Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Preoperative Estimation of Future Remnant Liver Function Following Portal Vein Embolization Using Relative Enhancement on Gadoxetic Acid Disodium-Enhanced Magnetic Resonance Imaging

  • Sato, Yozo (Department of Radiology, Aichi Medical University) ;
  • Matsushima, Shigeru (Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital) ;
  • Inaba, Yoshitaka (Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital) ;
  • Sano, Tsuyoshi (Department of Gastroenterological Surgery, Aichi Cancer Center Hospital) ;
  • Yamaura, Hidekazu (Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital) ;
  • Kato, Mina (Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital) ;
  • Shimizu, Yasuhiro (Department of Gastroenterological Surgery, Aichi Cancer Center Hospital) ;
  • Senda, Yoshiki (Department of Gastroenterological Surgery, Aichi Cancer Center Hospital) ;
  • Ishiguchi, Tsuneo (Department of Radiology, Aichi Medical University)
  • Received : 2014.08.30
  • Accepted : 2015.01.12
  • Published : 2015.06.01
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Abstract

Objective: To retrospectively evaluate relative enhancement (RE) in the hepatobiliary phase of gadoxetic acid disodium-enhanced magnetic resonance (MR) imaging as a preoperative estimation of future remnant liver (FRL) function in a patients who underwent portal vein embolization (PVE). Materials and Methods: In 53 patients, the correlation between the indocyanine green clearance (ICG-K) and RE imaging was analyzed before hepatectomy (first analysis). Twenty-three of the 53 patients underwent PVE followed by a repeat RE imaging and ICG test before an extended hepatectomy and their results were further analyzed (second analysis). Whole liver function and FRL function were calculated on the MR imaging as follows: RE x total liver volume (RE Index) and FRL-RE x FRL volume (Rem RE Index), respectively. Regarding clinical outcome, posthepatectomy liver failure (PHLF) was evaluated in patients undergoing PVE. Results: Indocyanine green clearance correlated with the RE Index (r = 0.365, p = 0.007), and ICG-K of FRL (ICG-Krem) strongly correlated with the Rem RE Index (r = 0.738, p < 0.001) in the first analysis. Both the ICG-Krem and the Rem RE Index were significantly correlated after PVE (r = 0.508, p = 0.013) at the second analysis. The rate of improvement of the Rem RE Index from before PVE to after PVE was significantly higher than that of ICG-Krem (p = 0.014). Patients with PHLF had a significantly lower Rem RE Index than patients without PHLF (p = 0.023). Conclusion: Relative enhancement imaging can be used to estimate FRL function after PVE.

