Evaluation of liver function using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging based on a three-dimensional volumetric analysis system

Kudo, Masashi; Gotohda, Naoto; Sugimoto, Motokazu; Kobayashi, Tatsushi; Kojima, Masaru; Takahashi, Shinichiro; Konishi, Masaru; Hayashi, Ryuichi

doi:10.1007/s12072-018-9874-x

Cited by 16 publications

(11 citation statements)

References 26 publications

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“…However, a volumetric determination can also be performed with MRI data, as shown in the study by Ippolito et al ( 55 ). Kudo et al opted for a more sophisticated approach using a 3D volumetric analysis system ( 63 ). By using a semiautomatic approach and an image processing algorithm, they extracted the liver and spleen parenchyma by placing volumes of interest; the resulting extracted 3D volumes allowed measurement of the average SI and determination of the liver-to-spleen ratio.…”

Section: Recent Approaches To Liver Function Measurement Using Contra...mentioning

confidence: 99%

“…Nevertheless, the rrT1 must still be calculated manually; thus, there is a demand for software solutions to establish the rrT1 value as a liver function parameter, ideally in prospective trials. In addition, 3D volumetry for the liver is not yet fully automated; however, various software solutions for 3D volumetry are available on the market, one of which was successfully used by Kudo et al ( 63 ) to semiautomatically determine the liver-to-spleen ratio. As in this case, semiautomatic or manual approaches are mostly used for volume determination.…”

Section: Recent Approaches To Liver Function Measurement Using Contra...mentioning

confidence: 99%

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Assessment of Liver Function With MRI: Where Do We Stand?

et al. 2022

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Liver disease and hepatocellular carcinoma (HCC) have become a global health burden. For this reason, the determination of liver function plays a central role in the monitoring of patients with chronic liver disease or HCC. Furthermore, assessment of liver function is important, e.g., before surgery to prevent liver failure after hepatectomy or to monitor the course of treatment. Liver function and disease severity are usually assessed clinically based on clinical symptoms, biopsy, and blood parameters. These are rather static tests that reflect the current state of the liver without considering changes in liver function. With the development of liver-specific contrast agents for MRI, noninvasive dynamic determination of liver function based on signal intensity or using T1 relaxometry has become possible. The advantage of this imaging modality is that it provides additional information about the vascular structure, anatomy, and heterogeneous distribution of liver function. In this review, we summarized and discussed the results published in recent years on this technique. Indeed, recent data show that the T1 reduction rate seems to be the most appropriate value for determining liver function by MRI. Furthermore, attention has been paid to the development of automated tools for image analysis in order to uncover the steps necessary to obtain a complete process flow from image segmentation to image registration to image analysis. In conclusion, the published data show that liver function values obtained from contrast-enhanced MRI images correlate significantly with the global liver function parameters, making it possible to obtain both functional and anatomic information with a single modality.

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Section: Recent Approaches To Liver Function Measurement Using Contra...mentioning

confidence: 99%

Section: Recent Approaches To Liver Function Measurement Using Contra...mentioning

confidence: 99%

Assessment of Liver Function With MRI: Where Do We Stand?

et al. 2022

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“…For the assessment of liver function on gadoxetic acid-enhanced HBP-MRI, spleen SI has been commonly used as an internal reference for normalizing liver SI [ 7 8 9 28 ]. However, LSSR is influenced by MRI parameters, which can hinder the use of this index in clinical practice when HBP-MRI is performed using various scanning parameters.…”

Section: Discussionmentioning

confidence: 99%

Deep Learning-Based Assessment of Functional Liver Capacity Using Gadoxetic Acid-Enhanced Hepatobiliary Phase MRI

et al. 2022

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Objective We aimed to develop and test a deep learning algorithm (DLA) for fully automated measurement of the volume and signal intensity (SI) of the liver and spleen using gadoxetic acid-enhanced hepatobiliary phase (HBP)-magnetic resonance imaging (MRI) and to evaluate the clinical utility of DLA-assisted assessment of functional liver capacity. Materials and Methods The DLA was developed using HBP-MRI data from 1014 patients. Using an independent test dataset (110 internal and 90 external MRI data), the segmentation performance of the DLA was measured using the Dice similarity score (DSS), and the agreement between the DLA and the ground truth for the volume and SI measurements was assessed with a Bland-Altman 95% limit of agreement (LOA). In 276 separate patients (male:female, 191:85; mean age ± standard deviation, 40 ± 15 years) who underwent hepatic resection, we evaluated the correlations between various DLA-based MRI indices, including liver volume normalized by body surface area (LV BSA ), liver-to-spleen SI ratio (LSSR), MRI parameter-adjusted LSSR (aLSSR), LSSR × LV BSA , and aLSSR × LV BSA , and the indocyanine green retention rate at 15 minutes (ICG-R15), and determined the diagnostic performance of the DLA-based MRI indices to detect ICG-R15 ≥ 20%. Results In the test dataset, the mean DSS was 0.977 for liver segmentation and 0.946 for spleen segmentation. The Bland-Altman 95% LOAs were 0.08% ± 3.70% for the liver volume, 0.20% ± 7.89% for the spleen volume, -0.02% ± 1.28% for the liver SI, and -0.01% ± 1.70% for the spleen SI. Among DLA-based MRI indices, aLSSR × LV BSA showed the strongest correlation with ICG-R15 ( r = -0.54, p < 0.001), with area under receiver operating characteristic curve of 0.932 (95% confidence interval, 0.895–0.959) to diagnose ICG-R15 ≥ 20%. Conclusion Our DLA can accurately measure the volume and SI of the liver and spleen and may be useful for assessing functional liver capacity using gadoxetic acid-enhanced HBP-MRI.

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“…10 Thus, the uptake and excretion of Gd-EOB-DTPA offers the potential for quantifying regional liver function, and several studies have suggested that the low signal intensity of liver parenchyma on EOB-MRI in the hepatobiliary phase reflects a poor liver function. 11,12 With EOB-MRI using a 3-dimensional (3D) volumetric analysis system, it is possible to evaluate signal intensity of specific liver regions. 11 Hence, this technique allows preoperative evaluation of the function of the future remnant liver region, by assessing the signal intensity of the proposed remnant liver separately from the resected region.…”

Section: Introductionmentioning

confidence: 99%

The Assessment of Regional Liver Function Before Major Hepatectomy Using Magnetic Resonance Imaging

Kudo

Gotohda

Sugimoto

et al. 2021

The American Surgeon

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Background The liver-to-spleen signal intensity ratio (LSR) on magnetic resonance imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid has been used as a parameter to assess liver function. LSR of the future remnant liver region (FR-LSR) is included in preoperative assessment of regional liver function. The aim of this study was to investigate the predictability of post-hepatectomy liver failure (PHLF) by FR-LSR. Methods Between May 2013 and May 2019, 127 patients underwent standardized EOB-MRI for diagnosis of liver tumor before major hepatectomy. The FR-LSR on EOB-MRI was calculated by a semiautomated three-dimensional volumetric analysis system. The cutoff value of FR-LSR in association with clinically relevant PHLF was determined according to the areas under the receiver operating characteristic curves. Then, FR-LSR and clinical variables were analyzed to assess the risk of clinically relevant PHLF. Results In patients with preoperative biliary drainage, metastatic liver tumor, estimated future remnant liver volume <50%, biliary reconstruction, operation time ≥ 480 min, estimated blood loss ≥ 1000 g, blood transfusion and a FR-LSR < 2.00 were associated with clinically relevant PHLF ( P < .05 for all) in univariable analysis. The liver-to-spleen signal intensity ratio of the future remnant liver region < 2.00 was the only independent risk factor for clinically relevant PHLF in multivariable risk analysis (OR, 27.90; 95% CI: 7.99-136.40; P < .05). Discussion The present study revealed that FR-LSR calculated using a 3-dimensional volumetric analysis system was an independent risk factor for clinically relevant PHLF. The liver-to-spleen signal intensity ratio of the future remnant liver region might be a reliable preoperative parameter in liver functional assessment, enabling safe performance of major hepatectomy.

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Evaluation of liver function using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging based on a three-dimensional volumetric analysis system

Cited by 16 publications

References 26 publications

Assessment of Liver Function With MRI: Where Do We Stand?

Assessment of Liver Function With MRI: Where Do We Stand?

Deep Learning-Based Assessment of Functional Liver Capacity Using Gadoxetic Acid-Enhanced Hepatobiliary Phase MRI

The Assessment of Regional Liver Function Before Major Hepatectomy Using Magnetic Resonance Imaging

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