Feasibility study of gadoxetic acid disodium enhanced MRI in preoperative one-stop-shop evaluation for parent liver donors

Abstract

Objective To explore the feasibility and clinical application of gadoxetic-acid-disodium (Gd-EOB-DTPA)-enhanced MRI in preoperative one-stop-shop evaluation for parent liver donors. Methods Forty parent liver donors were included in this prospective study. They all underwent Gd-EOB-DTPA-enhanced MRI for preoperative one-stop-shop evaluation. Two radiologists evaluated the anatomical variations of hepatic vessels, bile ducts, the shortest timing for bile ducts, image quality and graft liver volume. One transplantation surgeon recorded the intraoperative anatomy of hepatic vessels and bile ducts, and measured the transplanted liver volume. The consistency between imaging results and intraoperative findings was calculated. Interobserver agreements measuring the graft volume was assessed by intra-class correlation coefficient (ICC). Pearson correlation coefficients were measured between MRI-derived graft volume and actual graft volume. Interobserver agreements regarding the image quality were determined by calculating Kappa values. Results Thirty-two parent donors proceeded to liver donation. All anatomical findings of hepatic vessels and bile ducts accurately confirmed by intraoperative findings (32/32, 100%). MRI-derived graft volume measured by the two radiologists were (249.89±39.93) cm3, (242.76 ± 39.04) cm3, respectively and there was a high interobserver consistency (ICC=0.983). The intraoperative graft volume was (219.95±46.11) cm3 and correlated with actual graft volume moderately in both reviewers (r=0.820, 0.850, P<0.01). The image quality score were from 1 to 3 for hepatic arteries and bile ducts, 2 or 3 for portal and hepatic veins, which all met the clinical diagnostic requirements. The interobserver agreement was good for evaluating hepatic vessels (Kappa values were 0.841, 1.000, 1.000) and moderate for bile ducts (Kappa value was 0.658). Fifteen minutes delay in hepatoboliary phase can meet the demand of bile ducts classification in all donors. Conclusion One-stop-shop Gd-EOB-DTPA-enhanced MRI can be used in preoperative evaluation of parent donors effectively, and 15 minutes delay scanning is enough for cholangiography. Key words: Liver transplantation; Contrast media; Magnetic resonance imaging