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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 12/2019

01-12-2019 | Clinical Investigation

Monitoring Liver Function of Patients Undergoing Transarterial Chemoembolization (TACE) by a 13C Breath Test (LiMAx)

Authors: Emona S. Barzakova, Maximilian Schulze-Hagen, Markus Zimmermann, Georg Lurje, Jan Bednarsch, Federico Pedersoli, Peter Isfort, Christiane Kuhl, Philipp Bruners

Published in: CardioVascular and Interventional Radiology | Issue 12/2019

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Abstract

Purpose

Transarterial chemoembolization (TACE) is associated with the risk of deteriorating liver function, especially in patients with preexisting liver damage. Current liver function tests may fail to accurately predict the functional liver reserve. Aim of this study was to investigate whether changes of liver function caused by TACE are associated with detectable changes of LiMAx values.

Methods and Materials

Forty patients with primary or secondary liver cancer underwent TACE and LiMAx test on the day before, the day after, and 4 weeks after TACE. LiMAx results were evaluated, referenced to liver volume (CT/MR volumetry), correlated with the respective TACE volume (subsegmental vs. segmental vs. lobar), established liver function tests, and Child–Pugh and ALBI scores.

Results

The individual LiMAx values were significantly reduced by 10% (p = 0.01) on the day after TACE and fully recovered to baseline 1 month after treatment. Similar changes were observed regarding levels of bilirubin, transaminases, albumin, INR, and creatinine. LiMAx did not correlate significantly with the treated liver volume, but did correlate with the baseline liver volume (< 1200 ml vs. > 1200 ml; p < 0.01). No significant changes were observed in the Child–Pugh score or ALBI score.

Conclusion

LiMAx is capable of detecting changes in liver function, even modulations caused by superselective TACE procedures. Accordingly, it could be used as a tool for patient selection and monitoring of transarterial therapy. In comparison, Child–Pugh and ALBI scores did not reflect any of these changes. Some biochemical parameters also changed significantly after TACE, but they tend to be less specific in providing sufficient information on actual cellular dysfunction.
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Metadata
Title
Monitoring Liver Function of Patients Undergoing Transarterial Chemoembolization (TACE) by a 13C Breath Test (LiMAx)
Authors
Emona S. Barzakova
Maximilian Schulze-Hagen
Markus Zimmermann
Georg Lurje
Jan Bednarsch
Federico Pedersoli
Peter Isfort
Christiane Kuhl
Philipp Bruners
Publication date
01-12-2019
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 12/2019
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-019-02325-3

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