Gd-EOB-DTPA-enhanced T1 relaxometry for assessment of liver function determined by real-time 13C-methacetin breath test
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To determine whether liver function as determined by intravenous administration of 13C-methacetin and continuous real-time breath analysis can be estimated quantitatively from gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) relaxometry.
Sixty-six patients underwent a 13C-methacetin breath test (13C-MBT) for evaluation of liver function and Gd-EOB-DTPA-enhanced T1-relaxometry at 3 T. A transverse 3D VIBE sequence with an inline T1 calculation based on variable flip angles was acquired prior to (T1 pre) and 20 min post-Gd-EOB-DTPA (T1 post) administration. The reduction rate of T1 relaxation time (rrT1) and T1 relaxation velocity index (∆R1) between pre- and post-contrast images was evaluated. 13C-MBT values were correlated with T1post, ∆R1 and rrT1, providing an MRI-based estimated 13C-MBT value. The interobserver reliability was assessed by determining the intraclass correlation coefficient (ICC).
Stratified by three different categories of 13C-MBT readouts, there was a constant increase of T1 post with increasing progression of diminished liver function (p ≤ 0.030) and a constant significant decrease of ∆R1 (p ≤ 0.025) and rrT1 (p < 0.018) with progression of liver damage as assessed by 13C-methacetin breath analysis. ICC for all T1 relaxation values and indices was excellent (> 0.88). A simple regression model showed a log-linear correlation of 13C-MBT values with T1post (r = 0.57; p < 0.001), ∆R1 (r = 0.59; p < 0.001) and rrT1 (r = 0.70; p < 0.001).
Liver function as determined using real-time 13C-methacetin breath analysis can be estimated quantitatively from Gd-EOB-DTPA-enhanced MR relaxometry.
• Gd-EOB-DTPA-enhanced T1 relaxometry quantifies liver function
• Gd-EOB-DTPA-enhanced MR relaxometry may provide parameters for assessing liver function before surgery
• Gd-EOB-DTPA-enhanced MR relaxometry may be useful for monitoring liver disease progression
• Gd-EOB-DTPA-enhanced MR relaxometry has the potential to become a novel liver function index
KeywordsContrast media Liver diseases Liver function tests Breath test Magnetic resonance imaging
13C-methacetin breath test
Hepatocyte-specific cytochrome P450 1A2
Liver maximum capacity
Organic anion transporting peptide
Reduction rate of T1 relaxation times
Region of interest
T1 relaxation velocity index
- T1 post
T1-relaxometry measurements 20 min after Gd-EOB-DTPA administration
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is PD Dr. Philipp Wiggermann.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors has significant statistical expertise.
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• case-control study
• performed at one institution
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