title: Diagnostic accuracy of intracellular uptake rates calculated using dynamic Gd-EOB-DTPA-enhanced MRI for hepatic fibrosis stage.
abstract: To assess the diagnostic accuracy of intracellular uptake rates (Ki), and other quantitative pharmacokinetic (PK) parameters, for hepatic fibrosis stage; to compare this accuracy with a previously published semiquantitative metric, contrast enhancement index (CEI); and to assess variability of these parameters between liver regions.
  
  
  
  This was a case-control study design. Dynamic Gd-EOB-DTPA-enhanced 1.5T magnetic resonance imaging (MRI) was performed prospectively in 22 subjects with varying known stages of hepatic fibrosis. PK parameters and CEI were derived from the whole livers and from three fixed regions of interest (ROIs) in all subjects. Spearman rank correlation coefficients were computed to assess the relationship between fibrosis stages and each parameter. Receiver operating characteristic (ROC) curves were constructed to discriminate severe fibrosis (stages 3-4) from nonsevere fibrosis (stages 0-2). The coefficient of variation (CV) was calculated to assess variability in parameters between ROIs.
  
  
  
  Kiand fibrosis stage were significantly correlated (R = -0.55, 95% confidence interval [CI] [-0.79, -0.14], P = 0.01). Area under ROC curve (AUC) in distinguishing severe from nonsevere fibrosis for Kiwas 0.84 (95% CI [0.65,1.00]), and for CEI was 0.64 (95% CI [0.39, 0.89]) (P = 0.0248). CV for Kiand CEI were 33.4 and 5.8, respectively. The only other parameter in the PK model having significant correlation with fibrosis stage was absolute arterial blood flow (Fa) (R = -0.48, 95% CI [-0.75,-0.05], P = 0.03).
  
  
  
  Hepatocyte intracellular uptake rate, Ki, derived from dynamic contrast-enhanced MRI, correlates with fibrosis stage and may contribute to a noninvasive biomarker of hepatic fibrosis.
  
  
  
  2 J. Magn. Reson. Imaging 2017;45:1177-1185.
authors.affiliation: Department of Radiology, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Krishna
authors.identifier: 0000-0001-8203-8894
authors.initials: K
authors.lastname: Juluru
authors.affiliation: Department of Medicine, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Talal
authors.affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Rhonda K
authors.initials: RK
authors.lastname: Yantiss
authors.affiliation: Department of Radiology, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Pascal
authors.initials: P
authors.lastname: Spincemaille
authors.affiliation: Department of Radiology, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Weidman
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Giambrone
authors.affiliation: Department of Radiology, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Sadaf
authors.initials: S
authors.lastname: Jalili
authors.affiliation: Division of Biomedical Imaging, University of Leeds, Leeds, UK.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Sourbron
authors.affiliation: Department of Radiology, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Jonathan P
authors.identifier: 0000-0001-7170-488X
authors.initials: JP
authors.lastname: Dyke
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003287:Contrast Media / Q000493:pharmacokinetics*; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: DCE-MRI; Gd-EOB-DTPA; compartment; dynamic contrast enhanced MRI; hepatic fibrosis; input; liver; perfusion