Gadoxetate uptake as a possible marker of hepatocyte damage after liver resection-preliminary data

• Published in: Clinical radiology 2013-11, Vol.68 (11), p.1121-1127
• Main Authors: Bickelhaupt, S, Studer, P, Kim-Fuchs, C, Candinas, D, Froehlich, J.M, Patak, M.A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Contrast Media - pharmacokinetics; Feasibility Studies; Female; Gadolinium DTPA - pharmacokinetics; Hepatocytes; Humans; Image Enhancement - methods; Imaging, Three-Dimensional - methods; Liver - surgery; Liver Diseases - diagnosis; Magnetic Resonance Imaging - methods; Male; Middle Aged; Prospective Studies; Radiology; Signal-To-Noise Ratio
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2013.06.007

Aim To determine the feasibility of evaluating surgically induced hepatocyte damage using gadoxetate disodium (Gd-EOB-DTPA) as a marker for viable hepatocytes at magnetic resonance imaging (MRI) after liver resection. Material and methods Fifteen patients were prospectively enrolled in this institutional review board-approved study prior to elective liver resection after informed consent. Three Tesla MRI was performed 3–7 days after surgery. Three-dimensional (3D) T1-weighted (W) volumetric interpolated breath-hold gradient echo (VIBE) sequences covering the liver were acquired before and 20 min after Gd-EOB-DTPA administration. The signal-to-noise ratio (SNR) was used to compare the uptake of Gd-EOB-DTPA in healthy liver tissue and in liver tissue adjacent to the resection border applying paired Student's t -test. Correlations with potential influencing factors (blood loss, duration of intervention, age, pre-existing liver diseases, postoperative change of resection surface) were calculated using Pearson's correlation coefficient. Results Before Gd-EOB-DTPA administration the SNR did not differ significantly ( p  = 0.052) between healthy liver tissue adjacent to untouched liver borders [59.55 ± 25.46 (SD)] and the liver tissue compartment close to the resection surface (63.31 ± 27.24). During the hepatocyte-specific phase, the surgical site showed a significantly ( p  = 0.04) lower SNR (69.44 ± 24.23) compared to the healthy site (78.45 ± 27.71). Dynamic analyses revealed a significantly lower increase ( p  = 0.008) in signal intensity in the healthy tissue compared to the resection border compartment. Conclusion EOB-DTPA-enhanced MRI may have the potential to be an effective non-invasive tool for detecting hepatocyte damage after liver resection.