title: Multivariable analysis of clinical influence factors on liver enhancement of Gd-EOB-DTPA-enhanced 3T MRI.
abstract: OBJECTIVE
  The purpose of this study was to identify clinical factors influencing Gd-EOB-DTPA liver uptake in patients with healthy liver parenchyma.
  
  
  METHODS
  A total of 124 patients underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3 T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 minutes after contrast injection. The relative enhancement (RE) between plain and contrast-enhanced signal intensity was calculated. Simple and multiple linear regression analyses were performed to evaluate clinical factors influencing the relative enhancement. Patients were subdivided into three groups according to their relative liver enhancement (HRE, RE ≥ 100 %; MRE, 100 % > RE > 50 %; NRE, RE ≤ 50 %) and were analyzed according to the relevant risk factors.
  
  
  RESULTS
  Simple regression analyses revealed patient age, transaminases (AST, ALT, GGT), liver, spleen and delta-liver volume (the difference between the volumetrically measured liver volume and the estimated liver volume based on body weight) as significant factors influencing relative enhancement. In the multiple analysis the transaminase AST, spleen and delta liver volume remained significant factors influencing relative enhancement. Delta liver volume showed a significant difference between all analyzed groups.
  
  
  CONCLUSIONS
  Liver enhancement in the hepatobiliary phase depends on a variety of factors. Body weight-adapted administration of Gd-EOB-DTPA may lead to inadequate liver enhancement after 20 minutes especially when the actual liver volume differs from the expected volume.
  
  
  CONCLUSIONS
  • Differences between actual and expected liver volume can cause inadequate liver enhancement after 20 min. • A liver volume-adapted dose of Gd-EOB-DTPA may help to improve liver enhancement.
authors.affiliation: Department of Radiology, University Hospital Regensburg.
authors.forename: N
authors.initials: N
authors.lastname: Verloh
authors.affiliation: Department of Radiology, University Hospital Regensburg.
authors.forename: M
authors.initials: M
authors.lastname: Haimerl
authors.affiliation: Center for Clinical Trials, University Hospital Regensburg.
authors.forename: F
authors.initials: F
authors.lastname: Zeman
authors.affiliation: Department of Gastroenterology, University Hospital Regensburg.
authors.forename: A
authors.initials: A
authors.lastname: Teufel
authors.affiliation: Department of Surgery, University Hospital Regensburg.
authors.forename: S
authors.initials: S
authors.lastname: Lang
authors.affiliation: Department of Radiology, University Hospital Regensburg.
authors.forename: C
authors.initials: C
authors.lastname: Stroszczynski
authors.affiliation: Department of Radiology, University Hospital Regensburg.
authors.forename: C
authors.initials: C
authors.lastname: Fellner
authors.affiliation: Department of Radiology, University Hospital Regensburg.
authors.forename: P
authors.initials: P
authors.lastname: Wiggermann
mesh_terms: D000328:Adult; D000368:Aged; D016477:Artifacts; D001835:Body Weight; D003287:Contrast Media / Q000008:administration & dosage / Q000493:pharmacokinetics; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage / Q000493:pharmacokinetics; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008111:Liver Function Tests; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D012016:Reference Values; D013154:Spleen / Q000473:pathology
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA