Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 5/2014

01-05-2014 | Hepatobiliary-Pancreas

Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla

Authors: N. Verloh, M. Haimerl, F. Zeman, M. Schlabeck, A. Barreiros, M. Loss, A. G. Schreyer, C. Stroszczynski, C. Fellner, P. Wiggermann

Published in: European Radiology | Issue 5/2014

Login to get access

Abstract

Objectives

The purpose of this study was to evaluate the usefulness of Gd-EOB-DTPA-enhanced 3-T MRI to determine the hepatic functional reserve expressed by the model for end-stage liver disease (MELD) score.

Methods

A total of 121 patients with normal liver function (NLF; MELD score ≤ 10) and 29 patients with impaired liver function (ILF; MELD score > 10) underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 min after contrast injection. Relative enhancement (RE) between plain signal intensity and contrast-enhanced signal intensity was calculated and was used to determine Gd-EOB-DTPA uptake into the liver parenchyma for patients with different MELD scores.

Results

RE differed significantly (p ≤ 0.001) between patients with NLF (87.2 ± 29.5 %) and patients with ILF (45.4 ± 26.5 %). The optimal cut-off value for RE to differentiate NLF from ILF was 47.7 % (AUC 0.87). This cut-off value showed a sensitivity of 82.8 % and a specificity of 92.7 % for the differentiation of the analysed groups.

Conclusion

Gd-EOB-DTPA uptake in hepatocytes is strongly affected by liver function. Gd-EOB-DTPA-enhanced MRI and assessment of RE during the hepatobiliary phase (HBP) may serve as a useful image-based test in liver imaging for determining regional and global liver function.

