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Accurate liver function assessment is crucial for liver surgery. Imaging-based tests, particularly Gd-EOB-enhanced MRI, offer superior spatial resolution and seamless integration into preoperative imaging, potentially improving patient outcomes.

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Area of Science:

  • Hepatology
  • Medical Imaging
  • Radiology

Background:

  • Preoperative liver function assessment is vital for liver resection planning.
  • Current methods like laboratory tests and clinical scores have limitations, especially with uneven liver function distribution.
  • Established global liver function tests include indocyanine green (ICG) and LiMAx tests.

Purpose of the Study:

  • To evaluate the potential of imaging-based liver function tests for preoperative assessment.
  • To compare the advantages of nuclear medicine scans and MRI-based techniques.
  • To explore Gd-EOB-enhanced MRI as a promising tool for determining liver function.

Main Methods:

  • Review of existing liver function tests, including laboratory, clinical scores, ICG, and LiMAx tests.
  • Discussion of nuclear medicine imaging techniques (scintigraphy, SPECT-CT) using tracers like 99mTc mebrofenin.
  • Focus on Gd-EOB-enhanced MRI for assessing liver function with high temporal and spatial resolution.

Main Results:

  • Imaging-based tests offer spatial distribution of liver function, unlike global tests.
  • Gd-EOB-enhanced MRI provides high temporal and spatial resolution and integrates into routine imaging.
  • Nuclear medicine scans like 99mTc-Mebrofenin-scintigraphy are current standards but involve ionizing radiation.

Conclusions:

  • MRI-based liver function tests with Gd-EOB-DTPA offer potential for seamless clinical integration.
  • These MRI tests provide higher resolution and avoid ionizing radiation compared to nuclear medicine.
  • Further research is needed to optimize MRI sequences and parameters for liver function assessment.