Gd-EOB-DTPA-enhanced MRI for the assessment of liver function and volume in liver cirrhosis

Nilsson, Henrik; Blomqvist, Lennart; Douglas, Lena; Nordell, Anders; Janczewska, I; Näslund, Erik; Jonas, Eduard

doi:10.1259/bjr.20120653

Cited by 69 publications

(57 citation statements)

References 46 publications

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“…Subsequently, several studies were published showing correlation between MRI with Gd-EOB-DTPA and liver function in animal models [109,110,111,112,113,114]. Recently, data on the assessment of liver function using MRI with Gd-EOB-DTPA in humans have been published, all of them confirming the possibility of liver function assessment using MRI [115,116,117,118,119,120,121,122]. …”

Section: Assessment Of Liver Function Using Magnetic Resonance Imagingmentioning

confidence: 96%

“…MRI allows the segmental assessment of steatosis and can be used to assess fibrosis, making it a potential one-stop-shop modality for both liver anatomy as well as function [123,124,125,126]. Another advantage is that Gd-EOB-DTPA uptake is reliable in patients with and without compromised liver parenchyma [115,119,120]. Hence, although the use of MRI with Gd-EOB-DTPA for liver function assessment is still under investigation, so far the evidence has shown promising results and offers the attractive prospect of combining diagnostic and functional imaging in one procedure.…”

Section: Assessment Of Liver Function Using Magnetic Resonance Imagingmentioning

confidence: 99%

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New Perspectives in the Assessment of Future Remnant Liver

Cieslak¹,

Runge

Heger³

et al. 2014

Dig Surg

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In order to achieve microscopic radical resection margins and thus better survival, surgical treatment of hepatic tumors has become more aggressive in the last decades, resulting in an increased rate of complex and extended liver resections. Postoperative outcomes mainly depend on the size and quality of the future remnant liver (FRL). Liver resection, when performed in the absence of sufficient FRL, inevitably leads to postresection liver failure. The current gold standard in the preoperative assessment of the FRL is computed tomography volumetry. In addition to the volume of the liver remnant after resection, postoperative function of the liver remnant is directly related to the quality of liver parenchyma. The latter is mainly influenced by underlying diseases such as cirrhosis and steatosis, which are often inaccurately defined until microscopic examination after the resection. Postresection liver failure remains a point of major concern that calls for accurate methods of preoperative FRL assessment. A wide spectrum of tests has become available in the past years, attesting to the fact that the ideal methodology has yet to be defined. The aim of this review is to discuss the current modalities available and new perspectives in the assessment of FRL in patients scheduled for major liver resection. i 2014 S. Karger AG, Basel

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Section: Assessment Of Liver Function Using Magnetic Resonance Imagingmentioning

confidence: 96%

Section: Assessment Of Liver Function Using Magnetic Resonance Imagingmentioning

confidence: 99%

New Perspectives in the Assessment of Future Remnant Liver

Cieslak¹,

Runge

Heger³

et al. 2014

Dig Surg

View full text Add to dashboard Cite

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“…measurement of T 1 or T 2 * relaxation time) and dynamic contrast-enhanced MRI (DCE-MRI). [25][26][27][28] These methods are based on the fact that hepatic dysfunction causes a reduction of liver parenchymal enhancement in gadoxetate-enhanced liver MRI. The differential degree of liver parenchymal enhancement on gadoxetate-enhanced MRI can be used to assess hepatic function quantitatively.…”

Section: Clinical Applications Of Gadoxetate-enhanced Mri Evaluation mentioning

confidence: 99%

“…Among various DCE-MRI parameters, hepatic extraction fraction has been widely used and the correlation between ICG clearance and Child-Pugh score has been demonstrated in both pre-clinical and clinical studies. 28,33 Assessment of liver function with gadoxetate-enhanced MRI has several advantages over traditional ICG clearance and hepatic scintigraphy with 99m Tc-mebrofenin. 29 First, gadoxetate-enhanced MRI can provide information on hepatic function in localized hepatic abnormalities, which is more clinically relevant than a global assessment.…”

Section: Clinical Applications Of Gadoxetate-enhanced Mri Evaluation mentioning

confidence: 99%

Use of gadoxetate disodium for functional MRI based on its unique molecular mechanism