Key points

  • Hepatic uptake of Gd-EOB-DTPA is strongly affected by liver function.
  • Relative enhancement during HBP in GD-EOB-DTPA MRI correlates with the MELD score.
  • Assessment of relative enhancement may help improve treatment in routine clinical practice.
Literature
1.
2.
Gupta S, Chawla Y, Kaur J et al (2012) Indocyanine green clearance test (using spectrophotometry) and its correlation with model for end stage liver disease (MELD) score in Indian patients with cirrhosis of liver. Trop Gastroenterol 33(2):129–134PubMedCrossRef
3.
Tralhao JG, Hoti E, Oliveiros B, Botelho MF, Sousa FC (2012) Study of perioperative liver function by dynamic monitoring of ICG-clearance. Hepatogastroenterology 59(116):1179–1183PubMed
4.
Cassinotto C, Lapuyade B, Ait-Ali A et al (2013) Liver fibrosis: noninvasive assessment with acoustic radiation force impulse elastography–comparison with FibroScan M and XL probes and FibroTest in patients with chronic liver disease. Radiology. doi:10.​1148/​radiol.​13122208 PubMed
5.
Bota S, Sporea I, Sirli R, Popescu A, Danila M, Costachescu D (2012) Intra- and interoperator reproducibility of acoustic radiation force impulse (ARFI) elastography–preliminary results. Ultrasound Med Biol 38(7):1103–1108PubMedCrossRef
6.
Maharaj B, Maharaj RJ, Leary WP et al (1986) Sampling variability and its influence on the diagnostic yield of percutaneous needle biopsy of the liver. Lancet 1(8480):523–525PubMedCrossRef
7.
8.
Wang H, Feng M, Frey KA, Ten Haken RK, Lawrence TS, Cao Y (2013) Predictive models for regional hepatic function based on 99mTc-IDA SPECT and Local radiation dose for physiologic adaptive radiation therapy. Int J Radiat Oncol Biol Phys 86(5):1000–1006PubMedCrossRef
9.
Verloh N, Haimerl M, Rennert J et al (2013) Impact of liver cirrhosis on liver enhancement at Gd-EOB-DTPA enhanced MRI at 3Tesla. Eur J Radiol 82(10):1710–1715PubMedCrossRef
10.
Katsube T, Okada M, Kumano S et al (2011) Estimation of liver function using T1 mapping on Gd-EOB-DTPA-enhanced magnetic resonance imaging. Invest Radiol 46(4):277–283PubMedCrossRef
11.
Tamada T, Ito K, Higaki A et al (2011) Gd-EOB-DTPA-enhanced MR imaging: evaluation of hepatic enhancement effects in normal and cirrhotic livers. Eur J Radiol 80(3):e311–316PubMedCrossRef
12.
Tajima T, Takao H, Akai H et al (2010) Relationship between liver function and liver signal intensity in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging. J Comput Assist Tomogr 34(3):362–366PubMedCrossRef
13.
Motosugi U, Ichikawa T, Sou H et al (2009) Liver parenchymal enhancement of hepatocyte-phase images in Gd-EOB-DTPA-enhanced MR imaging: which biological markers of the liver function affect the enhancement? J Magn Reson Imaging 30(5):1042–1046PubMedCrossRef
14.
Dahlqvist Leinhard O, Dahlstrom N, Kihlberg J et al (2012) Quantifying differences in hepatic uptake of the liver specific contrast agents Gd-EOB-DTPA and Gd-BOPTA: a pilot study. Eur Radiol 22(3):642–653PubMedCrossRef
15.
Chernyak V, Kim J, Rozenblit AM, Mazzoriol F, Ricci Z (2011) Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: the role of laboratory factors. J Magn Reson Imaging 34(2):301–309PubMedCrossRef
16.
van Montfoort JE, Stieger B, Meijer DK, Weinmann HJ, Meier PJ, Fattinger KE (1999) Hepatic uptake of the magnetic resonance imaging contrast agent gadoxetate by the organic anion transporting polypeptide Oatp1. J Pharmacol Exp Ther 290(1):153–157PubMed
17.
Weinmann HJ, Bauer H, Frenzel T, Muhler A, Ebert W (1996) Mechanism of hepatic uptake of gadoxetate disodium. Acad Radiol 3(Suppl 2):S232–234PubMedCrossRef
18.
Van Beers BE, Pastor CM, Hussain HK (2012) Primovist, Eovist: what to expect? J Hepatol 57(2):421–429PubMedCrossRef
19.
Pascolo L, Cupelli F, Anelli PL et al (1999) Molecular mechanisms for the hepatic uptake of magnetic resonance imaging contrast agents. Biochem Biophys Res Commun 257(3):746–752PubMedCrossRef
20.
Tsuda N, Okada M, Murakami T (2007) Potential of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for differential diagnosis of nonalcoholic steatohepatitis and fatty liver in rats using magnetic resonance imaging. Invest Radiol 42(4):242–247PubMedCrossRef
21.
22.
Nishie A, Asayama Y, Ishigami K et al (2012) MR prediction of liver fibrosis using a liver-specific contrast agent: superparamagnetic iron oxide versus Gd-EOB-DTPA. J Magn Reson Imaging 36(3):664–671PubMedCrossRef
23.
Manizate F, Hiotis SP, Labow D, Roayaie S, Schwartz M (2010) Liver functional reserve estimation: state of the art and relevance to local treatments. Oncology 78(Suppl 1):131–134PubMedCrossRef
24.
