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Published in: European Radiology 1/2019

01-01-2019 | Gastrointestinal

A New Model for MR Evaluation of Liver Function with Gadoxetic Acid, Including Both Uptake and Excretion

Authors: Daniel Truhn, Christiane K. Kuhl, Alexander Ciritsis, Alexandra Barabasch, Nils A. Kraemer

Published in: European Radiology | Issue 1/2019

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Abstract

Objectives

Most existing models that are in use to model hepatic function through assessment of hepatic gadoxetic acid enhancement kinetics do not consider quantitative measures of gadoxetic excretion. We developed a model that allows a simultaneous quantitation of uptake and excretion of liver specific contrast agents. The aim was to improve the assessment of hepatic synthetic function, and provide quantitative measures of hepatic excretion function.

Methods

Sixteen patients underwent dynamic T1-weighted turbo gradient echo imaging at 1.5 T prior and after bolus injection of gadoxetic acid at 0.1 ml/kg. DCE-images were obtained for 30 min after injection. A dual-inlet two-compartment model was then used to fit the measured liver signal values. Four tissue parameters (extracellular volume fraction, arterial flow fraction, uptake rate and excretion half-time) were extracted for each liver segment.

Results

The proposed model provided a good fit to acquired data. Mean values for arterial flow fraction (0.08+-0.04), extracellular volume (0.20±0.08) and uptake rate (4.02 ±1.32 /100 ml/min) were comparable to those obtained with the conventional model (0.08±0.05, 0.21±0.12, and 4.93±1.74), but exhibited significantly less variation and improved fit quality.

Conclusions

The proposed model is more accurate than existing conventional models and provides an additional excretion parameter.

Key Points

• Models of hepatic contrast agent uptake can be extended to include excretion.
• Including an additional excretion parameter improves accuracy of the model.
• Standard diagnostic sequences can be extended to incorporate the model.
Literature
1.
go back to reference Haimerl M, Verloh N, Fellner C et al (2014) MRI-based estimation of liver function: Gd-EOB-DTPA-enhanced T1 relaxometry of 3T vs. the MELD score. Sci Rep 4:5621CrossRef Haimerl M, Verloh N, Fellner C et al (2014) MRI-based estimation of liver function: Gd-EOB-DTPA-enhanced T1 relaxometry of 3T vs. the MELD score. Sci Rep 4:5621CrossRef
2.
go back to reference Ryeom HK, Kim SH, Kim JY et al (2004) Quantitative evaluation of liver function with MRI Using Gd-EOB-DTPA. Korean J Radiol 5:231–239CrossRef Ryeom HK, Kim SH, Kim JY et al (2004) Quantitative evaluation of liver function with MRI Using Gd-EOB-DTPA. Korean J Radiol 5:231–239CrossRef
3.
go back to reference Kim T, Murakami T, Hasuike Y et al (1997) Experimental hepatic dysfunction: evaluation by MRI with Gd-EOB-DTPA. J Magn Reson Imaging 7:683–688CrossRef Kim T, Murakami T, Hasuike Y et al (1997) Experimental hepatic dysfunction: evaluation by MRI with Gd-EOB-DTPA. J Magn Reson Imaging 7:683–688CrossRef
4.
go back to reference Tsuda N, Harada K, Matsui O (2011) Effect of change in transporter expression on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging during hepatocarcinogenesis in rats. J Gastroenterol Hepatol 26:568–576CrossRef Tsuda N, Harada K, Matsui O (2011) Effect of change in transporter expression on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging during hepatocarcinogenesis in rats. J Gastroenterol Hepatol 26:568–576CrossRef
5.
go back to reference Bastati N, Feier D, Wibmer A et al (2014) Noninvasive differentiation of simple steatosis and steatohepatitis by using gadoxetic acid-enhanced MR imaging in patients with nonalcoholic fatty liver disease: a proof-of-concept study. Radiology 271:739–747CrossRef Bastati N, Feier D, Wibmer A et al (2014) Noninvasive differentiation of simple steatosis and steatohepatitis by using gadoxetic acid-enhanced MR imaging in patients with nonalcoholic fatty liver disease: a proof-of-concept study. Radiology 271:739–747CrossRef
6.
go back to reference Haimerl M, Verloh N, Zeman F et al (2013) Assessment of clinical signs of liver cirrhosis using T1 mapping on Gd-EOB-DTPA-enhanced 3T MRI. PLoS One 8:e85658CrossRef Haimerl M, Verloh N, Zeman F et al (2013) Assessment of clinical signs of liver cirrhosis using T1 mapping on Gd-EOB-DTPA-enhanced 3T MRI. PLoS One 8:e85658CrossRef
7.
go back to reference Noren B, Forsgren MF, Dahlqvist Leinhard O et al (2013) Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA. Eur Radiol 23:174–181CrossRef Noren B, Forsgren MF, Dahlqvist Leinhard O et al (2013) Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA. Eur Radiol 23:174–181CrossRef
8.
go back to reference Verloh N, Haimerl M, Rennert J et al (2013) Impact of liver cirrhosis on liver enhancement at Gd-EOB-DTPA enhanced MRI at 3 Tesla. Eur J Radiol 82:1710–1715CrossRef Verloh N, Haimerl M, Rennert J et al (2013) Impact of liver cirrhosis on liver enhancement at Gd-EOB-DTPA enhanced MRI at 3 Tesla. Eur J Radiol 82:1710–1715CrossRef
9.
go back to reference Nilsson H, Blomqvist L, Douglas L, Nordell A, Jonas E (2010) Assessment of liver function in primary biliary cirrhosis using Gd-EOB-DTPA-enhanced liver MRI. HPB (Oxford) 12:567–576CrossRef Nilsson H, Blomqvist L, Douglas L, Nordell A, Jonas E (2010) Assessment of liver function in primary biliary cirrhosis using Gd-EOB-DTPA-enhanced liver MRI. HPB (Oxford) 12:567–576CrossRef
10.
go back to reference Verloh N, Haimerl M, Zeman F et al (2014) Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla. Eur Radiol 24:1013–1019CrossRef Verloh N, Haimerl M, Zeman F et al (2014) Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla. Eur Radiol 24:1013–1019CrossRef
11.
go back to reference Georgiou L, Penny J, Nicholls G et al (2017) Quantitative Assessment of Liver Function Using Gadoxetate-Enhanced Magnetic Resonance Imaging: Monitoring Transporter-Mediated Processes in Healthy Volunteers. Invest Radiol 52:111–119CrossRef Georgiou L, Penny J, Nicholls G et al (2017) Quantitative Assessment of Liver Function Using Gadoxetate-Enhanced Magnetic Resonance Imaging: Monitoring Transporter-Mediated Processes in Healthy Volunteers. Invest Radiol 52:111–119CrossRef
12.
go back to reference Ringe KI, Hinrichs J, Merkle EM, Weismuller TJ, Wacker F, Meyer BC (2014) Gadoxetate disodium in patients with primary sclerosing cholangitis: An analysis of hepatobiliary contrast excretion. J Magn Reson Imaging 40:106–112CrossRef Ringe KI, Hinrichs J, Merkle EM, Weismuller TJ, Wacker F, Meyer BC (2014) Gadoxetate disodium in patients with primary sclerosing cholangitis: An analysis of hepatobiliary contrast excretion. J Magn Reson Imaging 40:106–112CrossRef
13.
go back to reference Wibmer A, Aliya Q, Steininger R et al (2012) Liver transplantation: impaired biliary excretion of gadoxate is associated with an inferior 1-year retransplantation-free survival. Invest Radiol 47:353–358CrossRef Wibmer A, Aliya Q, Steininger R et al (2012) Liver transplantation: impaired biliary excretion of gadoxate is associated with an inferior 1-year retransplantation-free survival. Invest Radiol 47:353–358CrossRef
14.
go back to reference Wibmer A, Prusa AM, Nolz R, Gruenberger T, Schindl M, Ba-Ssalamah A (2013) Liver failure after major liver resection: risk assessment by using preoperative Gadoxetic acid-enhanced 3-T MR imaging. Radiology 269:777–786CrossRef Wibmer A, Prusa AM, Nolz R, Gruenberger T, Schindl M, Ba-Ssalamah A (2013) Liver failure after major liver resection: risk assessment by using preoperative Gadoxetic acid-enhanced 3-T MR imaging. Radiology 269:777–786CrossRef
15.
go back to reference Sourbron S, Sommer WH, Reiser MF, Zech CJ (2012) Combined quantification of liver perfusion and function with dynamic gadoxetic acid-enhanced MR imaging. Radiology 263:874–883CrossRef Sourbron S, Sommer WH, Reiser MF, Zech CJ (2012) Combined quantification of liver perfusion and function with dynamic gadoxetic acid-enhanced MR imaging. Radiology 263:874–883CrossRef
16.
go back to reference Saito K, Ledsam J, Sourbron S et al (2013) Assessing liver function using dynamic Gd-EOB-DTPA-enhanced MRI with a standard 5-phase imaging protocol. J Magn Reson Imaging 37:1109–1114CrossRef Saito K, Ledsam J, Sourbron S et al (2013) Assessing liver function using dynamic Gd-EOB-DTPA-enhanced MRI with a standard 5-phase imaging protocol. J Magn Reson Imaging 37:1109–1114CrossRef
17.
go back to reference Sharma A, Houshyar R, Bhosale P, Choi JI, Gulati R, Lall C (2014) Chemotherapy induced liver abnormalities: an imaging perspective. Clin Mol Hepatol 20:317–326CrossRef Sharma A, Houshyar R, Bhosale P, Choi JI, Gulati R, Lall C (2014) Chemotherapy induced liver abnormalities: an imaging perspective. Clin Mol Hepatol 20:317–326CrossRef
18.
go back to reference Kim H, Taksali SE, Dufour S et al (2008) Comparative MR study of hepatic fat quantification using single-voxel proton spectroscopy, two-point dixon and three-point IDEAL. Magn Reson Med 59:521–527CrossRef Kim H, Taksali SE, Dufour S et al (2008) Comparative MR study of hepatic fat quantification using single-voxel proton spectroscopy, two-point dixon and three-point IDEAL. Magn Reson Med 59:521–527CrossRef
19.
go back to reference 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 23:2555–2560CrossRef 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 23:2555–2560CrossRef
20.
go back to reference Yoon JH, Lee JM, Paek M, Han JK, Choi BI (2016) Quantitative assessment of hepatic function: modified look-locker inversion recovery (MOLLI) sequence for T1 mapping on Gd-EOB-DTPA-enhanced liver MR imaging. Eur Radiol 26:1775–1782CrossRef Yoon JH, Lee JM, Paek M, Han JK, Choi BI (2016) Quantitative assessment of hepatic function: modified look-locker inversion recovery (MOLLI) sequence for T1 mapping on Gd-EOB-DTPA-enhanced liver MR imaging. Eur Radiol 26:1775–1782CrossRef
21.
go back to reference 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):131–134CrossRef 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):131–134CrossRef
22.
go back to reference 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 22:642–653CrossRef 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 22:642–653CrossRef
23.
go back to reference Choi JW, Lee JM, Kim SJ et al (2013) Hepatocellular carcinoma: imaging patterns on gadoxetic acid-enhanced MR Images and their value as an imaging biomarker. Radiology 267:776–786CrossRef Choi JW, Lee JM, Kim SJ et al (2013) Hepatocellular carcinoma: imaging patterns on gadoxetic acid-enhanced MR Images and their value as an imaging biomarker. Radiology 267:776–786CrossRef
24.
go back to reference Saito K, Ledsam J, Sourbron S et al (2014) 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 24:112–119CrossRef Saito K, Ledsam J, Sourbron S et al (2014) 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 24:112–119CrossRef
25.
go back to reference Rohrer M, Bauer H, Mintorovitch J, Requardt M, Weinmann HJ (2005) Comparison of magnetic properties of MRI contrast media solutions at different magnetic field strengths. Invest Radiol 40:715–724CrossRef Rohrer M, Bauer H, Mintorovitch J, Requardt M, Weinmann HJ (2005) Comparison of magnetic properties of MRI contrast media solutions at different magnetic field strengths. Invest Radiol 40:715–724CrossRef
26.
go back to reference Stockmann M, Lock JF, Malinowski M, Niehues SM, Seehofer D, Neuhaus P (2010) The LiMAx test: a new liver function test for predicting postoperative outcome in liver surgery. HPB (Oxford) 12:139–146CrossRef Stockmann M, Lock JF, Malinowski M, Niehues SM, Seehofer D, Neuhaus P (2010) The LiMAx test: a new liver function test for predicting postoperative outcome in liver surgery. HPB (Oxford) 12:139–146CrossRef
27.
go back to reference Haimerl M, Schlabeck M, Verloh N et al (2016) Volume-assisted estimation of liver function based on Gd-EOB-DTPA-enhanced MR relaxometry. Eur Radiol 26:1125–1133CrossRef Haimerl M, Schlabeck M, Verloh N et al (2016) Volume-assisted estimation of liver function based on Gd-EOB-DTPA-enhanced MR relaxometry. Eur Radiol 26:1125–1133CrossRef
Metadata
Title
A New Model for MR Evaluation of Liver Function with Gadoxetic Acid, Including Both Uptake and Excretion
Authors
Daniel Truhn
Christiane K. Kuhl
Alexander Ciritsis
Alexandra Barabasch
Nils A. Kraemer
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5500-5

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