Tomoelastography based on multifrequency MR elastography predicts liver function reserve in patients with hepatocellular carcinoma: a prospective study

• Published in: Insights into imaging Vol. 13; no. 1; p. 95
• Main Authors: Lin, Huimin, Wang, Yihuan, Zhou, Jiahao, Yang, Yuchen, Xu, Xinxin, Ma, Di, Chen, Yongjun, Yang, Chunxue, Sack, Ingolf, Guo, Jing, Li, Ruokun, Yan, Fuhua
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 03.06.2022; Springer Nature B.V; SpringerOpen
• Subjects: Correlation; Diagnostic Radiology; Hepatectomy; Hepatocellular carcinoma; Imaging; Indocyanine green retention rate; Internal Medicine; Interventional Radiology; Liver; Liver cancer; Liver function reserve; Magnetic resonance; Magnetic resonance elastography; Medicine; Medicine & Public Health; Neuroradiology; Original; Original Article; Prediction models; Radiology; Regression models; Stiffness; Tomoelastography; Ultrasound; Viscoelasticity; Viscosity; Indocyanine green retention rate; Tomoelastography; Hepatocellular carcinoma; Liver function reserve; Magnetic resonance elastography
• ISSN: 1869-4101; 1869-4101
• DOI: 10.1186/s13244-022-01232-5

Background Estimating liver function reserve is essential for preoperative surgical planning and predicting post-hepatectomy complications in patients with hepatocellular carcinoma (HCC). We investigated hepatic viscoelasticity quantified by tomoelastography, a multifrequency magnetic resonance elastography technique, to predict liver function reserve. Methods One hundred fifty-six patients with suspected HCC (mean age, 60 ± 1 years; 131 men) underwent preoperative tomoelastography examination between July 2020 and August 2021. Sixty-nine were included in the final analysis, and their 15-min indocyanine green retention rates (ICG-R15s) were obtained to determine liver function reserve. Tomoelastography quantified the shear wave speed ( c , m/s), which represents stiffness, and loss angle ( φ , rad), which represents fluidity. Both were correlated with the ICG-R15. A prediction model based on logistic regression for major hepatectomy tolerance (ICG-R15 ≥ 14%) was established. Results Patients were assigned to either the ICG-R15 < 14% ( n  = 50) or ICG-R15 ≥ 14% ( n  = 19) group. Liver c ( r  = 0.617) and φ ( r  = 0.517) were positively correlated with the ICG-R15 (both p  < 0.001). At fibrosis stages F1–2, φ was positively correlated with the ICG-R15 ( r  = 0.528; p  = 0.017), but c was not ( p  = 0.104). At stages F3–4, c ( r  = 0.642; p  < 0.001) and φ ( r  = 0.377; p  = 0.008) were both positively correlated with the ICG-R15. The optimal cutoffs of c and φ for predicting ICG-R15 ≥ 14% were 2.04 m/s and 0.79 rad, respectively. The area under the receiver operating characteristic curve was higher for c (0.892) than for φ (0.779; p  = 0.045). Conclusions Liver stiffness and fluidity, quantified by tomoelastography, were correlated with liver function and may be used clinically to noninvasively assess liver function reserve and stratify treatments.