Choi¹,

Huh²,

Woo³

et al. 2016

BJR

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Gadolinium ethoxybenzyl dimeglumine (gadoxetate) is a recently developed hepatocyte-specific MRI contrast medium. Gadoxetate demonstrates unique pharmacokinetic and pharmacodynamic properties, because its uptake in hepatocytes occurs via the organic anion transporting polypeptide (OATP) transporter expressed at the sinusoidal membrane, and its biliary excretion via the multidrug resistance-associated proteins (MRPs) at the canalicular membrane. Based on these characteristics, gadoxetate-enhanced MRI can provide functional information on hepatobiliary diseases, including liver function estimation, biliary drainage evaluation and characterization of hepatocarcinogenesis. In addition, understanding its mode of action can provide an opportunity to use gadoxetate for cellular and molecular imaging. Radiologists and imaging scientists should be familiar with the basic mechanism of gadoxetate and OATP/MRP transporters.

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“…This method has two disadvantages: only one input function, the arterial (AIF) or the portal venous (PVIF), which differ greatly, can be taken into consideration; singular value decomposition is very susceptible to noise. The validity of this approach in primary biliary cirrhosis, liver cirrhosis, and primary sclerosing cholangitis was able to be shown [58,59,66]. The additional use of the keyhole technique as implemented in the TWIST sequence allows inclusion of the AIF as a result of the higher temporal resolution [65,67].…”

Section: Mri As Imaging-based Liver Function Testmentioning

confidence: 99%

Imaging-Based Liver Function Tests – Past, Present and Future

Geisel

Lüdemann

Hamm

et al. 2015

Fortschr Röntgenstr

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Preoperative assessment of liver function and?prediction of postoperative functional reserve are important in patients scheduled for liver resection. While determination of absolute liver function currently mostly relies on laboratory tests and clinical scores, postoperative remnant liver function is estimated volumetrically using imaging data obtained with computed tomography (CT) or magnetic resonance imaging (MRI). Accurate estimation of hepatic function is also relevant for intensive care patients, oncologic patients, and patients with diffuse liver disease. The indocyanine green (ICG) test is still the only established test for estimating true global liver function. However, more recent tools such as the LiMAx test also allow global assessment of hepatic function. These tests are limited when liver function is inhomogeneously distributed, which is the case in such conditions as unilateral cholestasis or after portal vein embolization. Imaging-based liver function tests were first developed in nuclear medicine and, compared with laboratory tests, have the advantage of displaying the spatial distribution of liver function. Nuclear medicine scans are obtained using tracers such as?99mTc galactosyl and 99mTc mebrofenin. Liver function is typically assessed using planar scintigraphy. However, three-dimensional volumetry is possible with single-photon emission computed tomography (SPECT-CT). Another technique for image-based liver function estimation is Gd-EOB-enhanced MRI. While metabolization of Gd-EOB in the body is similar to that of ICG and mebrofenin, its distribution in the liver can be displayed by MRI with higher temporal and spatial resolution. Moreover, MRI-based determination of liver function can be integrated into routine preoperative imaging. This makes MRI an ideal candidate for preoperative determination of?liver function, though the best pulse sequence and the parameter to be derived from the image information remain to be identified. Another question to be answered is how the results may be affected by renal function and the presence of hyperbilirubinemia. As more results from clinical evaluation including comparison with postoperative liver function data become available, image-based liver function tests, especially with use of Gd-EOB as the contrast medium, have the potential to add another dimension to preoperative imaging. Key Points: ??Liver function consists of a multitude of subfunctions such as biotransformation, excretion and storage. ??Global liver function tests are score-based tests such as Child-Pugh or MELD as well as the ICG- and LiMAx-test. ??Imaging-based liver function tests add spatial information. Current clinical standard is the 99mTc-Mebrofenin-scintigraphy. ??MRI-based function tests with Gd-EOB-DTPA have the potential to integrate seamlessly into clinical workup, feature a higher temporal and spatial resolution and do not rely on ionizing radiation. Citation Format: ??Geisel D, L?demann L, Hamm B et?al. Imaging-Based Liver Function Tests ? Past, Present and F...

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Gd-EOB-DTPA-enhanced MRI for the assessment of liver function and volume in liver cirrhosis

Cited by 69 publications

References 46 publications

New Perspectives in the Assessment of Future Remnant Liver

New Perspectives in the Assessment of Future Remnant Liver

Use of gadoxetate disodium for functional MRI based on its unique molecular mechanism

Imaging-Based Liver Function Tests – Past, Present and Future

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