title: Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA.
abstract: OBJECTIVE
  To apply dynamic contrast-enhanced (DCE) MRI on patients presenting with elevated liver enzymes without clinical signs of hepatic decompensation in order to quantitatively compare the hepatocyte-specific uptake of Gd-EOB-DTPA with histopathological fibrosis stage.
  
  
  METHODS
  A total of 38 patients were prospectively examined using 1.5-T MRI. Data were acquired from regions of interest in the liver and spleen by using time series of single-breath-hold symmetrically sampled two-point Dixon 3D images (non-enhanced, arterial and venous portal phase; 3, 10, 20 and 30 min) following a bolus injection of Gd-EOB-DTPA (0.025 mmol/kg). The signal intensity (SI) values were reconstructed using a phase-sensitive technique and normalised using multiscale adaptive normalising averaging (MANA). Liver-to-spleen contrast ratios (LSC_N) and the contrast uptake rate (K (Hep)) were calculated. Liver biopsy was performed and classified according to the Batts and Ludwig system.
  
  
  RESULTS
  Area under the receiver-operating characteristic curve (AUROC) values of 0.71, 0.80 and 0.78, respectively, were found for K (Hep), LSC_N10 and LSC_N20 with regard to severe versus mild fibrosis. Significant group differences were found for K (Hep) (borderline), LSC_N10 and LSC_N20.
  
  
  CONCLUSIONS
  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.
authors: Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, SE-58185, Sweden. bengt.noren@lio.se
authors: Bengt
authors: B
authors: Norén
authors: Mikael Fredrik
authors: MF
authors: Forsgren
authors: Olof
authors: O
authors: Dahlqvist Leinhard
authors: Nils
authors: N
authors: Dahlström
authors: Johan
authors: J
authors: Kihlberg
authors: Thobias
authors: T
authors: Romu
authors: Stergios
authors: S
authors: Kechagias
authors: Sven
authors: S
authors: Almer
authors: Örjan
authors: Ö
authors: Smedby
authors: Peter
authors: P
authors: Lundberg
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D003287:Contrast Media / Q000493:pharmacokinetics*; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012984:Software; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA