Gadoxetic acid-enhanced MRI-derived functional liver imaging score (FLIS) and spleen diameter predict outcomes in ACLD

Bastati, Nina; Beer, Lucian; Ba‐Ssalamah, Ahmed; Poetter-Lang, Sarah; Ambros, Raphael; Kristic, Antonia; Lauber, David; Pomej, Katharina; Binter, Teresa; Simbrunner, Benedikt; Semmler, Georg; Balcar, Lorenz; Bican, Yesim; Hodge, Jacqueline C.; Wrba, Thomas; Trauner, Michael; Reiberger, Thomas; Mandorfer, Mattias

doi:10.1016/j.jhep.2022.04.032

Cited by 10 publications

(7 citation statements)

References 40 publications

(59 reference statements)

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“…Signal intensity-based indices such as relative liver enhancement and liver-to-spleen index are easy to implement because there is no need for specific sequences or post-processing [ 35 ]. Studies have shown a good correlation of signal intensity (SI)-based indices with liver function tests and established clinical scores [ 3 36 ]. However, it must be noted that SI measurements are only relative values and are dependent on technical parameters.…”

Section: Hepatic Fibrosismentioning

confidence: 99%

Strategies and Techniques for Liver Magnetic Resonance Imaging: New and Pending Applications for Routine Clinical Practice

Ringe

Yoon

2023

Korean J Radiol

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Section: Hepatic Fibrosismentioning

confidence: 99%

Strategies and Techniques for Liver Magnetic Resonance Imaging: New and Pending Applications for Routine Clinical Practice

Ringe

Yoon

2023

Korean J Radiol

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“…[27][28][29] Patients with decompensated ACLD (dACLD) presented at least one of the following characteristics: ascites, variceal bleeding, overt hepatic encephalopathy or death related to CSPH. [27][28][29] LSM were obtained using transient elastography (FibroScan®, Echosens) when clinically indicated, as previously described. 30,31 Presence and size of gastroesophageal varices was recorded according to Austrian Billroth III guidelines.…”

Section: Definition Of Csph and Compensated Versus Decompensated Acldmentioning

confidence: 99%

Portal hypertension and its prognostic implications in patients with Wilson's disease

Burghart,

Ferenci,

Petrenko

et al. 2024

Aliment Pharmacol Ther

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SummaryBackground and AimsWilson's disease may progress to cirrhosis and clinically significant portal hypertension (CSPH). We aimed to assess the prevalence and prognostic impact of CSPH‐related features on hepatic decompensation and transplant‐free survival in patients with Wilson's disease.Methods and ResultsAbout 137 patients with Wilson's disease (Leipzig score ≥4), followed for a median observation period of 9.0 (3.9–17.7) years at the Vienna General Hospital, were included in this retrospective study. Overall, 49 (35.8%) developed features of CSPH: 14 (10.2%) varices, 40 (29.2%) splenomegaly, 20 (14.6%) ascites, 18 (13.1%) hepatic encephalopathy and 3 (2.2%) experienced acute variceal bleeding. Overall, 8 (5.8%) patients died, including three deaths caused by CSPH‐related complications. Within 10 years, compensated patients with features of CSPH developed more decompensation events (8.3% vs. 1.5% in patients without CSPH, p = 0.3) and had worse transplant‐free‐survival (91.7% vs. 98.6%), which further declined in patients with hepatic decompensation (26.7%, log‐rank: p < 0.0001). Patients with liver stiffness <15 kPa and normal platelets (≥150 G/L) were less likely to decompensate within 10 years (2.6% vs. 8.4%, p = 0.002) and had a better 10‐year transplant‐free‐survival (97.7% vs. 83.9%, p = 0.006).ConclusionsPatients with Wilson's disease developing features of CSPH are at an increased risk for hepatic decompensation and liver‐related mortality, warranting for regular screening and timely initiation of effective CSPH‐directed treatments.

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“…This algorithm can independently predict transplant-free mortality and determine the likelihood of transplant-free survival in patients with advanced CLD. 61…”

Section: Evaluation Of Liver Fibrosis and Functionmentioning

confidence: 99%

“…Bastati et al created an algorithm to predict the probability of adverse liver-related outcomes in advanced CLD by combining the FLIS with the splenic craniocaudal diameter. This algorithm can independently predict transplant-free mortality and determine the likelihood of transplant-free survival in patients with advanced CLD 61 …”

Section: Other Potential or Investigational Applicationsmentioning

confidence: 99%

Gadoxetic Acid–Enhanced Liver MRI

Ichikawa

Goshima

2023

Invest Radiol

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Since its introduction in the worldwide medical market, gadoxetic acid has attracted considerable interest. The year 2023 marks the 15th anniversary of the introduction of gadoxetic acid in Japan. Gadoxetic acid–enhanced magnetic resonance imaging (GA-MRI) is the predominantly performed contrast MRI examination for the liver. Its most essential characteristic, namely, the hepatobiliary phase, revolutionized the clinical management of liver disease. Gadoxetic acid–enhanced MRI is currently the most efficient method for focal liver lesion detection and analysis. Meta-analyses demonstrated its excellent effectiveness for the diagnosis of hepatocellular carcinoma and liver metastases. Owing to the extensive usage of gadoxetic acid, a hepatobiliary phase hypointense nodule without arterial phase hyperenhancement is well documented. The existence of such nodules may be a sign of hypervascular hepatocellular carcinoma in nodules and other areas in the liver. Apart from its role in tumor identification and characterization, GA-MRI can help assess response to therapy and liver fibrosis. Therefore, it is proposed to use gadoxetic acid as the first option for MRI of the liver in the majority of patients. The efficacy of gadoxetic acid surpasses its disadvantages, rendering this contrast agent the preferred choice for routine MRI of the liver. The clinical use of GA-MRI is discussed in this review article.

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Gadoxetic acid-enhanced MRI-derived functional liver imaging score (FLIS) and spleen diameter predict outcomes in ACLD

Cited by 10 publications

References 40 publications

Strategies and Techniques for Liver Magnetic Resonance Imaging: New and Pending Applications for Routine Clinical Practice

Strategies and Techniques for Liver Magnetic Resonance Imaging: New and Pending Applications for Routine Clinical Practice

Portal hypertension and its prognostic implications in patients with Wilson's disease

Gadoxetic Acid–Enhanced Liver MRI

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