Value of gadoxetate biliary transit time in determining hepatocyte function

Wu, Jianwei; Li, Hui; Yang, Lin; Chen, Ziqian; Zhong, Qun; Gao, Hong; Fu, Liyuan; Sandrasegaran, Kumar

doi:10.1007/s00261-014-0200-3

Cited by 7 publications

(6 citation statements)

References 28 publications

(35 reference statements)

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“…In the present study, 95% of the patients in the non-cirrhosis group (35/37) had the IBD visualized within 10 min after the administration of Gd-EOB-DTPA. Only 54.2% of cirrhotic patients (CP A + CP B) (38/70) had the IBD visualized within 10 min after the administration, which was slightly lower than that reported by Wu et al ( 7 ) (65.4%). The reason may be that the proportion of CP A group patients in the cirrhotic patients (CP A + CP B) in our study is relatively lower than that in the study of Wu et al (57.1% vs. 63.1%).…”

Section: Discussioncontrasting

confidence: 55%

“…For the detection of liver lesions, patients with impaired liver function often need a longer time to increase the uptake of Gd-EOB-DTPA by liver parenchyma. Furthermore, recent studies have indicated that the timing of the initial visualization of the IBD is intrinsically associated with the liver function, the better the liver function, the earlier the initial visualization of the IBD after the administration ( 7 , 23 ). Consequently, the visualization of the IBD is utilized in optimizing the HCP acquisition protocol as one of the preconditions for consideration of an adequate HCP.…”

Section: Discussionmentioning

confidence: 99%

“…Sufficient drug accumulation in the liver is a prerequisite for obtaining the HCP image with adequate liver enhancement, namely, the adequate HCP. The uptake speed of Gd-EOB-DTPA by the hepatocytes varies substantially among patients because of individual differences in liver function ( 7 ). In most patients, drug accumulation in the liver peaks within 20 min, then is maintained at a relatively high plateau with concurrent gradual drug excretion from the bile.…”

Section: Introductionmentioning

confidence: 99%

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A convenient and reproducible protocol for acquisition of the hepatocyte phase for liver function-impaired patients in gadoxetic acid disodium-enhanced magnetic resonance imaging

Wang,

Sun,

et al. 2024

Quant Imaging Med Surg

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Background The hepatocyte phase (HCP) in gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) plays an important role in the detection and characterization of liver lesions, treatment planning, and liver function evaluation. However, the imaging protocol is complicated and time-consuming. This cross-sectional study aimed to develop a convenient and reproducible protocol for the HCP acquisition in Gd-EOB-DTPA-enhanced MRI. Methods A total of 107 patients were prospectively included and assigned to three groups based on Child-Pugh (CP) classification, with 37, 40, and 30 in the non-cirrhosis, CP A, and CP B groups, respectively. Dynamic HCPs were acquired every 5 min after the Gd-EOB-DTPA administration and ended in 25 min in non-cirrhosis patients and 40 min in cirrhotic patients. The HCP acquired 5 min after the initial visualization of the intrahepatic bile duct (IBD) was selected from the dynamic HCPs as the adequate HCP (HCP proposed ) and the corresponding acquisition time was recorded as Time proposed . In addition, according to the 2016 Expert Consensus (EC) on the definition of the adequate HCP from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), the adequate HCP EC and the corresponding Time EC were also determined from the dynamic HCPs. The hepatic relative enhancement ratio (RER), the contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) of hepatic focal lesions in the HCP EC and HCP proposed images, as well as the Time EC and Time proposed were compared by the paired t -test for the three groups, respectively. Inter-observer agreement of the determination of the HCP EC and HCP proposed was compared by the χ 2 test. Results The RER, CNR, and SNR showed no significant difference between the HCP EC and HCP proposed in all three groups (all P>0.05). The paired differences between Time EC and Time proposed were 1.08±3.56 min (P=0.07), 2.88±4.22 min (P < 0.001), and 5.83±5.27 min (P < 0.001) in the three groups, respectively. Inter-observer agreement of the determination of the HCP EC and HCP proposed were 0.804 (86/107) and 0.962 (103/107), respectively (χ² = 13.09, P=0.001). Conclusions The adequate HCP could be acquired 5 min after the initial visualization of the IBD, which could serve as a convenient and reproducible protocol for the HCP imaging.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A convenient and reproducible protocol for acquisition of the hepatocyte phase for liver function-impaired patients in gadoxetic acid disodium-enhanced magnetic resonance imaging

Wang,

Sun,

et al. 2024

Quant Imaging Med Surg

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“…11,13–17 A series of studies have also monitored the time course of contrast agent accumulation and appearance in the biliary system and gallbladder (eg, hepatobiliary transit times) as a means to characterize the biliary ductal system. 18–20 …”

mentioning

confidence: 99%

Quantitative Assessment of Liver Function Using Gadoxetate-Enhanced Magnetic Resonance Imaging

