Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA

Norén, Bengt; Forsgren, Mikael; Leinhard, Olof Dahlqvist; Dahlström, Nils; Kihlberg, Johan; Romu, Thobias; Kechagias, Stergios; Almér, Sven; Smedby, Örjan; Lundberg, Peter

doi:10.1007/s00330-012-2583-2

Cited by 65 publications

(57 citation statements)

References 29 publications

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“…In previous studies with Gd-EOB-DTPA in clinic, the evaluation of liver fibrosis focus on the slope, the contrast agent uptake rate ( K Hep ), liver-to-spleen contrast ratios (LSC) and RE and so on [9, 32–33]. Chen BB [9] found slope and AUC were the best perfusion parameters to predict the severity of liver fibrosis in their study.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Contrast-Enhanced Magnetic Resonance Imaging with Gd-EOB-DTPA for the Evaluation of Liver Fibrosis Induced by Carbon Tetrachloride in Rats

et al. 2015

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PurposeTo investigate the utility of dynamic contrast-enhanced MRI (DCE-MRI) with Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for detecting liver fibrosis induced by carbon tetrachloride (CCl4) in rats.MethodsThis study was approved by the institutional animal care and use committee. Liver fibrosis in rats was induced by intraperitoneal injection of 1 mL/kg 50% CCl4 twice a week for 4-13 weeks. Control rats were injected with saline. Liver fibrosis was graded using the Metaviar score: no fibrosis (F0), mild fibrosis (F1-F2) and advanced fibrosis (F3-F4). DCE-MRI with Gd-EOB-DTPA was performed for all rats. Ktrans, Kep, Ve and iAUC of the liver parenchyma were measured. Relative enhancement (RE) value of the liver was calculated on T1-weighted images at 15, 20 and 25 min after Gd-EOB-DTPA administration.ResultsThirty-five rats were included: no fibrosis (n=13), mild fibrosis (n=11) and advanced fibrosis (n=11). Ktrans and iAUC values were highest in advanced fibrosis group and lowest in no fibrosis group (P＜0.05). The area under the receiver operating characteristic curve (AUROC) for fibrosis (stages F1 and greater) were 0.773 and 0.882 for Ktrans and iAUC, respectively. AUROC for advanced fibrosis were 0.835 and 0.867 for Ktrans and iAUC, respectively. Kep and RE values were not able to differentiate fibrosis stages (all P＞0.05).ConclusionKtrans and iAUC obtained from DCE-MRI with Gd-EOB-DTPA are useful for the detection and staging of rat liver fibrosis induced by CCl4.

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Section: Discussionmentioning

confidence: 99%

Dynamic Contrast-Enhanced Magnetic Resonance Imaging with Gd-EOB-DTPA for the Evaluation of Liver Fibrosis Induced by Carbon Tetrachloride in Rats

et al. 2015

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“…Regarding contrast-enhanced MR, especially with gadolinium-EOB-DTPA, a reduced SI in patients with cirrhosis is mostly reported. Particularly, Feier et al [81] found that relative enhancement values correlated strongly with fibrosis stage, with an AUC of 0.83 for > F4; Norén et al [82] found that liver-to-spleen contrast ratios at 10 and at 20 min and contrast uptake rate had AUROCs values of respectively 0.80, 0.78, and 0.71 with regard to severe vs mild fibrosis; Verloh et al [83] found that the mean relative enhancement in patients with Child-Pugh Score A cirrhosis had significant increase between arterial, late arterial, portal and hepato-biliary phases, while for Child-Pugh B+C cirrhosis, relative enhancement increased until portal phase and was significantly reduced in C cirrhosis during hepatobiliary phase; Nojiri et al [84] found that SI at 25 min could discriminate F = 0-3 vs F = 4, with AU-ROC of 0.87; Goshima et al [85] reported that sensitivity, specificity, and AUROC demonstrated by linear regression formula generated by volumetric ratio and contrast enhancement index in predicting fibrous scores were 91%, 100% and 97% for F4. Kim et al [86] reported that the relative enhancement [(hepatocyte phase SI -precontrast SI)/pre-contrast SI] of patients with Child-Pugh cirrhosis was significantly higher than that of patients with Child-Pugh B or C cirrhosis.…”

Section: Mrmentioning

confidence: 98%

Noninvasive diagnosis of cirrhosis: A review of different imaging modalities

Robertis

D’Onofrio

Demozzi

et al. 2014

WJG

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Progressive hepatic fibrosis can lead to cirrhosis, so its early detection is fundamental. Staging fibrosis is also critical for prognosis and management. The gold standard for these aims is liver biopsy, but it has several drawbacks, as it is invasive, expensive, has poor acceptance, is prone to inter observer variability and sampling errors, has poor repeatability, and has a risk of complications and mortality. Therefore, non-invasive imaging tests have been developed. This review mainly focuses on the role of transient elastography, acoustic radiation force impulse imaging, and magnetic resonance-based methods for the noninvasive diagnosis of cirrhosis.

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“…In cirrhosis, hepatocytes are progressively replaced by fibrotic tissue, so that the more advanced the fibrosis, the smaller the hepatic parenchyma enhancement in the hepatobiliary phase. Additionally, as compared with healthy livers, cirrhotic livers present later enhancement peak and slower washout (32-37) . Further potential hepatobiliary contrast applications include the evaluation of the functional hepatic reserve before partial hepatectomy; evaluation of live donor's hepatic function as well as evaluation of early liver failure after transplant (4) .…”

Section: Assessment Of Hepatic Fibrosismentioning

confidence: 99%

Contraste hepatobiliar: diagnóstico diferencial das lesões hepáticas focais, armadilhas e outras indicações

et al. 2014

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The characterization of focal liver lesions is very important. Magnetic resonance imaging is considered the best imaging method for evaluating such lesions, but does not allow for the diagnosis in all cases. The use of hepatobiliary contrast agents increases the diagnostic accuracy of magnetic resonance imaging and reduces the number of non-specific liver lesions. The main indications for the method include: differentiation between focal nodular hyperplasia and adenoma; characterization of hepatocellular carcinomas in cirrhotic patients; detection of small liver metastases; evaluation of biliary anatomy; and characterization of postoperative biliary fistulas. The use of hepatobiliary contrast agents may reduce the need for invasive diagnostic procedures and further investigations with other imaging methods, besides the need for imaging follow-up.

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Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA

Abstract: Liver fibrosis stage strongly influences the hepatocyte-specific uptake of Gd-EOB-DTPA. Potentially the normalisation technique and K (Hep) will reduce patient and system bias, yielding a robust approach to non-invasive liver function determination.

Cited by 65 publications

References 29 publications

Dynamic Contrast-Enhanced Magnetic Resonance Imaging with Gd-EOB-DTPA for the Evaluation of Liver Fibrosis Induced by Carbon Tetrachloride in Rats

Dynamic Contrast-Enhanced Magnetic Resonance Imaging with Gd-EOB-DTPA for the Evaluation of Liver Fibrosis Induced by Carbon Tetrachloride in Rats

Noninvasive diagnosis of cirrhosis: A review of different imaging modalities

Contraste hepatobiliar: diagnóstico diferencial das lesões hepáticas focais, armadilhas e outras indicações

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