Quantification of liver function using gadoxetic acid-enhanced MRI

Poetter-Lang, Sarah; Bastati, Nina; Messner, Alina; Kristic, Antonia; Herold, Alexander; Hodge, Jacqueline C.; Ba‐Ssalamah, Ahmed

doi:10.1007/s00261-020-02779-x

Cited by 45 publications

(38 citation statements)

References 87 publications

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“…As a result of these advantages, gadoxetic acid–enhanced MRI has been the primary evaluation tool in HCC patients [ 40 ]. Our research adds further evidence to the implementation of gadoxetic acid–derived liver function assessment in patients with hepatocellular carcinoma [ 41 ].…”

Section: Discussionmentioning

confidence: 86%

Correlation of liver enhancement in gadoxetic acid–enhanced MRI with liver functions: a multicenter-multivendor analysis of hepatocellular carcinoma patients from SORAMIC trial

et al. 2021

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Objectives To evaluate the correlation between liver enhancement on hepatobiliary phase and liver function parameters in a multicenter, multivendor study. Methods A total of 359 patients who underwent gadoxetic acid–enhanced MRI using a standardized protocol with various scanners within a prospective multicenter phase II trial (SORAMIC) were evaluated. The correlation between liver enhancement on hepatobiliary phase normalized to the spleen (liver-to-spleen ratio, LSR) and biochemical laboratory parameters, clinical findings related to liver functions, liver function grading systems (Child-Pugh and Albumin-Bilirubin [ALBI]), and scanner characteristics were analyzed using uni- and multivariate analyses. Results There was a significant positive correlation between LSR and albumin (rho = 0.193; p < 0.001), platelet counts (rho = 0.148; p = 0.004), and sodium (rho = 0.161; p = 0.002); and a negative correlation between LSR and total bilirubin (rho = −0.215; p < 0.001) and AST (rho = −0.191; p < 0.001). Multivariate analysis confirmed independent significance for each of albumin (p = 0.022), total bilirubin (p = 0.045), AST (p = 0.031), platelet counts (p = 0.012), and sodium (p = 0.006). The presence of ascites (1.47 vs. 1.69, p < 0.001) and varices (1.55 vs. 1.69, p = 0.006) was related to significantly lower LSR. Similarly, patients with ALBI grade 1 had significantly higher LSR than patients with grade 2 (1.74 ± 0.447 vs. 1.56 ± 0.408, p < 0.001); and Child-Pugh A patients had a significantly higher LSR than Child-Pugh B (1.67 ± 0.44 vs. 1.49 ± 0.33, p = 0.021). Also, LSR was negatively correlated with MELD-Na scores (rho = −0.137; p = 0.013). However, one scanner brand was significantly associated with lower LSR (p < 0.001). Conclusions The liver enhancement on the hepatobiliary phase of gadoxetic acid–enhanced MRI is correlated with biomarkers of liver functions in a multicenter cohort. However, this correlation shows variations between scanner brands. Key Points • The correlation between liver enhancement on the hepatobiliary phase of gadoxetic acid–enhanced MRI and liver function is consistent in a multicenter-multivendor cohort. • Signal intensity–based indices (liver-to-spleen ratio) can be used as an imaging biomarker of liver function. • However, absolute values might change between vendors.

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Section: Discussionmentioning

confidence: 86%

Correlation of liver enhancement in gadoxetic acid–enhanced MRI with liver functions: a multicenter-multivendor analysis of hepatocellular carcinoma patients from SORAMIC trial

et al. 2021

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“…This may be due to the role of FGFR4 gene in mediating tumor angiogenesis. The performance of contrast agent gadoxetic acid in hepatocarcinoma tissues during enhanced MRI is mainly related to the uptake and excretion of gadolinium acid by proteins such as organic anion transport polypeptide (OATP), multi-drug resistance associated protein 2(MRP2) and MRP3, resulting in the corresponding changes in the signal intensity in the hepatobiliary phase [21]. FGFR4 for tissue proliferation repair, may lead to cancer the inconsistency of the ingredients in the organization, and to the corresponding organization contrast agent to absorb and discharge distribution change of transporter, which may cause enhancement scanning courage period mixed high and low signal.…”

Section: Rna Extraction and Rt-pcrmentioning

confidence: 99%

A Novel Correlation of Preoperative Gd-EOB-DTPA-contrast-enhanced MRI with FGFR4 Expression and Its Value in Targeted Therapy for Hepatocellular Carcinoma

Лонг

Ding

et al. 2021

Preprint

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Purpose: To assess the relationship between preoperative gadolinium ethoxy-benzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) features and fibroblast growth factor receptor 4 (FGFR4) gene expression in hepatocellular carcinoma (HCC).Materials and methods: Fifty-nine HCC patients (54 males, 5 females) who underwent preoperative enhanced MRI were retrospectively enrolled in this study. Quantitative and qualitative features of Gd-EOB-DTPA-enhanced MRI were analyzed in these pathologically confirmed HCC patients. Immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) were performed to determine the mRNA and protein levels of FGFR4 in HCC. The relationship between these image features and the level of FGFR4 gene expression in HCC was evaluated by correlation analysis.Results: The FGFR4 mRNA and protein expression has significant correlation with the change of signal intensity in the phase of hepatobiliary, IHC analysis revealed significant correlation between the protein expression of FGFR4 and the qualitative enhanced MRI feature, mainly the manifestation of the intratumoral vessels at the arterial phase. Furthermore, the presence of intratumoral vessels (P =0.034, OR=4.71) and heterogeneous 3 signal performance in the hepatobiliary phase (P =0.008, OR=4.2) were identified as independent indicators for high FGFR4 expression in HCC. Conclusions: The findings demonstrate novel correlation between enhanced MRI features and FGFR4 gene expression, suggesting the heterogeneous signal intensity at the phase of hepatobiliary and the present of intratumoral vessels in the arterial phase as indicators for high FGFR4 expression in HCC. Our study may have clinical implication that enhanced MRI holds promise as useful modality in treatment selection of targeted therapies to HCC patients.

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“…Another possible limitation for the use of ECV in routine clinical liver MRI is that ECV calculation is based on the use of MR contrast agents with extracellular distribution, while routine clinical liver MRI is often performed using hepatocyte-specific contrast agents, such as gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA). Instead of distributing to the extracellular space as an extracellular contrast agent, approximately 50% of circulating Gd-EOB-DTPA is actively taken up from hepatic sinusoids into hepatocytes by organic anion-transporting polypeptides (OATP1B1 and OATP1B3) [19,20], thereby rendering ECV calculation in the liver impossible. Because Gd-EOB-DTPA is a paramagnetic substance that shortens the longitudinal relaxation (T1) time, ΔT1 of the liver can be calculated as a noninvasive imaging biomarker to quantify hepatocellular function.…”

Section: Introductionmentioning

confidence: 99%

“…Because Gd-EOB-DTPA is a paramagnetic substance that shortens the longitudinal relaxation (T1) time, ΔT1 of the liver can be calculated as a noninvasive imaging biomarker to quantify hepatocellular function. ΔT1 represents the difference in the T1 relaxation time before and after Gd-EOB-DTPA application in the hepatobiliary phase [19].…”

Section: Introductionmentioning

confidence: 99%

Noninvasive assessment of clinically significant portal hypertension using ΔT1 of the liver and spleen and ECV of the spleen on routine Gd-EOB-DTPA liver MRI

Catucci

Obmann

Berzigotti

et al. 2021

European Journal of Radiology

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To analyze the predictive value of ΔT1 of the liver and spleen as well as the extracellular volume fraction (ECV) of the spleen as noninvasive biomarkers for the determination of clinically significant portal hypertension (CSPH) on routine Gd-EOB-DTPA liver MRI. Method: 195 consecutive patients with known or suspected chronic liver disease from 9/2018 to 7/2019 with Gd-EOB-DTPA liver MRI and abdominal T1 mapping were retrospectively included. Based on the presence of splenomegaly with thrombocytopenia, ascites and portosystemic collaterals, the patients were divided into noCSPH (n = 113), compensated CSPH (cCSPH, ≥1 finding without ascites; n = 55) and decompensated CSPH (dCSPH, ascites ± other findings; n = 27). T1 times were measured in the liver, spleen and abdominal aorta in the unenhanced and contrast-enhanced T1 maps. Native T1 times and ΔT1 of the liver and spleen as well as ECV of the spleen were compared between groups using the Kruskal-Wallis test with Dunn's post hoc test. Furthermore, cutoff values for group differentiation were calculated using ROC analysis with Youden's index. Results: ΔT1 of the liver was significantly lower in patients with cCSPH and dCSPH (p < 0.001) compared to patients with noCSPH. In the ROC analyses for differentiation between noCSPH and CSPH (cCSPH + dCSPH), a cutoff of < 0.67 for ΔT1 of the liver (AUC = 0.79) performed better than ΔT1 (AUC = 0.69) and ECV (AUC = 0.63) of the spleen with cutoffs of > 0.29 and > 41.9, respectively. Conclusion: ΔT1 of the liver and spleen in addition to ECV of the spleen allow for determination of CSPH on routine Gd-EOB-DTPA liver MRI.

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Quantification of liver function using gadoxetic acid-enhanced MRI

Cited by 45 publications

References 87 publications

Correlation of liver enhancement in gadoxetic acid–enhanced MRI with liver functions: a multicenter-multivendor analysis of hepatocellular carcinoma patients from SORAMIC trial

Correlation of liver enhancement in gadoxetic acid–enhanced MRI with liver functions: a multicenter-multivendor analysis of hepatocellular carcinoma patients from SORAMIC trial

A Novel Correlation of Preoperative Gd-EOB-DTPA-contrast-enhanced MRI with FGFR4 Expression and Its Value in Targeted Therapy for Hepatocellular Carcinoma

Noninvasive assessment of clinically significant portal hypertension using ΔT1 of the liver and spleen and ECV of the spleen on routine Gd-EOB-DTPA liver MRI

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