2020
DOI: 10.1148/radiol.2019190734
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Does the Functional Liver Imaging Score Derived from Gadoxetic Acid–enhanced MRI Predict Outcomes in Chronic Liver Disease?

Abstract: G adoxetic acid-enhanced MRI is used to depict and help characterize focal liver nodules (1,2) in patients with chronic liver diseases (CLDs) (3,4), including nonalcoholic steatohepatitis (5) and chronic hepatitis C (5,6). Gadoxetic acid-enhanced MRI has been shown to help predict both liver failure after subtotal hepatectomy and graft survival after liver transplant (7-9).As laboratory and clinical estimators of liver disease severity, the albumin-bilirubin index, the Model for End-Stage Liver Disease, and th… Show more

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Cited by 58 publications
(48 citation statements)
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“…The largest study to date evaluated ACLD patients with LSM by MRE and observed an association between decompensated cirrhosis and MRE on a cross-sectional level; moreover, LSM by MRE predicted hepatic decompensation in patients with compensated disease at baseline. 68 In addition, there is evidence supporting the prognostic value of gadoxetic acid-enhanced MRI, including a study demonstrating the predictive value of the functional liver imaging score (FLIS) for hepatic decompensation in cACLD, as well as mortality in decompensated ACLD 69 in a large cohort of patients. Finally, liver perfusion and T 1 relaxation times of the liver and renal cortex assessed by multiparametric MRI were found to be predictive of hepatic decompensation in a cohort of 60 patients with compensated cirrhosis.…”
Section: Magnetic Resonancementioning
confidence: 99%
“…The largest study to date evaluated ACLD patients with LSM by MRE and observed an association between decompensated cirrhosis and MRE on a cross-sectional level; moreover, LSM by MRE predicted hepatic decompensation in patients with compensated disease at baseline. 68 In addition, there is evidence supporting the prognostic value of gadoxetic acid-enhanced MRI, including a study demonstrating the predictive value of the functional liver imaging score (FLIS) for hepatic decompensation in cACLD, as well as mortality in decompensated ACLD 69 in a large cohort of patients. Finally, liver perfusion and T 1 relaxation times of the liver and renal cortex assessed by multiparametric MRI were found to be predictive of hepatic decompensation in a cohort of 60 patients with compensated cirrhosis.…”
Section: Magnetic Resonancementioning
confidence: 99%
“…With the emergence of functional MRI, the focus has changed from morphology to function (16). For example, a gadoxetic acid enhanced MRI was used to assess liver function in cirrhosis (17). DTI is one of the functional MRIs that can effectively detect the free diffusion rate of water molecules with different structures in vivo and can more accurately re ect changes in the direction of water molecule dispersion, which provides both functional and microstructural information for the liver through water diffusivity and diffusion anisotropy quantitation and may contribute to the evaluation of liver brosis (13).…”
Section: Discussionmentioning
confidence: 99%
“…The thereby calculated IAC can range from close to 0, meaning no relevant intracellular accumulation with a gadoxetate retention similar to blood, to around eight, indicating a high intracellular accumulation capacity due to well-functioning hepatocytes, as Gd-EOB-DTPA uptake into hepatocytes depends on the integrity of the hepatic transport proteins 4,5,19,20 . There are other approaches to quantify liver function using gadoxetate disodium of which most refer to signal intensity measurements and their derived measures liver-to-spleen ratio, liver-to-muscle-ratio, and relative enhancement [21][22][23][24][25][26] . Still, apart from field strength, signal intensities in MRI are also dependent on the manufacturer, the device, and also the sequence used, and, therefore, cannot be easily transferred, and in direct comparison, relaxation time measurements showed higher correlation to scintigraphically evaluated liver function than signal intensity-based measurements 21 .…”
Section: Discussionmentioning
confidence: 99%