title: Preoperative estimation of future remnant liver function following portal vein embolization using relative enhancement on gadoxetic acid disodium-enhanced magnetic resonance imaging.
abstract: OBJECTIVE
  To retrospectively evaluate relative enhancement (RE) in the hepatobiliary phase of gadoxetic acid disodium-enhanced magnetic resonance (MR) imaging as a preoperative estimation of future remnant liver (FRL) function in a patients who underwent portal vein embolization (PVE).
  
  
  METHODS
  In 53 patients, the correlation between the indocyanine green clearance (ICG-K) and RE imaging was analyzed before hepatectomy (first analysis). Twenty-three of the 53 patients underwent PVE followed by a repeat RE imaging and ICG test before an extended hepatectomy and their results were further analyzed (second analysis). Whole liver function and FRL function were calculated on the MR imaging as follows: RE x total liver volume (RE Index) and FRL-RE x FRL volume (Rem RE Index), respectively. Regarding clinical outcome, posthepatectomy liver failure (PHLF) was evaluated in patients undergoing PVE.
  
  
  RESULTS
  Indocyanine green clearance correlated with the RE Index (r = 0.365, p = 0.007), and ICG-K of FRL (ICG-Krem) strongly correlated with the Rem RE Index (r = 0.738, p < 0.001) in the first analysis. Both the ICG-Krem and the Rem RE Index were significantly correlated after PVE (r = 0.508, p = 0.013) at the second analysis. The rate of improvement of the Rem RE Index from before PVE to after PVE was significantly higher than that of ICG-Krem (p = 0.014). Patients with PHLF had a significantly lower Rem RE Index than patients without PHLF (p = 0.023).
  
  
  CONCLUSIONS
  Relative enhancement imaging can be used to estimate FRL function after PVE.
authors.affiliation: Department of Radiology, Aichi Medical University, Aichi 480-1195, Japan. ; Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
authors.forename: Yozo
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Matsushima
authors.affiliation: Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Inaba
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sano
authors.affiliation: Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamaura
authors.affiliation: Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
authors.forename: Mina
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Senda
authors.affiliation: Department of Radiology, Aichi Medical University, Aichi 480-1195, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Ishiguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics; D008099:Liver / Q000473:pathology* / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: C073590:gadolinium ethoxybenzyl DTPA; D007208:Indocyanine Green; D019786:Gadolinium DTPA
keywords: Future remnant liver function; Gd-EOB-DTPA-enhanced MR imaging; Portal vein embolization