Assessing liver function using dynamic Gd-EOB-DTPA-enhanced MRI with a standard 5-phase imaging protocol

J Magn Reson Imaging. 2013 May;37(5):1109-14. doi: 10.1002/jmri.23907. Epub 2012 Oct 19.

Abstract

Purpose: To evaluate liver function obtained by tracer-kinetic modeling of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data acquired with a routine gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced protocol.

Materials and methods: Data were acquired from 25 cases of nonchronic liver disease and 94 cases of cirrhosis. DCE-MRI was performed with a dose of 0.025 mmol/kg Gd-EOB-DTPA injected at 2 mL/sec. A 3D breath-hold sequence acquired 5 volumes of 72 slices each: precontrast, double arterial phase, portal phase, and 4-minute postcontrast. Regions of interest (ROIs) were selected semiautomatically in the aorta, portal vein, and whole liver on a middle slice. A constrained dual-inlet two-compartment uptake model was fitted to the ROI curves, producing three parameters: intracellular uptake rate (UR), extracellular volume (Ve), and arterial flow fraction (AFF).

Results: Median UR dropped from 4.46 10(-2) min(-1) in the noncirrhosis to 3.20 in Child-Pugh A (P = 0.001), and again to 1.92 in Child-Pugh B (P < 0.0001). Median Ve dropped from 6.64 mL 100 mL(-1) in the noncirrhosis to 5.80 in Child-Pugh A (P = 0.01). Other combinations of Ve and AFF changes were not significant for any group.

Conclusion: UR obtained from tracer kinetic analysis of a routine DCE-MRI has the potential to become a novel index of liver function.

MeSH terms

  • Aged
  • Algorithms
  • Computer Simulation
  • Contrast Media / pharmacokinetics
  • End Stage Liver Disease / diagnosis*
  • End Stage Liver Disease / metabolism*
  • Female
  • Gadolinium DTPA / pharmacokinetics*
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Liver Function Tests / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Models, Biological
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA