title: Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the usefulness of Gd-EOB-DTPA-enhanced 3-T MRI to determine the hepatic functional reserve expressed by the model for end-stage liver disease (MELD) score.
  
  
  METHODS
  A total of 121 patients with normal liver function (NLF; MELD score ≤ 10) and 29 patients with impaired liver function (ILF; MELD score > 10) underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 min after contrast injection. Relative enhancement (RE) between plain signal intensity and contrast-enhanced signal intensity was calculated and was used to determine Gd-EOB-DTPA uptake into the liver parenchyma for patients with different MELD scores.
  
  
  RESULTS
  RE differed significantly (p ≤ 0.001) between patients with NLF (87.2 ± 29.5 %) and patients with ILF (45.4 ± 26.5 %). The optimal cut-off value for RE to differentiate NLF from ILF was 47.7 % (AUC 0.87). This cut-off value showed a sensitivity of 82.8 % and a specificity of 92.7 % for the differentiation of the analysed groups.
  
  
  CONCLUSIONS
  Gd-EOB-DTPA uptake in hepatocytes is strongly affected by liver function. Gd-EOB-DTPA-enhanced MRI and assessment of RE during the hepatobiliary phase (HBP) may serve as a useful image-based test in liver imaging for determining regional and global liver function.
  
  
  CONCLUSIONS
  Hepatic uptake of Gd-EOB-DTPA is strongly affected by liver function. Relative enhancement during HBP in GD-EOB-DTPA MRI correlates with the MELD score. Assessment of relative enhancement may help improve treatment in routine clinical practice.
authors: Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany, niklas.verloh@stud.uni-regensburg.de.
authors: N
authors: N
authors: Verloh
authors: M
authors: M
authors: Haimerl
authors: F
authors: F
authors: Zeman
authors: M
authors: M
authors: Schlabeck
authors: A
authors: A
authors: Barreiros
authors: M
authors: M
authors: Loss
authors: A G
authors: AG
authors: Schreyer
authors: C
authors: C
authors: Stroszczynski
authors: C
authors: C
authors: Fellner
authors: P
authors: P
authors: Wiggermann
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D005069:Evaluation Studies as Topic; D005260:Female; D019786:Gadolinium DTPA; D022781:Hepatocytes / Q000473:pathology; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008111:Liver Function Tests / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA