Akira Yamada MD, Presenter: Nothing to Disclose

Kazuhiko Ueda MD, Abstract Co-Author: Nothing to Disclose

Masahiro Kurozumi MD, Abstract Co-Author: Nothing to Disclose

Satoshi Kawakami MD, Abstract Co-Author: Nothing to Disclose

Yasunari Fujinaga MD, Abstract Co-Author: Nothing to Disclose

Masumi Kadoya MD, Abstract Co-Author: Nothing to Disclose

The liver volume and a quantitative liver function test such as indocyanine green (ICG) clearance test have been considered to be an indicator of the liver reserve. Because the same uptake mechanisms by hepatocytes have been considered for ICG and gadoxetate disodium, we speculated that the segmental liver reserve can be quantitatively estimated by use of gadoxetate disodium-enhanced MR imaging. The subject of this study was to evaluate the usefulness of gadoxetate-enhanced MR imaging in a prediction of a liver dysfunction after transcatheter arterial chemoembolization (TACE) comparing to volumetry.

3D-GRE T1-weighted images with fat suppression at 20 min after gadoxetate disodium administration were obtained from 45 patients prior to TACE using ethiodized oil. The greatest increase of serum total bilirubin within 1 week after TACE was measured, and increase more than 1 mg/dL was regarded as a liver dysfunction. Ethiodized oil-enhanced CT was obtained right after TACE to evaluate the embolised volume. The remnant liver volume (rV) which is the unembolized liver volume, and the mean signal intensity of the remnant liver (rL20) and the spleen (S20) were measured from gadoxetate disodium-enhanced MR images and ethiodized oil-enhanced CT. The feature value rV(rL20 - S20)/S20 were determined, and ROC analysis was made between rV and rV(rL20 - S20)/S20 in the prediction of the liver dysfunction after TACE. The informed consent requirement was waived, and this retrospective study was approved by the Institutional Review Board.

A significant difference in rV(rL20 - S20)/S20 was observed between the group with (mean = 0.40, 95%CI = 0.22 - 0.58) and without (mean = 0.69, 95%CI = 0.60 - 0.79) a liver dysfunction after TACE. By ROC analysis, the Az value of rV(rL20 - S20)/S20 for the prediction of liver dysfunction after TACE was 0.782 (95%CI = 0.777 - 0.787) and higher than rV (95%CI = 0.510 - 0.524).

The risk of a liver dysfunction after TACE can be quantitatively estimated by use of the feature value rV(rL20 - S20)/S20 obtained from gadoxetate disodium-enhanced MR imaging, and this feature value would be superior to volumetry in estimating segmental liver reserve.

The risk of a liver dysfunction after TACE can be quantitatively estimated by use of gadoxetate disodium-enhanced MR imaging.

Yamada, A, Ueda, K, Kurozumi, M, Kawakami, S, Fujinaga, Y, Kadoya, M, Quantitative Evaluation of Segmental Liver Reserve after Transcatheter Arterial Chemoembolization by Use of Gadoxetate Disodium-enhanced MR imaging.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9015967.html