Hepatobiliary phase images using gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI as an imaging surrogate for the albumin–bilirubin grading system

Takatsu, Yasuo; Kobayashi, Satoshi; Miyati, Tosiaki; Shiozaki, Toshiki

doi:10.1016/j.ejrad.2016.10.010

Cited by 13 publications

(15 citation statements)

References 23 publications

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“…The most commonly used parameters are the RLE, CUI, LSI, and HUI, as they are solely based on changes of signal intensities in the HBP images compared with the unenhanced images, and therefore, easily obtainable. Various different groups have shown that these parameters correlate with established tests of liver function [21, 23–26, 28, 34–38]. Our study corroborates these results, highlighting that they all correlate with clinical parameters in a comparable strength, with no parameter being superior.…”

Section: Discussionsupporting

confidence: 89%

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Inter- and intra-reader agreement for gadoxetic acid–enhanced MRI parameter readings in patients with chronic liver diseases

et al. 2019

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ObjectivesTo examine inter- and intra-observer agreement for four simple hepatobiliary phase (HBP)–based scores on gadoxetic acid (GA)–enhanced MRI and their correlation with liver function in patients with mixed chronic liver disease (CLD).MethodsThis single-center, retrospective study included 287 patients (62% male, 38% female, mean age 53.5 ± 13.7 years) with mixed CLD (20.9% hepatitis C, 19.2% alcoholic liver disease, 8% hepatitis B) who underwent GA-enhanced MRI of the liver for clinical care between 2010 and 2015. Relative liver enhancement (RLE), contrast uptake index (CUI), hepatic uptake index (HUI), and liver-to-spleen contrast index (LSI) were calculated by two radiologists independently using unenhanced and GA-enhanced HPB (obtained 20 min after GA administration) images; 50 patients selected at random were reviewed twice by one reader to assess intra-observer reliability. Agreement was assessed by intraclass correlation coefficient (ICC). The albumin-bilirubin (ALBI) score, the model of end-stage liver disease (MELD), and the Child-Turcotte-Pugh (CTP) score were calculated as standards of reference for hepatic function.ResultsIntra-observer ICCs ranged from 0.814 (0.668–0.896) for CUI to 0.969 (0.945–0.983) for RLE. Inter-observer ICCs ranged from 0.777 (0.605–0.874) for HUI to 0.979 (0.963–0.988) for RLE. All HBP-based scores correlated significantly (all p < 0.001) with the ALBI, MELD, and CTP scores and were able to discriminate patients with a MELD score ≥ 15 versus ≤ 14, with area under the curve values ranging from 0.760 for RLE to 0.782 for HUI.ConclusionGA-enhanced, MRI-derived, HBP-based parameters showed excellent inter- and intra-observer agreement. All HBP-based parameters correlated with clinical and laboratory scores of hepatic dysfunction, with no significant differences between each other.Key Points • Radiological parameters that quantify the hepatic uptake of gadoxetic acid are highly reproducible. • These parameters can be used interchangeably because they correlate with each other and with scores of hepatic dysfunction. • Assessment of these parameters may be helpful in monitoring disease progression. Electronic supplementary materialThe online version of this article (10.1007/s00330-019-06182-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 89%

“…Quantitative image scores were calculated as previously described (Table 2) [23, 26]. Briefly, the RLE was calculated by subtracting the SI of the unenhanced images from the SI in the HBP, and dividing the difference by the SI of the unenhanced images.…”

Section: Methodsmentioning

confidence: 99%

Inter- and intra-reader agreement for gadoxetic acid–enhanced MRI parameter readings in patients with chronic liver diseases

et al. 2019

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“…We obtained accuracy data to verify the prediction using late dynamic imaging based on the ALBI grades because of the tendency for direct uptake of the contrast medium and the good correlation between the ALBI grade and HBP image. 14 When the delay time was extended, Q-LSC was increased at least with a 15-min delay in cases of each ALBI grade. According to a previous report, a 15-min delay is sufficient for a b Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Details of the ROI setting for the liver parenchyma and spleen have been reported previously. 14 MRI data were analyzed using a clinical workstation (SYNAPSE VINCENT version 4.1.0003; FUJIFILM Medical, Tokyo, Japan) by a single radiological technologist with 18 years of experience in MRI who was blinded to the diagnosis and medical background of patients.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of Sufficient Liver Enhancement on the Gadoxetate Disodium-enhanced Hepatobiliary Phase Imaging Using Transitional Phase Images and Albumin–bilirubin Grade

et al. 2021

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To investigate whether the contrast enhancement effect in hepatobiliary phase (HBP) images can be predicted using transitional phase (3-min delay) images on liver magnetic resonance imaging (MRI) based on the quantitative liver-spleen contrast ratio (Q-LSC) and albumin-bilirubin (ALBI) grade. Methods: Overall, 212 patients (124 men and 88 women; mean age 66.7 ± 11.1 years) who underwent blood tests (assessed within 1 month of performing MRI) were included; patients with diffuse tumor, hepatectomy, splenectomy, Gamna-Gandy bodies in the spleen, and movement artifacts were excluded. Q-LSC was calculated using the signal intensity of the liver divided that of the spleen. Q-LSC > 1.5 (cut-off value) indicates a relatively higher sensitivity for detecting of hepatic lesions. To predict the contrast enhancement effect in HBP using Q-LSC of 3-min delay images, Q-LSC of 10-and 15-min delay images were compared for each ALBI grade based on Q-LSC of 3-min delay images. Furthermore, to verify the accuracy of this prediction, the proportion of cases with Q-LSC > 1.5 in 10-and 15 min delay images was calculated based on Q-LSC on 3-min delay images. Results: The higher the Q-LSC on the 3-min delay image, the higher was the Q-LSC on its 10-and 15-min delay images. The proportion of cases with Q-LSC > 1.5 in 10-and 15-min delay images was higher for ALBI grade 1 than for ALBI grades 2 and 3 even in the same Q-LSC on 3-min delay images. Q-LSC was <1 in a 3-min delay image and <1.5 in a 15-min delay image in 62.2% of patients with ALBI grade 1 and 82.1% of patients with ALBI grades 2 and 3. Conclusion: The liver contrast enhancement effect in HBP images could be predicted using a 3-min delay image based on Q-LSC and ALBI grade.

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Determining the efficacy of functional liver imaging score (FLIS) obtained from gadoxetic acid-enhanced MRI in patients with chronic liver disease and liver cirrhosis: the relationship between Albumin-Bilirubin (ALBI) grade and FLIS

Aslan

Tasdemir²,

Çakır³

2022

Abdom Radiol

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Hepatobiliary phase images using gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI as an imaging surrogate for the albumin–bilirubin grading system

Cited by 13 publications

References 23 publications

Inter- and intra-reader agreement for gadoxetic acid–enhanced MRI parameter readings in patients with chronic liver diseases

Inter- and intra-reader agreement for gadoxetic acid–enhanced MRI parameter readings in patients with chronic liver diseases

Prediction of Sufficient Liver Enhancement on the Gadoxetate Disodium-enhanced Hepatobiliary Phase Imaging Using Transitional Phase Images and Albumin–bilirubin Grade

Determining the efficacy of functional liver imaging score (FLIS) obtained from gadoxetic acid-enhanced MRI in patients with chronic liver disease and liver cirrhosis: the relationship between Albumin-Bilirubin (ALBI) grade and FLIS

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