Child-Pugh Classification using Magnetic Resonance Imaging using Gadoxetic Acid-based Contrast Agent Compared with Indocyanine Green and 99mTc-galactosyl-human Serum Albumin Liver Scintigraphy

• Published in: Kita Kantō igaku (The Kitakanto Medical Journal) Vol. 69; no. 3; pp. 183 - 189
• Main Authors: Manduul, Enkhjargal, Nakajima, Takahito, Shibuya, Kei, Shrestha, Suman, Hirasawa, Hiromi, Tsushima, Yoshito
• Format: Journal Article
• Language: English
• Published: The Kitakanto Medical Society 01.08.2019
• Subjects: Child-Pugh classification; EOB; Hepatobiliary phase; Liver function; MRI
• ISSN: 1343-2826; 1881-1191
• DOI: 10.2974/kmj.69.183

This study evaluated liver function using gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) to improve assessment of patients with liver tumors compared to Child-Pugh classification (CPC). Materials and methods: The liver function of 59 patients was assessed to determine the indication for heavy ion therapy. Clinical and laboratory assessments, including 99mTc-GSA liver scintigraphy and indocyanine green retention index (ICGR15), were performed for liver function assessment. EOB-MRI was performed on T1W1 images both before and after Gd-EOB-DTPA administration and hepatobiliary phase images were acquired 20-min post-injection. Liver parenchymal enhancement ratio (LER) was measured based on liver-to-spleen (L/Sp) ratios calculating the average liver intensity divided by spleen intensity. Results: The mean LER values on MRI were 138.2±12.8 (133.9-142.5), 115.7±11.6 (110.0-121.5), and 93.2±15.8 (73.6-112.9) in CPC-A, -B and -C, respectively. From the correlation between the LER on MRI and ICGR15 and parameters of 99mTc-GSA liver scintigraphy, LER on MRI was highly significantly correlated with ICGR15 (r=-0.67; p<0.0001). Discussion: This study demonstrated that LER values on EOB-MRI could classify liver function and had high correlation with CPC and ICGR15.