Multivariable Analysis of Clinical Influence Factors on Liver Enhancement of Gd-EOB-DTPA-Enhanced 3T MRI

Abstract

!Purpose: The purpose of this study was to identify clinical factors influencing Gd-EOB-DTPA liver uptake in patients with healthy liver parenchyma. Materials and Methods: A total of 124 patients underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3 T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 minutes after contrast injection. The relative enhancement (RE) between plain and contrast-enhanced signal intensity was calculated. Simple and multiple linear regression analyses were performed to evaluate clinical factors influencing the relative enhancement. Patients were subdivided into three groups according to their relative liver enhancement (HRE, RE ≥ 100 %; MRE, 100 % > RE > 50 %; NRE, RE ≤ 50 %) and were analyzed according to the relevant risk factors. Results: Simple regression analyses revealed patient age, transaminases (AST, ALT, GGT), liver, spleen and delta-liver volume (the difference between the volumetrically measured liver volume and the estimated liver volume based on body weight) as significant factors influencing relative enhancement. In the multiple analysis the transaminase AST, spleen and delta liver volume remained significant factors influencing relative enhancement. Delta liver volume showed a significant difference between all analyzed groups. Conclusion: Liver enhancement in the hepatobiliary phase depends on a variety of factors. Body weight-adapted administration of Gd-EOB-DTPA may lead to inadequate liver enhancement after 20 minutes especially when the actual liver volume differs from the expected volume.

Gd-EOB-DTPA-enhanced MRI for evaluation of liver function: Comparison between signal-intensity-based indices and T1 relaxometry

“…It is important to recognize that Gd-EOB-DTPA uptake does not correlate with various clinical factors (weight, height, gender, kidney function, bilirubin)30. Especially the repeated hyothesis that unconjugated bilirubin levels do compete in a marked way with Gd-EOB-DTPA uptake can not be supported: the well known organic anion- transporting ploypeptides OATP1B1 and OATP1B3 mediate the bulk of intracellular Gd-EOB-DTPA uptake.…”

Prediction of high-stage liver fibrosis using ADC value on diffusion-weighted imaging and quantitative enhancement ratio at the hepatobiliary phase of Gd-EOB-DTPA–enhanced MRI at 1.5 T

“…We supposed it to be the T2* shortening effect (20), because the signal intensity of liver parenchyma on in-phase imaging was lower than that of opposedphase imaging. Actually, chronic liver disease can lead to iron overload (21), and this is critical for quantitative evaluation using ADC value. LMR and CEI could differentiate high-grade fibrosis from low-grade fibrosis better than ADC value.…”

Gender Differences in Pharmacokinetics: A Perspective on Contrast Agents

“…This conclusion is however most likely due to differences in bile acid synthesis rate resulting in quantitively different GCDCA-3G and GDCA-3G synthesis between genders, and thus in lower plasma concentrations for these substrates in women rather than higher OATP activity . Other clinical data established that OATP expression had no direct relationship with gender and that liver accumulation of gadoxetate did not differ between genders . Moreover, neither genetic variant of OATP1B (SCLO1B1 521T > C), associated with impaired uptake activity of numerous drug substrates, or any other OATP1B1 genotypes differ between women and men.…”

“…63 Other clinical data established that OATP expression had no direct relationship with gender 64 and that liver accumulation of gadoxetate did not differ between genders. 65 Moreover, neither genetic variant of OATP1B (SCLO1B1 521T > C), associated with impaired uptake activity of numerous drug substrates, 66 or any other OATP1B1 genotypes 67 differ between women and men. It is thus unlikely that OATP expression is different between genders and impacts the PK profile of gadoxetate and gadobenate in women.…”