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European Radiology
Published in: European Radiology 10/2020

01-10-2020 | Hepatocellular Carcinoma | Hepatobiliary-Pancreas

Quantification of liver extracellular volume using dual-energy CT: utility for prediction of liver-related events in cirrhosis

Authors: Seongjun Bak, Ji Eun Kim, Kyungsoo Bae, Jae Min Cho, Ho Cheol Choi, Mi Jung Park, Hye Young Choi, Hwa Seon Shin, Sang Min Lee, Hyun Ok Kim

Published in: European Radiology | Issue 10/2020

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Abstract

Objectives

To determine whether quantification of liver extracellular volume fraction (fECV) using dual-energy CT (DECT) allows prediction of liver-related events (LREs) in cirrhotic patients.

Methods

This retrospective study included 305 cirrhotic patients who underwent dual-source DECT imaging and had serum markers analyzed within 2 weeks of initial CT imaging. The fECV score was measured using an iodine map of equilibrium-phase images obtained 3 min after contrast injection at 100/140 Sn kVp. The association of the fECV score and serum markers with LREs was investigated. A risk model combining the fECV score (< 27 versus ≥ 27%) and serum albumin level (< 4 versus ≥ 4 g/dL) was constructed for LRE prediction.

Results

An increased fECV score (odds ratio, 1.27; 95% confidence interval (CI), 1.15, 1.40) was independently associated with decompensated cirrhosis at baseline (n = 85) along with the Model for End-Stage Liver Disease score (odds ratio, 1.32; 95% CI, 1.07, 1.63). Among patients with compensated cirrhosis, 10.5% (23 of 220) experienced LREs during the median follow-up period of 2.0 years (decompensation, n = 14; hepatocellular carcinoma, n = 9). The fECV score (hazard ratio, 1.40; 95% CI, 1.22, 1.62) and serum albumin level (hazard ratio, 0.26; 95% CI, 0.09, 0.73) were independent predictors of LRE. The mean times to LRE among the high (16.5 months, n = 18)-, intermediate (25.6 months, n = 44)-, and low (30.5 months, n = 158)-risk groups were significantly different (p < 0.001).

Conclusions

The fECV score derived from DECT allows prediction of LREs in cirrhotic patients.

Key Points

• The extracellular volume fraction (fECV) score derived from the iodine map of dual-energy CT (DECT) was independently associated with the presence of hepatic decompensation.
• The fECV score derived from the iodine map of DECT can predict liver-related events (LREs) in patients with cirrhosis.
• Equilibrium-phase scanning in dual-energy mode is recommended as part of liver CT in cirrhotic patients because it can provide a prognostic indicator for LRE development.
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Metadata
Title
Quantification of liver extracellular volume using dual-energy CT: utility for prediction of liver-related events in cirrhosis
Authors
Seongjun Bak
Ji Eun Kim
Kyungsoo Bae
Jae Min Cho
Ho Cheol Choi
Mi Jung Park
Hye Young Choi
Hwa Seon Shin
Sang Min Lee
Hyun Ok Kim
Publication date
01-10-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-06876-9

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