title: Pre-treatment estimation of future remnant liver function using gadoxetic acid MRI in patients with HCC.
abstract: This study aimed to determine whether the predicted remnant liver function on dynamic hepatocyte-specific contrast media-enhanced magnetic resonance (DHCE-MR) imaging correlates with the results of the indocyanin green retention test (ICG R15) after hepatic resection or radiofrequency ablation (RFA).
  
  
  
  This prospective multicenter study was approved by the Institutional Review Boards of each hospital. Informed consents were obtained from all. DHCE-MRI and ICG R15were performed in 57 patients scheduled to undergo hepatectomy or RFA for hepatocellular carcinoma, once before treatment and repeated on post-treatment day 3. In nine donors and three recipients, DHCE-MRI and ICG R15were performed only preoperatively. The predicted remnant liver function (HEFml) was estimated using the hepatic extraction fraction (HEF) multiplied by the remnant liver volume, and compared with post-treatment ICG R15. Intra-individual heterogeneity of HEF was assessed using pooled coefficients of variation (CV) among hepatic segments. Finally, development of post-treatment hepatic failure was assessed according to the 50-50 criteria on post-treatment day 5.
  
  
  
  Predicted remnant HEFml showed a negative correlation with post-treatment ICG R15(r=-0.45, p=0.001), whereas liver volume did not (p>0.05). There were significant correlations between pre-treatment HEFml and pre-treatment ICG R15(r=-0.33, p=0.006) and between post-treatment HEFml and post-treatment ICG R15(r=-0.54, p<0.001). Pooled CV among segmental HEFs was 12.6%. No patients showed post-treatment liver failure on post-treatment day 5.
  
  
  
  DHCE-MRI using Gd-EOB-DTPA was able to provide both global and segmental liver function information, and post-treatment remnant liver function predicted on pre-treatment DHCE-MRI showed a significant negative correlation with post-treatment ICG R15.
  
  
  
  Post-treatment liver function could be predicted at pre-treatment DHCE-MRI. Liver function was heterogeneous among the liver segments. Liver anatomy, disease extent, and underlying liver function can be assessed in one DHCE-MRI examination.
  
  
  
  ClinicalTrials.gov number, NCT01490203.
authors.affiliation: Radiology, Seoul National University Hospital, Seoul, Republic of Korea; College of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong Hee
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Radiology, Catholic Medical Center, Seoul, Republic of Korea.
authors.forename: Joon-Il
authors.initials: JI
authors.lastname: Choi
authors.affiliation: Chonnam National University Hwasun Hospital and Medical School, Gwang-Ju, Republic of Korea.
authors.forename: Yong Yeon
authors.initials: YY
authors.lastname: Jeong
authors.affiliation: Fraunhofer Mevis, Bremen, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Schenk
authors.affiliation: Fraunhofer Mevis, Bremen, Germany.
authors.forename: Longquan
authors.initials: L
authors.lastname: Chen
authors.affiliation: Fraunhofer Mevis, Bremen, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Laue
authors.affiliation: Radiology, Asan Medical Center, Seoul, Republic of Korea. Electronic address: sykimrad@amc.seoul.kr.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Radiology, Seoul National University Hospital, Seoul, Republic of Korea; College of Medicine, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul 03087, Republic of Korea. Electronic address: jmlshy2000@gmail.com.
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
mesh_terms: D006528:Carcinoma, Hepatocellular; D019786:Gadolinium DTPA; D006801:Humans; D008099:Liver; D008111:Liver Function Tests; D008113:Liver Neoplasms; D008279:Magnetic Resonance Imaging; D011446:Prospective Studies
chemical_list: C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Hepatectomy; Hepatic extraction fraction; Hepatocellular carcinoma; Liver function test; Radiofrequency ablation