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- Title
Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA.
- Authors
Norén B; Forsgren MF; Dahlqvist Leinhard O; Dahlström N; Kihlberg J; Romu T; Kechagias S; Almer S; Smedby O; Lundberg P; Norén, Bengt; Forsgren, Mikael Fredrik; Dahlqvist Leinhard, Olof; Dahlström, Nils; Kihlberg, Johan; Romu, Thobias; Kechagias, Stergios; Almer, Sven; Smedby, Örjan; Lundberg, Peter
- Abstract
<bold>Objectives: </bold>To apply dynamic contrast-enhanced (DCE) MRI on patients presenting with elevated liver enzymes without clinical signs of hepatic decompensation in order to quantitatively compare the hepatocyte-specific uptake of Gd-EOB-DTPA with histopathological fibrosis stage.<bold>Methods: </bold>A total of 38 patients were prospectively examined using 1.5-T MRI. Data were acquired from regions of interest in the liver and spleen by using time series of single-breath-hold symmetrically sampled two-point Dixon 3D images (non-enhanced, arterial and venous portal phase; 3, 10, 20 and 30 min) following a bolus injection of Gd-EOB-DTPA (0.025 mmol/kg). The signal intensity (SI) values were reconstructed using a phase-sensitive technique and normalised using multiscale adaptive normalising averaging (MANA). Liver-to-spleen contrast ratios (LSC_N) and the contrast uptake rate (K (Hep)) were calculated. Liver biopsy was performed and classified according to the Batts and Ludwig system.<bold>Results: </bold>Area under the receiver-operating characteristic curve (AUROC) values of 0.71, 0.80 and 0.78, respectively, were found for K (Hep), LSC_N10 and LSC_N20 with regard to severe versus mild fibrosis. Significant group differences were found for K (Hep) (borderline), LSC_N10 and LSC_N20.<bold>Conclusions: </bold>Liver fibrosis stage strongly influences the hepatocyte-specific uptake of Gd-EOB-DTPA. Potentially the normalisation technique and K (Hep) will reduce patient and system bias, yielding a robust approach to non-invasive liver function determination.
- Publication
European Radiology, 2013, Vol 23, Issue 1, p174
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-012-2583-2