Georgiou

Penny²,

Nicholls³

et al. 2017

Invest Radiol

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ObjectiveThe objective of this study was to use noninvasive dynamic contrast-enhanced magnetic resonance imaging (MRI) techniques to study, in vivo, the distribution and elimination of the hepatobiliary contrast agent gadoxetate in the human body and characterize the transport mechanisms involved in its uptake into hepatocytes and subsequent efflux into the bile using a novel tracer kinetic model in a group of healthy volunteers.Materials and MethodsTen healthy volunteers (age range, 18–29 years), with no history of renal or hepatic impairment, were recruited via advertisement. Participants attended 2 MRI visits (at least a week apart) with gadoxetate as the contrast agent. Dynamic contrast-enhanced MRI data were acquired for approximately 50 minutes with a 3-dimensional gradient-echo sequence in the axial plane, at a temporal resolution of 6.2 seconds. Data from regions of interest drawn in the liver were analyzed using the proposed 2-compartment uptake and efflux model to provide estimates for the uptake rate of gadoxetate in hepatocytes and its efflux rate into the bile. Reproducibility statistics for the 2 visits were obtained to examine the robustness of the technique and its dependence in acquisition time.ResultsEight participants attended the study twice and were included into the analysis. The resulting images provided the ability to simultaneously monitor the distribution of gadoxetate in multiple organs including the liver, spleen, and kidneys as well as its elimination through the common bile duct, accumulation in the gallbladder, and excretion in the duodenum. The mean uptake (ki) and efflux (kef) rates in hepatocytes, for the 2 visits using the 50-minute acquisition, were 0.22 ± 0.05 and 0.017 ± 0.006/min, respectively. The hepatic extraction fraction was estimated to be 0.19 ± 0.04/min. The variability between the 2 visits within the group level (95% confidence interval; ki: ±0.02/min, kef: ±0.004/min) was lower compared with the individual variability (repeatability; ki: ±0.06/min, kef: ±0.012/min). Data truncation demonstrated that the uptake rate estimates retained their precision as well as their group and individual reproducibility down to approximately 10 minutes of acquisition. Efflux rate estimates were underestimated (compared with the 50-minute acquisition) as the duration of the acquisition decreased, although these effects were more pronounced for acquisition times shorter than approximately 30 minutes.ConclusionsThis is the first study that reports estimates for the hepatic uptake and efflux transport process of gadoxetate in healthy volunteers in vivo. The results highlight that dynamic contrast-enhanced MRI with gadoxetate can provide novel quantitative insights into liver function and may therefore prove useful in studies that aim to monitor liver pathology, as well as being an alternative approach for studying hepatic drug-drug interactions.

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“…ExiTron is advised to be used in longitudinal monitoring with repeated injections, and Primovist (Gd-EOB-DTPA) is a new hepatocyte-specific contrast agent for MRI of the liver. Compared to extracellular contrast agents, Primovist shows a partial specific uptake by hepatocytes followed by a subsequent biliary excretion [79,80]. …”

Section: Assessment Techniquesmentioning

confidence: 99%

Rodent Models and Imaging Techniques to Study Liver Regeneration

Wei

Dirsch²,

McLean³

et al. 2014

Eur Surg Res

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The liver has the unique capability of regeneration from various injuries. Different animal models and in vitro methods are used for studying the processes and mechanisms of liver regeneration. Animal models were established either by administration of hepatotoxic chemicals or by surgical approach. The administration of hepatotoxic chemicals results in the death of liver cells and in subsequent hepatic regeneration and tissue repair. Surgery includes partial hepatectomy and portal vein occlusion or diversion: hepatectomy leads to compensatory regeneration of the remnant liver lobe, whereas portal vein occlusion leads to atrophy of the ipsilateral lobe and to compensatory regeneration of the contralateral lobe. Adaptation of modern radiological imaging technologies to the small size of rodents made the visualization of rodent intrahepatic vascular anatomy possible. Advanced knowledge of the detailed intrahepatic 3D anatomy enabled the establishment of refined surgical techniques. The same technology allows the visualization of hepatic vascular regeneration. The development of modern histological image analysis tools improved the quantitative assessment of hepatic regeneration. Novel image analysis tools enable us to quantify reliably and reproducibly the proliferative rate of hepatocytes using whole-slide scans, thus reducing the sampling error. In this review, the refined rodent models and the newly developed imaging technology to study liver regeneration are summarized. This summary helps to integrate the current knowledge of liver regeneration and promises an enormous increase in hepatological knowledge in the near future. © 2014 S. Karger AG, Basel

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Value of gadoxetate biliary transit time in determining hepatocyte function

Cited by 7 publications

References 28 publications

A convenient and reproducible protocol for acquisition of the hepatocyte phase for liver function-impaired patients in gadoxetic acid disodium-enhanced magnetic resonance imaging

A convenient and reproducible protocol for acquisition of the hepatocyte phase for liver function-impaired patients in gadoxetic acid disodium-enhanced magnetic resonance imaging

Quantitative Assessment of Liver Function Using Gadoxetate-Enhanced Magnetic Resonance Imaging

Rodent Models and Imaging Techniques to Study Liver Regeneration

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