title: Gd-EOB-DTPA-enhanced MRI for monitoring future liver remnant function after portal vein embolization and extended hemihepatectomy: A prospective trial.
abstract: OBJECTIVE
  To evaluate changes in liver function after right portal vein embolization (PVE) and extended right hemihepatectomy using gadolinium ethoxybenzyl-DTPA-enhanced (Gd-EOB-DTPA) MRI.
  
  
  METHODS
  In this prospective trial, 37 patients undergoing PVE were examined before and 14 and 28 days after PVE and 10 days after extended hemihepatectomy using Gd-EOB-DTPA-enhanced MRI. Lobar volume, kinetic growth rate (KGR), relative enhancement (RE) as well as hepatocellular uptake index (HUI) and fat signal fraction (FSF) were calculated for each lobe.
  
  
  RESULTS
  RE of the left liver lobe (LLL) was steadily increasing after PVE and decreased to 0.48 ± 0.19 10 days after surgery, which is significantly lower than 14 days and 28 days post PVE (P < 0.05). KGR was 14.06 ± 9.82%/week for the period from PVE to 14 days after PVE. HUI of the LLL increased steadily after PVE and was significantly higher at both 14 and 28 days after PVE compared to pre PVE (P < 0.05). HUI of the residual liver after surgery was lower than before.
  
  
  CONCLUSIONS
  Gd-EOB-DTPA-enhanced MRI may be used to monitor the functional increase in the FLR after PVE and to depict the intraoperative liver injury leading to a decrease in liver remnant function.
  
  
  CONCLUSIONS
  • The most significant FLR volume increase happens within the first 14 days. • No MRI parameter was able to predict the success of FLR growth. • Our data suggest an early resection about 14 days after PVE. • Routine Gd-EOB-DTPA-enhanced MRI might be suitable to replace ICG-test.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. dominik.geisel@charite.de.
authors.forename: Dominik
authors.identifier: http://orcid.org/0000-0001-7348-0971
authors.initials: D
authors.lastname: Geisel
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Philip
authors.initials: P
authors.lastname: Raabe
authors.affiliation: Department of Medical Physics, Essen University Hospital, Essen, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Lüdemann
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Maciej
authors.initials: M
authors.lastname: Malinowski
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Stockmann
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Seehofer
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000494:pharmacology; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA / Q000494:pharmacology*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D011169:Portal Vein; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Gadolinium ethoxybenzyl DTPA; Liver; Liver function tests; Magnetic resonance imaging; Portal vein embolization