Visual assessment of biliary excretion of Gd-EOB-DTPA in patients with suspected diffuse liver disease – A biopsy-verified prospective study. (2015)

• Record Type: Journal Article
• Authors: Norén, Bengt; Dahlström, Nils; Forsgren, Mikael Fredrik; Dahlqvist Leinhard, Olof; Kechagias, Stergios; Almer, Sven; Wirell, Staffan; Smedby, Örjan; Lundberg, Peter
• Is Part Of: European journal of radiology open. Volume 2(2015)
• Page Start: 19
• Page End: 25
• Publication Date: 2015
• Subjects: Gd-EOB-DTPA gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid -- CLD chronic liver disease -- DCE-MRI Dynamic Contrast Enhanced Magnetic Resonance Imaging -- LSC_N normalised liver-to-spleen contrast ratio -- KHep contrast uptake rate -- ALT alanine aminotransferase -- ALP alkaline phosphatase -- NAFLD non-alcoholic fatty liver disease -- PSC primary sclerosing cholangitis -- HCV hepatitis C -- AIH autoimmune hepatitis -- AAT deficiency α1-antitrypsin deficiency -- DILI drug induced liver injury -- MANA multi scale adaptive normalizing averaging -- AUROC area under the receiver operating characteristic curve -- OATP organic anion transporting polypeptides -- MRP multidrug resistance protein -- RE relative enhancement -- FA flip angle -- SNR signal to noise ratio; Gd-EOB-DTPA -- Dynamic contrast enhanced MRI -- Liver -- Bile -- Excretion; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2014.12.004
• Languages: English
• ISSNs: 2352-0477

Abstract

Highlights: MR using hepatocyte specific contrast may potentially assess liver function. Covariance between contrast uptake and histo-pathological scoring of liver fibrosis. No relationship between visually assessed biliary contrast excretion and fibrosis scoring. No relationship between visually assessed biliary excretion and contrast uptake parameters. Abstract: Objectives: To qualitatively evaluate late dynamic contrast phases, 10, 20 and 30 min, after administration of Gd-EOB-DTPA with regard to biliary excretion in patients presenting with elevated liver enzymes without clinical signs of cirrhosis or hepatic decompensation and to compare the visual assessment of contrast agent excretion with histo-pathological fibrosis stage, contrast uptake parameters and blood tests. Methods: 29 patients were prospectively examined using 1.5 T MRI. The visually assessed presence or absence of contrast agent for each of five anatomical regions in randomly reviewed time-series was summarized on a four grade scale for each patient. The scores, including a total visual score, were related to the histo-pathological findings, the quantitative contrast agent uptake parameters, expressed as K Hep or LSC_N, and blood tests. Results: No relationship between the fibrosis grade or contrast uptake parameters could be established. A negative correlation between the visual assessment and alkaline phosphatase (ALP) was found. Comparing a sub-group of cholestatic patients with fibrosis score and Gd-EOB-DTPA dynamic parameters did not add any additional significant correlation. Conclusions: No correlation between visually assessed biliary excretion of Gd-EOB-DTPA and histo-pathological or contrast uptake parameters was found. A negative correlation between the visual assessment and alkaline phosphatase (ALP) was found.