Can preoperative diffusion-weighted MRI predict postoperative hepatic insufficiency after curative resection of HBV-related hepatocellular carcinoma? A pilot study

Kim, Seung Up; Kim, Young Chul; Choi, Ji Soo; Kim, Kyung Sik; Choi, Gi Hong; Choi, Jin Sub; Park, Jun Yong; Ahn, Sang Hoon; Choi, Eun Hee; Park, Young Nyun; Chon, Chae Yoon; Han, Kwang Hyub

doi:10.1016/j.mri.2010.03.018

Cited by 16 publications

(12 citation statements)

References 44 publications

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“…In our department, therefore, we routinely perform the DWI before the injection of Gd-EOB-DTPA. Our poor results with DWI-ADC for the assessment of liver function were in keeping with those in a study by Kim et al [12]. They reported that ADC values were not predictive of postoperative insufficiency in liver function, including persistent hyperbilirubinemia (total bilirubin level >5 mg/dl for more than five days after surgery) and postoperative death, in the absence of other causes in patients with HBV-related HCC.…”

Section: Discussionsupporting

confidence: 89%

“…A previous study showed that ADC values could reflect underlying cellular swelling and damage, which may be useful for identifying patients at risk of hepatocellular impairment from biliary obstruction [6]. However, Kim et al [12] reported that DWI-ADC was not suitable for predicting postoperative hepatic insufficiency, advanced liver fibrosis, or cirrhosis in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Gd-EOB-DTPA is taken up by hepatocytes and secreted into the biliary system, and this pathway is similar to those for ICG.…”

Section: Introductionmentioning

confidence: 99%

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Assessing liver function in patients with HBV-related HCC: a comparison of T1 mapping on Gd-EOB-DTPA-enhanced MR imaging with DWI

et al. 2014

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Assessing liver function in patients with HBV-related HCC: a comparison of T1 mapping on Gd-EOB-DTPA-enhanced MR imaging with DWI

et al. 2014

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“…In another study by Kim et al 22. for assessment of advanced fibrosis and cirrhosis, DWI with b-values of 50, 400, and 800 s/mm 2 performed inferior to transient elastography measured liver stiffness.…”

Section: Discussionmentioning

confidence: 93%

Magnetic Resonance Elastography and Diffusion Weighted Imaging in the Evaluation of Hepatic Fibrosis in Chronic Hepatitis B

et al. 2017

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Background/AimsComparison of the accuracy of magnetic resonance elastography (MRE) and diffusion weighted imaging (DWI) for the diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB).MethodsIn this retrospective analysis, we investigated 63 patients with CHB and liver fibrosis. DWI was performed with both breath-hold (DWI-BH) and free-breathing (DWI-FB) sequences (b=0, 500). The mean liver stiffness and apparent diffusion coefficient (ADC) were calculated by drawing regions of interest maps. Fibrosis staging according to the METAVIR system was independently performed by an experienced pathologist. A receiver operating curve (ROC) analysis was conducted to determine the accuracy of MRE, DWI-BH and DWI-FB in the detection and stratification of liver fibrosis. The performance of the detection of significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4) was also evaluated by comparing areas under the ROC.ResultsThere was a moderate and significantly negative correlation between the ADC values and liver stiffness. The accuracies for the detection of ≥F2/≥F3/F4 stage fibrosis with DWI-FB, DWI-BH and MRE were 0.84/0.76/0.72, 0.72/0.83/0.79 and 0.99/0.99/0.98, respectively. The performance of MRE was significantly better than DWI-FB and DWI-BH. There were no significant differences between the performance of DWI-FB and DWI-BH.ConclusionsMRE is more accurate than DWI for the detection and stratification of liver fibrosis in CHB.

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“…Based on a similar hypothesis by Kim et al [21,33], a more recent study from Hong Kong [24] also proposed the superior performance of TE to that of the ICG R15 in predicting major postoperative complications, defined as ≥grade 3 complications based on a modified Clavien classification [36,37]. The AUROC of TE and ICG R15 in predicting major postoperative complication was 0.79 and 0.51, respectively, and only TE showed a significant positive correlation to the primary endpoint.…”

Section: Prediction Of Short- and Long-term Outcomes Using Te After Hmentioning

confidence: 94%

“…The area under the receiver operating characteristic curve (AUROC) of LS values using TE was higher than that of ICG R15 measurements (0.824 vs. 0.620, respectively). The usefulness of TE in assessing postoperative hepatic insufficiency was also demonstrated in subsequent investigations [33] that compared the predictive ability of TE with another radiological tool, diffusion-weighted magnetic resonance imaging (DW-MRI), using apparent diffusion coefficient values [34,35]. In patients who underwent liver resection for HBV-related HCC, the predictive performance of TE was superior to that of DW-MRI (AUROC 0.942 vs. 0.797, respectively).…”

Section: Prediction Of Short- and Long-term Outcomes Using Te After Hmentioning

confidence: 98%

Clinical Application of Liver Stiffness Measurement Using Transient Elastography: A Surgical Perspective

Kim¹,

Han²

2013

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Liver biopsy (LB) remains the gold standard for assessing the severity of liver fibrosis; however, LB is often limited by its invasiveness, sampling error, and intra-/inter-observer variability in histological interpretation. Furthermore, repeated LB examinations within a short time interval are ineligible in real clinical practice. Thus, due to the pressing need for non-invasive surrogates, over the past decade, significant progress has been made in non-invasively assessing liver fibrosis. Of the methods now available, transient elastography (TE) appears to be an excellent tool for assessing liver fibrosis and also has some prognostic value in surgical settings. Recent studies have proposed the extended role of TE in the surgical field, based on the concept that TE values show significant correlations with portal hypertension and hepatocellular carcinoma development. TE appears promising in predicting postoperative short-term outcomes such as hepatic insufficiency or complications and long-term outcomes such as recurrence or liver-related death. Furthermore, TE may be useful in predicting the severity of liver fibrosis progression due to recurrence of hepatitis C virus infection or other underlying liver diseases after transplantation. TE cannot completely replace other tests accompanied with hepatic surgical treatments, including LB, endoscopic examination, hepatic venous pressure gradient evaluation, or the indocyanine green retention test. However, TE represents an important non-invasive tool that enables more efficient and tailored management strategies for patients who were treated with liver resection or transplantation. This review discusses extended TE applications in the surgical setting, such as hepatic resection or transplantation.

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Can preoperative diffusion-weighted MRI predict postoperative hepatic insufficiency after curative resection of HBV-related hepatocellular carcinoma? A pilot study

Cited by 16 publications

References 44 publications

Assessing liver function in patients with HBV-related HCC: a comparison of T1 mapping on Gd-EOB-DTPA-enhanced MR imaging with DWI

Assessing liver function in patients with HBV-related HCC: a comparison of T1 mapping on Gd-EOB-DTPA-enhanced MR imaging with DWI

Magnetic Resonance Elastography and Diffusion Weighted Imaging in the Evaluation of Hepatic Fibrosis in Chronic Hepatitis B

Clinical Application of Liver Stiffness Measurement Using Transient Elastography: A Surgical Perspective

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