title: Assessing liver function using dynamic Gd-EOB-DTPA-enhanced MRI with a standard 5-phase imaging protocol.
abstract: OBJECTIVE
  To evaluate liver function obtained by tracer-kinetic modeling of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data acquired with a routine gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced protocol.
  
  
  METHODS
  Data were acquired from 25 cases of nonchronic liver disease and 94 cases of cirrhosis. DCE-MRI was performed with a dose of 0.025 mmol/kg Gd-EOB-DTPA injected at 2 mL/sec. A 3D breath-hold sequence acquired 5 volumes of 72 slices each: precontrast, double arterial phase, portal phase, and 4-minute postcontrast. Regions of interest (ROIs) were selected semiautomatically in the aorta, portal vein, and whole liver on a middle slice. A constrained dual-inlet two-compartment uptake model was fitted to the ROI curves, producing three parameters: intracellular uptake rate (UR), extracellular volume (Ve), and arterial flow fraction (AFF).
  
  
  RESULTS
  Median UR dropped from 4.46 10(-2) min(-1) in the noncirrhosis to 3.20 in Child-Pugh A (P = 0.001), and again to 1.92 in Child-Pugh B (P < 0.0001). Median Ve dropped from 6.64 mL 100 mL(-1) in the noncirrhosis to 5.80 in Child-Pugh A (P = 0.01). Other combinations of Ve and AFF changes were not significant for any group.
  
  
  CONCLUSIONS
  UR obtained from tracer kinetic analysis of a routine DCE-MRI has the potential to become a novel index of liver function.
authors.affiliation: Department of Radiology, Tokyo Medical University, Tokyo, Japan. saito-k@tokyo-med.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Saito
authors.forename: Joseph
authors.initials: J
authors.lastname: Ledsam
authors.forename: Steven
authors.initials: S
authors.lastname: Sourbron
authors.forename: Jun
authors.initials: J
authors.lastname: Otaka
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Araki
authors.forename: Soichi
authors.initials: S
authors.lastname: Akata
authors.forename: Koichi
authors.initials: K
authors.lastname: Tokuuye
mesh_terms: D000368:Aged; D000465:Algorithms; D003198:Computer Simulation; D003287:Contrast Media / Q000493:pharmacokinetics; D058625:End Stage Liver Disease / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008111:Liver Function Tests / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA