Shigeru Matsushima PhD, Presenter: Nothing to Disclose

Yozo Sato MD, PhD, Abstract Co-Author: Nothing to Disclose

Hidekazu Yamaura MD, Abstract Co-Author: Nothing to Disclose

Mina Kato MD, Abstract Co-Author: Nothing to Disclose

Yasutomi Kinosada MD, PhD, Abstract Co-Author: Nothing to Disclose

Seiichi Era MD, PhD, Abstract Co-Author: Nothing to Disclose

Kazuya Takahashi BS, Abstract Co-Author: Nothing to Disclose

Yoshitaka Inaba MD, Abstract Co-Author: Nothing to Disclose

Preoperative evaluation of future remnant liver (FRL) function is crucial in the determination of whether a patient can safely undergo liver resection. A more reliable index for estimating postoperative liver failure is ICG clearance of the future remnant liver (ICG-Krem). However, ICG-Krem assumes that uptake is homogeneous throughout the liver. Gadoxetic acid disodium is a newly developed MR contrast agent for hepatocellular imaging; we reported that the contrast enhance ratio in hepatocellular (CERH) imaging is a potentially useful method for heterogeneous liver function image by MRI. The purpose of this study is to evaluate of FRL function through the coefficient variation of CERH value (CvCERH).

21 patients underwent surgery for tumor excision. All were found to have Child–Pugh class A disease. FRL function was evaluated by an increased international normalized ratio (INR) after postoperative five day that defined according to the grading system of the International Study Group of Liver Surgery. INR increased in the three patients. Hepatocellular images were obtained 20 minutes after an intravenous bolus injection of gadoxetic acid disodium. The CERH value was defined as the percentage of signal gain between the before contrast and hepatocellular images. The CERH images were constructed on the basis of the percentage of CERH values. In the whole liver and FRL, the CERH value measured the tumor-free liver parenchyma in the CERH images. The heterogeneous liver function was evaluated by CvCERH. We corrected　ICG-Krem to heterogeneous liver function by CvCERH. The corrected　ICG-Krem were defined as ICG-Krem　×（total liver CvCERH / FRL CvCERH). In the FRL, we examined a correlation between ICG-Krem, the corrected　ICG-Krem and INR. We used the corrected　ICG-Krem for detection of FRL liver function abnormality.

ICG-Krem and the corrected　ICG-Krem correlated with INR (r=-0.52 and -0.53, p < 0.05). The corrected　ICG-Krem was able to detect three patients with increased INR.

The corrected　ICG-Krem are able to add the heterogeneous liver function to ICG-Krem. The corrected　ICG-Krem is useful parameters to evaluate FRL function more correctly.

The corrected　ICG-Krem is a potentially useful method for preoperative evaluation of FRL function.

Matsushima, S, Sato, Y, Yamaura, H, Kato, M, Kinosada, Y, Era, S, Takahashi, K, Inaba, Y, Preoperative Evaluation of Future Remnant Liver Function by the Coefficient Variation of Contrast Enhanced Ratio in Hepatocellular Image.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003016.html