Quantification of hepatic perfusion and hepatocyte function with dynamic gadoxetic acid-enhanced MR imaging in patients with chronic liver disease

The purpose of this study was to develop and perform initial validation of dynamic MR imaging enhanced with gadoxetic acid as hepatobiliary contrast agent to quantify hepatic perfusion and hepatocyte function in patients with chronic liver disease. Free-breathing, dynamic gadoxetic acid-enhanced MR imaging was performed at 3.0 T using a three-dimensional time-resolved angiography sequence with stochastic trajectories during 38 minutes. A dual-input three-compartment model was developed to derive hepatic perfusion and hepatocyte function parameters. Method feasibility was assessed in 23 patients with biopsy-proven chronic liver disease. Parameter analysis could be performed in 21 patients (91%). The hepatocyte function parameters were more discriminant than the perfusion parameters to differentiate between patients with minimal fibrosis (METAVIR F0 - 1), intermediate fibrosis (F2 - F3) and cirrhosis (F4). The areas under the receiver operating characteristic curves to diagnose significant fibrosis (METAVIR F ≥ 2) were: 0.95 (95% CI: 0.87 - 1; p < 0.001) for biliary efflux, 0.88 (95% CI: 0.73 - 1; p < 0.01) for sinusoidal backflux, 0.81 (95% CI: 0.61 - 1; p < 0.05) for hepatocyte uptake fraction and 0.75 (95% CI: 0.54 - 1; p < 0.05) for hepatic perfusion index, respectively. These initial results in patients with chronic liver diseases show that simultaneous quantification of hepatic perfusion and hepatocyte function is feasible with free breathing dynamic gadoxe...
Source: Clinical Science - Category: Biomedical Science Authors: Tags: PublishAheadOfPrint Source Type: research