title: Possible utility of MRI using Gd-EOB-DTPA for estimating liver functional reserve.
abstract: BACKGROUND
  Preoperative estimation of the liver functional reserve is important in liver surgery. We evaluated the role of dynamic magnetic resonance (MR) imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA), i.e., EOB-MRI, for determining liver functional reserve.
  
  
  METHODS
  Fifty patients who underwent EOB-MRI to examine their liver tumors were included in this study. We first performed a pixel-by-pixel comparison of registered MR images and activity images with Tc-99m galactosyl human serum albumin (GSA) on each slice, and the correlation coefficient was calculated for 8 patients. We also determined the correlation coefficient between the relative signal intensity (SI) values of EOB-MRI and preoperative liver function, such as the GSA, indocyanine green dye retention at 15 min (ICGR15), and prothrombin time.
  
  
  RESULTS
  The mean of the correlation coefficients for 512 × 512 matrices between the EOB-MRI and the GSA was 0.83 ± 0.05 (ranging from 0.73 to 0.87). The correlation coefficient between the relative SI of the EOB-MRI and the receptor index (LHL15) of GSA was 0.56 (P < 0.01). Better correlation coefficients were observed between the relative SI and the liver function test, including ICGR15 (r = -0.67, P < 0.01) and prothrombin time (r = 0.59, P < 0.01). In a patient with hilar cholangiocarcinoma whose right hepatic duct was obstructed, the relative SI in the right lobe (2.4 ± 0.3) was significantly lower than that in the left lobe (3.1 ± 0.1).
  
  
  CONCLUSIONS
  EOB-MRI represents a practical and reliable imaging technique that may be used to estimate regional liver functional reserve in the clinical setting.
authors.affiliation: Department of Surgery, The University of Tokushima, 13-18-15 Kuramoto-cho, Tokushima 770-8503, Japan. utsunomiya@clin.med.tokushima-u.ac.jp
authors.forename: Tohru
authors.initials: T
authors.lastname: Utsunomiya
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.forename: Jun
authors.initials: J
authors.lastname: Hanaoka
authors.forename: Mami
authors.initials: M
authors.lastname: Kanamoto
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ikemoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morine
authors.forename: Satoru
authors.initials: S
authors.lastname: Imura
authors.forename: Masafui
authors.initials: M
authors.lastname: Harada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008111:Liver Function Tests; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA