Abstract

ObjectivesDiffuse liver disease (DLD), such as non-alcoholic fatty liver disease (NASH) and cirrhosis, is a rapidly growing problem throughout the Westernized world. Magnetic resonance imaging (MRI), based on uptake of the hepatocyte-specific contrast agent (CA) Gd-EOB-DTPA, is a promising non-invasive approach for diagnosing DLD. However, to fully utilize the potential of such dynamic measurements for clinical or research purposes, more advanced methods for data analysis are required.MethodsA mathematical model that can be used for such data-analysis was developed. Data was obtained from healthy human subjects using a clinical protocol with high spatial resolution. The model is based on ordinary differential equations and goes beyond local diffusion modeling, taking into account the complete system accessible to the CA.ResultsThe presented model can describe the data accurately, which was confirmed using chi-square statistics. Furthermore, the model is minimal and identifiable, meaning that all parameters were determined with small degree of uncertainty. The model was also validated using independent data.ConclusionsWe have developed a novel approach for determining previously undescribed physiological hepatic parameters in humans, associated with CA transport across the liver. The method has a potential for assessing regional liver function in clinical examinations of patients that are suffering of DLD and compromised hepatic function.

Highlights

  • Diffuse liver disease is a rapidly growing problem throughout the Western world

  • The pathology include conditions such as viral hepatitis C, and nonalcoholic fatty liver disease, which all can provoke the formation of fibrosis, inflammation and cirrhosis

  • These issues can all be overcome by use of magnetic resonance imaging (MRI) and MRI contrast agents (CA), providing a local completely noninvasive assessment of liver function, without the use of ionizing radiation

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Summary

Introduction

Diffuse liver disease is a rapidly growing problem throughout the Western world. Liver function is often assessed using methods such as Indocyanin-Green 15 retention rate (ICGR15) or Tc-99m galactosyl human serum albumin (GSA) measurements [4,5,6]. ICGR15 and GSA are both exclusively global indicators, i.e. they do not provide any information about regional liver function. GSA involves the injection of a radioactive isotope, and is associated with certain risks as well as costs. These issues can all be overcome by use of magnetic resonance imaging (MRI) and MRI contrast agents (CA), providing a local completely noninvasive assessment of liver function, without the use of ionizing radiation

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