Tomoelastography based on multifrequency MR elastography predicts liver function reserve in patients with...

Area of Science:

• Hepatobiliary imaging and intervention
• Non-invasive liver assessment
• Quantitative MRI techniques

Background:

• Accurate estimation of liver function reserve is critical for surgical planning in hepatocellular carcinoma (HCC) patients.
• Predicting post-hepatectomy complications relies on precise assessment of remaining liver function.
• Tomoelastography, a multifrequency MRI technique, offers a novel approach to quantify hepatic viscoelasticity.

Purpose of the Study:

• To investigate the utility of hepatic viscoelasticity, measured by tomoelastography, in predicting liver function reserve.
• To correlate tomoelastography-derived stiffness (c) and fluidity (φ) with 15-min indocyanine green retention rates (ICG-R15).
• To develop a predictive model for major hepatectomy tolerance based on liver viscoelastic parameters.

Main Methods:

• Preoperative tomoelastography was performed on 156 patients with suspected HCC.
• Sixty-nine patients were analyzed, with liver function reserve assessed using 15-min indocyanine green retention rates (ICG-R15).
• Shear wave speed (c) and loss angle (φ) were quantified and correlated with ICG-R15; a logistic regression model was built for hepatectomy tolerance.

Main Results:

• Both liver stiffness (c) and fluidity (φ) showed positive correlations with ICG-R15 (p < 0.001).
• At advanced fibrosis stages (F3-4), both c and φ were significantly correlated with ICG-R15.
• Optimal cutoffs for predicting ICG-R15 ≥ 14% were c = 2.04 m/s and φ = 0.79 rad, with higher predictive accuracy for c (AUC = 0.892).

Conclusions:

• Hepatic viscoelasticity, measured by tomoelastography, is significantly correlated with liver function reserve.
• Tomoelastography parameters (stiffness and fluidity) can noninvasively assess liver function in HCC patients.
• This technique holds potential for clinical use in stratifying treatment and guiding surgical decisions.