Abstract
Gd-EOB-DTPA, a liver-specific contrast agent with T1-shortening effects, is routinely used in clinical routine for detection and characterization of focal liver lesions and has recently received increasing attention as a tool for the quantitative analyses of liver function. We report the relationship between the extent of Gd-EOB-DTPA- induced T1 relaxation and the degree of liver fibrosis, which was assessed according to the METAVIR score. For the T1 relaxometry, a transverse 3D VIBE sequence with inline T1 calculation was acquired prior to and 20 minutes after Gd-EOB-DTPA administration. The reduction rates of the T1 relaxation time (rrT1) between the pre- and postcontrast images were calculated, and the optimal cutoff values for the fibrosis stages were determined with receiver operating characteristic (ROC) curve analyses. The rrT1 decreased with the severity of liver fibrosis and regression analysis revealed a significant correlation of the rrT1 with the stage of liver fibrosis (r = −0.906, p < 0.001). ROC analysis revealed sensitivities ≥78% and specificities ≥94% for the differentiation of different fibrosis stages. Gd-EOB-DTPA–enhanced T1 relaxometry is a reliable tool for both the detection of initial hepatic fibrosis and the staging of hepatic fibrosis.
Highlights
Liver fibrosis results from chronic damage to the liver, which is caused by, e.g., viral infection, alcohol abuse (ASH) or nonalcoholic steatohepatitis (NASH), in conjunction with the accumulation of extracellular matrix proteins that distort the hepatic architecture
Age Sex Men, n (%) Women, n (%) Weight dependent on the integrity of the hepatocyte mass, the quantification of Gd-EOB-DTPA uptake should represent the same aspects of liver function that can be assessed with ICG clearance tests[8,9]
Before Gd-EOB-DTPA administration, there was no significant difference in the T1 relaxation times (T1 pre) between the patients without fibrosis(F0; 731.5 ± 73.1 ms) and patients with mild liver fibrosis (F1; 739.2 ± 72.3, p = 0.886)
Summary
Liver fibrosis results from chronic damage to the liver, which is caused by, e.g., viral infection, alcohol abuse (ASH) or nonalcoholic steatohepatitis (NASH), in conjunction with the accumulation of extracellular matrix proteins that distort the hepatic architecture. The increasing success of antiviral treatments in the blocking or reversing of the fibrogenic progression of chronic liver disease has established important principles and targets for antifibrotic drugs Both the early detection and continuous monitoring of hepatic fibrosis have important clinical implications[3]. Healthcare, Berlin, Germany) is a paramagnetic hepatobiliary magnetic resonance (MR) contrast agent for T1weighted imaging[6] This agent is a gadolinium chelator that is taken up into the hepatocytes through organic anion-transporting polypeptides (OATP1B1/B3) in an ATP-dependent manner and is eventually excreted by the biliary pathway[7]. This is a property that Gd-EOB-DTPA shares with indocyanine green (ICG), which is commonly used to quantitatively assess liver function. The development of an accurate noninvasive method for assessing hepatic fibrosis could result in improved diagnostic abilities in terms of staging chronic liver disease[18]
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