Keywords

References

  1. Matsumata T, Kanematsu T, Yoshida Y, Furuta T, Yanaga K, Sugimachi K. The indocyanine green test enables prediction of postoperative complications after hepatic resection. World J Surg 1987;11:678-681 https://doi.org/10.1007/BF01655848
  2. Sano T, Shimada K, Sakamoto Y, Yamamoto J, Yamasaki S, Kosuge T. One hundred two consecutive hepatobiliary resections for perihilar cholangiocarcinoma with zero mortality. Ann Surg 2006;244:240-247 https://doi.org/10.1097/01.sla.0000217605.66519.38
  3. Imamura H, Sano K, Sugawara Y, Kokudo N, Makuuchi M. Assessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test. J Hepatobiliary Pancreat Surg 2005;12:16-22 https://doi.org/10.1007/s00534-004-0965-9
  4. Seyama Y, Kokudo N. Assessment of liver function for safe hepatic resection. Hepatol Res 2009;39:107-116 https://doi.org/10.1111/j.1872-034X.2008.00441.x
  5. Sakka SG. Assessing liver function. Curr Opin Crit Care 2007;13:207-214 https://doi.org/10.1097/MCC.0b013e328012b268
  6. Okochi O, Kaneko T, Sugimoto H, Inoue S, Takeda S, Nakao A. ICG pulse spectrophotometry for perioperative liver function in hepatectomy. J Surg Res 2002;103:109-113 https://doi.org/10.1006/jsre.2001.6328
  7. Nagino M, Kamiya J, Nishio H, Ebata T, Arai T, Nimura Y. Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: surgical outcome and long-term follow-up. Ann Surg 2006;243:364-372 https://doi.org/10.1097/01.sla.0000201482.11876.14
  8. Ohwada S, Kawate S, Hamada K, Yamada T, Sunose Y, Tsutsumi H, et al. Perioperative real-time monitoring of indocyanine green clearance by pulse spectrophotometry predicts remnant liver functional reserve in resection of hepatocellular carcinoma. Br J Surg 2006;93:339-346 https://doi.org/10.1002/bjs.5258
  9. Yumoto Y, Yagi T, Sato S, Nouso K, Kobayashi Y, Ohmoto M, et al. Preoperative estimation of remnant hepatic function using fusion images obtained by (99m)Tc-labelled galactosyl-human serum albumin liver scintigraphy and computed tomography. Br J Surg 2010;97:934-944 https://doi.org/10.1002/bjs.7025
  10. Abdalla EK, Barnett CC, Doherty D, Curley SA, Vauthey JN. Extended hepatectomy in patients with hepatobiliary malignancies with and without preoperative portal vein embolization. Arch Surg 2002;137:675-680; discussion 680-681 https://doi.org/10.1001/archsurg.137.6.675
  11. Ebata T, Yokoyama Y, Igami T, Sugawara G, Takahashi Y, Nagino M. Portal vein embolization before extended hepatectomy for biliary cancer: current technique and review of 494 consecutive embolizations. Dig Surg 2012;29:23-29 https://doi.org/10.1159/000335718
  12. van Lienden KP, van den Esschert JW, de Graaf W, Bipat S, Lameris JS, van Gulik TM, et al. Portal vein embolization before liver resection: a systematic review. Cardiovasc Intervent Radiol 2013;36:25-34 https://doi.org/10.1007/s00270-012-0440-y
  13. Vogl TJ, Kummel S, Hammerstingl R, Schellenbeck M, Schumacher G, Balzer T, et al. Liver tumors: comparison of MR imaging with Gd-EOB-DTPA and Gd-DTPA. Radiology 1996;200:59-67 https://doi.org/10.1148/radiology.200.1.8657946
  14. Huppertz A, Balzer T, Blakeborough A, Breuer J, Giovagnoni A, Heinz-Peer G, et al. Improved detection of focal liver lesions at MR imaging: multicenter comparison of gadoxetic acidenhanced MR images with intraoperative findings. Radiology 2004;230:266-275 https://doi.org/10.1148/radiol.2301020269
  15. Reimer P, Schneider G, Schima W. Hepatobiliary contrast agents for contrast-enhanced MRI of the liver: properties, clinical development and applications. Eur Radiol 2004;14:559-578 https://doi.org/10.1007/s00330-004-2236-1
  16. Bluemke DA, Sahani D, Amendola M, Balzer T, Breuer J, Brown JJ, et al. Efficacy and safety of MR imaging with liver-specific contrast agent: U.S. multicenter phase III study. Radiology 2005;237:89-98 https://doi.org/10.1148/radiol.2371031842
  17. Schuhmann-Giampieri G, Schmitt-Willich H, Press WR, Negishi C, Weinmann HJ, Speck U. Preclinical evaluation of Gd-EOBDTPA as a contrast agent in MR imaging of the hepatobiliary system. Radiology 1992;183:59-64 https://doi.org/10.1148/radiology.183.1.1549695
  18. Leonhardt M, Keiser M, Oswald S, Kuhn J, Jia J, Grube M, et al. Hepatic uptake of the magnetic resonance imaging contrast agent Gd-EOB-DTPA: role of human organic anion transporters. Drug Metab Dispos 2010;38:1024-1028 https://doi.org/10.1124/dmd.110.032862
  19. Nassif A, Jia J, Keiser M, Oswald S, Modess C, Nagel S, et al. Visualization of hepatic uptake transporter function in healthy subjects by using gadoxetic acid-enhanced MR imaging. Radiology 2012;264:741-750 https://doi.org/10.1148/radiol.12112061
  20. Kitao A, Matsui O, Yoneda N, Kozaka K, Shinmura R, Koda W, et al. The uptake transporter OATP8 expression decreases during multistep hepatocarcinogenesis: correlation with gadoxetic acid enhanced MR imaging. Eur Radiol 2011;21:2056-2066 https://doi.org/10.1007/s00330-011-2165-8
  21. Motosugi U, Ichikawa T, Sou H, Sano K, Tominaga L, Kitamura T, et al. Liver parenchymal enhancement of hepatocytephase images in Gd-EOB-DTPA-enhanced MR imaging: which biological markers of the liver function affect the enhancement? J Magn Reson Imaging 2009;30:1042-1046 https://doi.org/10.1002/jmri.21956
  22. Yamada A, Hara T, Li F, Fujinaga Y, Ueda K, Kadoya M, et al. Quantitative evaluation of liver function with use of gadoxetate disodium-enhanced MR imaging. Radiology 2011;260:727-733 https://doi.org/10.1148/radiol.11100586
  23. Utsunomiya T, Shimada M, Hanaoka J, Kanamoto M, Ikemoto T, Morine Y, et al. Possible utility of MRI using Gd-EOBDTPA for estimating liver functional reserve. J Gastroenterol 2012;47:470-476 https://doi.org/10.1007/s00535-011-0513-8
  24. Kim HY, Choi JY, Park CH, Song MJ, Song do S, Kim CW, et al. Clinical factors predictive of insufficient liver enhancement on the hepatocyte-phase of Gd-EOB-DTPA-enhanced magnetic resonance imaging in patients with liver cirrhosis. J Gastroenterol 2013;48:1180-1187 https://doi.org/10.1007/s00535-012-0740-7
  25. Matsushima S, Sato Y, Yamaura H, Kato M, Kinosada Y, Era S, et al. Visualization of liver uptake function using the uptake contrast-enhanced ratio in hepatobiliary phase imaging. Magn Reson Imaging 2014;32:654-659 https://doi.org/10.1016/j.mri.2014.02.017
  26. Geisel D, Ludemann L, Keuchel T, Malinowski M, Seehofer D, Stockmann M, et al. Increase in left liver lobe function after preoperative right portal vein embolisation assessed with gadolinium-EOB-DTPA MRI. Eur Radiol 2013;23:2555-2560 https://doi.org/10.1007/s00330-013-2859-1
  27. Rahbari NN, Garden OJ, Padbury R, Brooke-Smith M, Crawford M, Adam R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 2011;149:713-724 https://doi.org/10.1016/j.surg.2010.10.001
  28. Wibmer A, Prusa AM, Nolz R, Gruenberger T, Schindl M, Ba-Ssalamah A. Liver failure after major liver resection: risk assessment by using preoperative Gadoxetic acid-enhanced 3-T MR imaging. Radiology 2013;269:777-786 https://doi.org/10.1148/radiol.13130210
  29. Komori K, Nagino M, Nimura Y. Hepatocyte morphology and kinetics after portal vein embolization. Br J Surg 2006;93:745-751 https://doi.org/10.1002/bjs.5332

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