarkers for investigation of DILI, such approaches could aid the evaluation of clinically relevant drug-drug interactions mediated via hepatobiliary transporter perturbation.

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Assessment of Orthotopic Liver Transplant Graft Survival on Gadoxetic Acid–Enhanced Magnetic Resonance Imaging Using Qualitative and Quantitative Parameters

Abstract: In liver transplant recipients, gadoxetic acid-enhanced MRI-derived QSs (ie, EnQS, ExQS, and PVsQS), as well as the FLIS and RLE, can predict graft survival probability.

Cited by 39 publications

References 34 publications

Hepatic gadoxetic acid uptake as a measure of diffuse liver disease: Where are we?

Hepatic gadoxetic acid uptake as a measure of diffuse liver disease: Where are we?

Dechelation (Transmetalation)

Noninvasive Preclinical and Clinical Imaging of Liver Transporter Function Relevant to Drug-Induced Liver Injury

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