Gd-EOB-DTPA-enhanced MRI for monitoring future liver remnant function after portal vein embolization and extended hemihepatectomy: A prospective trial

Geisel, Dominik; Raabe, Philip; Lüdemann, Lutz; Malinowski, Maciej; Stockmann, Martin; Seehofer, Daniel; Pratschke, Johann; Hamm, Bernd; Denecke, Timm

doi:10.1007/s00330-016-4674-y

Cited by 29 publications

(20 citation statements)

References 38 publications

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“…Fourth, there were a large number of patients excluded for having prior history of portal vein embolization. Previous studies showed a significant decrease of signal intensity of the liver lobe after portal vein embolization [ 26 ]. Therefore, in the present study, we decided to investigate the entire liver function, instead of regional liver function.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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BackgroundMagnetic resonance imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (EOB-MRI) is a diagnostic modality for liver tumors. Three-dimensional (3D) volumetric analysis systems using EOB-MRI data are used to simulate liver anatomy for surgery. This study was conducted to investigate clinical utility of a 3D volumetric analysis system on EOB-MRI to evaluate liver function.MethodsBetween August 2014 and December 2015, 181 patients underwent laboratory and radiological exams as standardized preoperative evaluation for liver surgery. The liver-spleen contrast-enhanced ratio (LSR) was measured by a semi-automated 3D volumetric analysis system on EOB-MRI. First, the inter-evaluator variability of the calculated LSR was evaluated. Additionally, a subset of liver surgical specimens was evaluated histologically by using immunohistochemical staining. Finally, the correlations between the LSR and grading systems of liver function, laboratory data, or histological findings were analyzed.ResultsThe inter-evaluator correlation coefficient of the measured LSR was 0.986. The mean LSR was significantly correlated with the Child–Pugh score (p = 0.014) and the ALBI score (p < 0.001). Significant correlations were also observed between the LSR and indocyanine green retention rate at 15 min (r = − 0.601, p < 0.001), between the LSR and liver fibrosis stage (r = − 0.556, p < 0.001), and between the LSR and liver steatosis grade (r = − 0.396, p < 0.001).ConclusionThe LSR calculated by a 3D volumetric analysis system on EOB-MRI was highly reproducible and was shown to be correlated with liver function parameters and liver histology. These data suggest that this imaging modality can be a reliable tool to evaluate liver function.Electronic supplementary materialThe online version of this article (10.1007/s12072-018-9874-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…This could, in combination with liver volume, become a novel tool to assess liver function. [61][62][63][64][65] Very recently, liver surface nodularity, quantitatively assessed on CT using dedicated software, was found to be an independent predictor of post-hepatectomy liver failure after LR for HCC. 66 This promising method needs to be validated in further studies.…”

Section: Improvements In Patient Selection Evaluation Of Liver Functionmentioning

confidence: 99%

“…This could, in combination with liver volume, become a novel tool to assess liver function. [61] , [62] , [63] , [64] , [65] …”

Section: Improvements In Patient Selectionmentioning

confidence: 99%

New frontiers in liver resection for hepatocellular carcinoma

et al. 2020

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Liver resection is one of the main curative options for early hepatocellular carcinoma (HCC) in patients with cirrhosis and is the treatment of choice in non-cirrhotic patients. However, careful patient selection is required to balance the risk of postoperative liver failure and the potential benefit on long-term outcomes. In the last decades, improved surgical techniques and perioperative management, as well as better patient selection, have enabled the indications for liver resection to be expanded. In this review, we aim to describe the main indications for liver resection in the management of HCC, its role compared to percutaneous ablation and liver transplantation in the therapeutic algorithm, as well as the recent advances in liver surgery that could be used to improve the prognosis of patients with HCC.

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“…Level of total bilirubin in the bile of the future remnant liver of patients with obstructive jaundice undergoing hepatectomy predicts postoperative liver failure patients undergoing hepatectomy. FRL function is evaluable by volumetry and liver function testing (e.g., indocyanine green [ICG] clearance or technetium-99m-diethylenetriaminepenta-acetic acid-galactosyl human serum albumin single-photon emission computed tomography [99mTc-GSA SPECT)/CT] fusion imaging) [8][9][10][11][12][13] . However, it is sometimes difficult to measure the FRL function in patients undergoing major hepatectomy with bile duct resection because functional parameters are influenced by several other factors, including obstructive jaundice, which is often observed in such patients 14 .…”

Section: O R I G I N a L A R T I C L Ementioning

confidence: 99%

Level of total bilirubin in the bile of the future remnant liver of patients with obstructive jaundice undergoing hepatectomy predicts postoperative liver failure

Uemura

Higuchi

Yazawa

et al. 2020

J Hepato Biliary Pancreat

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Background We investigated whether the daily level of total bilirubin in the bile (LTB) excreted from the future remnant liver (FRL) can predict post‐hepatectomy liver failure (PHLF) in patients with obstructive jaundice undergoing hepatectomy. Methods Seventy‐four patients who underwent biliary drainage and collection of bile juice from the FRL before undergoing right hepatectomy or right/left trisectionectomy with bile duct resection were included. The LTB from the FRL (mg/d) was calculated as the volume of the bile (dL) per day multiplied by the density of total bilirubin in the bile (mg/dL). We compared patients' characteristics with or without PHLF, which was defined as the total serum bilirubin level remaining >10 mg/dL after postoperative day 10. Then, pre‐ and intraoperative factors related to PHLF were examined. Results PHLF was observed in six patients. LTB was significantly lower in the PHLF group. The LTB cut‐off value for predicting PHLF, as determined using the receiver operating characteristic curve, was 56 mg/d. On multivariate analysis, LTB was found to be an independent risk factor for PHLF (P = .01, OR 35.88). Conclusions LTB may be a potential functional assessment in jaundiced patients before right hepatectomy and right/left trisectionectomy.

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Gd-EOB-DTPA-enhanced MRI for monitoring future liver remnant function after portal vein embolization and extended hemihepatectomy: A prospective trial

Abstract: • The most significant FLR volume increase happens within the first 14 days. • No MRI parameter was able to predict the success of FLR growth. • Our data suggest an early resection about 14 days after PVE. • Routine Gd-EOB-DTPA-enhanced MRI might be suitable to replace ICG-test.

Cited by 29 publications

References 38 publications

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

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

New frontiers in liver resection for hepatocellular carcinoma

Level of total bilirubin in the bile of the future remnant liver of patients with obstructive jaundice undergoing hepatectomy predicts postoperative liver failure

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