Predictive value of gadoxetic acid enhanced magnetic resonance imaging for posthepatectomy liver failure after a major hepatectomy. (21st June 2020)

• Record Type: Journal Article
• Authors: Orimo, Tatsuya; Kamiyama, Toshiya; Kamachi, Hirofumi; Shimada, Shingo; Nagatsu, Akihisa; Asahi, Yoh; Sakamoto, Yuzuru; Abo, Daisuke; Taketomi, Akinobu
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 27:Number 8(2020)
• Page Start: 531
• Page End: 540
• Publication Date: 2020-06-21
• Subjects: posthepatectomy liver failure -- magnetic resonance imaging -- hepatectomy -- liver resection; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.769
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background: We assessed the usefulness of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging for the prediction of posthepatectomy liver failure (PHLF) after a major hepatectomy. Methods: We reviewed 140 cases involving a hepatectomy of two or more sections between 2010 and 2016 (study cohort). We used the standardized remnant hepatocellular uptake index (SrHUI) which was calculated by: SrHUI = future remnant liver volume × [(signal intensity of remnant liver on hepatobiliary phase images/signal intensity of spleen on hepatobiliary phase images) − 1]/body surface area. Validation of the SrHUI was performed in another cohort of 52 major hepatectomy cases between 2017 and 2018 (validation cohort). Results: The SrHUI of patients with PHLF was significantly lower than that of non‐PHLF cases. Receiver operating characteristic analysis and the Youden index revealed that the SrHUI cutoff value for the prediction of PHLF and PHLF grade ≥ B were 0.313 L/m 2 and 0.257 L/m 2, respectively. In the validation cohort, the cutoff value of SrHUI for the prediction of PHLF or PHLF grade ≥ B had a sensitivity of 75.0% or 88.8%, and specificity of 78.1% or 91.6%, respectively. Conclusions: The SrHUI value is a predictor for PHLF after a major hepatectomy. Abstract : Highlight Orimo and colleagues investigated the usefulness of EOB‐MRI for post‐hepatectomy liver failure (PHLF) after a major hepatectomy. The standardized remnant hepatocellular uptake index was significantly lower in PHLF cases than in non‐PHLF cases in the study cohort, and a predictor for PHLF after a major hepatectomy in the validation cohort.