Wiesner R, Edwards E, Freeman R et al (2003) Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology 124(1):91–96PubMedCrossRef
25.
Wakabayashi H, Yachida S, Maeba T, Maeta H (2002) Evaluation of liver function for the application of preoperative portal vein embolization on major hepatic resection. Hepatogastroenterology 49(46):1048–1052PubMed
26.
Cho SH, Kang UR, Kim JD, Han YS, Choi DL (2011) The value of gadoxetate disodium-enhanced MR imaging for predicting posthepatectomy liver failure after major hepatic resection: a preliminary study. Eur J Radiol 80(2):e195–200PubMedCrossRef
27.
Bluemke DA, Sahani D, Amendola M et al (2005) Efficacy and safety of MR imaging with liver-specific contrast agent: U.S. multicenter phase III study. Radiology 237(1):89–98PubMedCrossRef
28.
Kobayashi S, Matsui O, Gabata T et al (2012) Relationship between signal intensity on hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MR imaging and prognosis of borderline lesions of hepatocellular carcinoma. Eur J Radiol 81(11):3002–3009PubMedCrossRef
29.
Weinmann HJ, Schuhmann-Giampieri G, Schmitt-Willich H, Vogler H, Frenzel T, Gries H (1991) A new lipophilic gadolinium chelate as a tissue-specific contrast medium for MRI. Magn Reson Med 22(2):233–237, discussion 242PubMedCrossRef
30.
Hamm B, Staks T, Muhler A et al (1995) Phase I clinical evaluation of Gd-EOB-DTPA as a hepatobiliary MR contrast agent: safety, pharmacokinetics, and MR imaging. Radiology 195(3):785–792PubMed
31.
Muhler A, Heinzelmann I, Weinmann HJ (1994) Elimination of gadolinium-ethoxybenzyl-DTPA in a rat model of severely impaired liver and kidney excretory function. An experimental study in rats. Invest Radiol 29(2):213–216PubMedCrossRef
32.
Tsuda N, Matsui O (2010) Cirrhotic rat liver: reference to transporter activity and morphologic changes in bile canaliculi–gadoxetic acid-enhanced MR imaging. Radiology 256(3):767–773PubMedCrossRef
33.
Tsuboyama T, Onishi H, Kim T et al (2010) Hepatocellular carcinoma: hepatocyte-selective enhancement at gadoxetic acid-enhanced MR imaging–correlation with expression of sinusoidal and canalicular transporters and bile accumulation. Radiology 255(3):824–833PubMedCrossRef
34.
35.
Chen BB, Hsu CY, Yu CW et al (2012) Dynamic contrast-enhanced magnetic resonance imaging with Gd-EOB-DTPA for the evaluation of liver fibrosis in chronic hepatitis patients. Eur Radiol 22(1):171–180PubMedCrossRef
36.
Saito K, Ledsam J, Sourbron S et al (2013) Measuring hepatic functional reserve using low temporal resolution Gd-EOB-DTPA dynamic contrast-enhanced MRI: a preliminary study comparing galactosyl human serum albumin scintigraphy with indocyanine green retention. Eur Radiol. doi:10.​1007/​s00330-013-2983-y
37.
Geisel D, Ludemann L, Keuchel T et al (2013) Increase in left liver lobe function after preoperative right portal vein embolisation assessed with gadolinium-EOB-DTPA MRI. Eur Radiol 23(9):2555–2560PubMedCrossRef
38.
Planchamp C, Montet X, Frossard JL et al (2005) Magnetic resonance imaging with hepatospecific contrast agents in cirrhotic rat livers. Invest Radiol 40(4):187–194PubMedCrossRef
39.
Geier A, Kim SK, Gerloff T et al (2002) Hepatobiliary organic anion transporters are differentially regulated in acute toxic liver injury induced by carbon tetrachloride. J Hepatol 37(2):198–205PubMedCrossRef
40.
Geier A, Dietrich CG, Voigt S et al (2003) Effects of proinflammatory cytokines on rat organic anion transporters during toxic liver injury and cholestasis. Hepatology 38(2):345–354PubMedCrossRef
Metadata
Title
Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla
Authors
N. Verloh
M. Haimerl
F. Zeman
M. Schlabeck
A. Barreiros
M. Loss
A. G. Schreyer
C. Stroszczynski
C. Fellner
P. Wiggermann
Publication date
01-05-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3108-y

Other articles of this Issue 5/2014

European Radiology 5/2014 Go to the issue

Breast

Variations in screening outcome among pairs of screening radiologists at non-blinded double reading of screening mammograms: a population-based study

Magnetic Resonance

Multi-delay arterial spin labeling perfusion MRI in moyamoya disease–comparison with CT perfusion imaging

Urogenital

Routinely performed multiparametric magnetic resonance imaging helps to differentiate common subtypes of renal tumours

Hepatobiliary-Pancreas

Hepatic cysts treated with percutaneous ethanol sclerotherapy: time to extend the indications to haemorrhagic cysts and polycystic liver disease

Computed Tomography

Emergency CT head and neck imaging: effects of swimmer’s position on dose and image quality

Gastrointestinal

Training readers to improve their accuracy in grading Crohn’s disease activity on MRI