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Assessing liver function using dynamic Gd-EOB-DTPA-enhanced MRI with a standard 5-phase imaging protocol.

Kazuhiro Saito1, Joseph Ledsam, Steven Sourbron

  • 1Department of Radiology, Tokyo Medical University, Tokyo, Japan. saito-k@tokyo-med.ac.jp

Journal of Magnetic Resonance Imaging : JMRI
|October 23, 2012
PubMed
Summary

Dynamic contrast-enhanced MRI (DCE-MRI) with tracer kinetic modeling shows that intracellular uptake rate (UR) can serve as a novel index of liver function, decreasing with liver disease severity.

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Area of Science:

  • Radiology
  • Medical Imaging
  • Hepatology

Background:

  • Liver function assessment is crucial for diagnosing and managing liver diseases.
  • Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) offers functional insights into liver tissue.
  • Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) is a contrast agent used in DCE-MRI.

Purpose of the Study:

  • To evaluate liver function using tracer-kinetic modeling of DCE-MRI data.
  • To assess the utility of a routine Gd-EOB-DTPA-enhanced DCE-MRI protocol for liver function evaluation.
  • To determine if tracer kinetic parameters can serve as novel indices of liver function.

Main Methods:

  • DCE-MRI data were acquired from patients with nonchronic liver disease (n=25) and cirrhosis (n=94).
  • A constrained dual-inlet two-compartment uptake model was applied to regions of interest (ROIs) in the aorta, portal vein, and liver.
  • Key parameters derived included intracellular uptake rate (UR), extracellular volume (Ve), and arterial flow fraction (AFF).

Main Results:

  • Median UR significantly decreased with increasing liver disease severity, from noncirrhosis to Child-Pugh A and B cirrhosis.
  • Median extracellular volume (Ve) also showed a significant decrease in Child-Pugh A cirrhosis compared to noncirrhosis.
  • Changes in Ve and AFF were not consistently significant across all disease severity groups.

Conclusions:

  • Intracellular uptake rate (UR) derived from tracer kinetic analysis of routine DCE-MRI shows potential as a novel index of liver function.
  • DCE-MRI with tracer kinetic modeling can provide quantitative functional information about the liver.
  • This method may offer a non-invasive approach to assess liver function and disease progression.