Efficiency of regional functional liver volume assessment using Gd-EOB-DTPA-enhanced magnetic resonance imaging for hepa
- PDF / 1,221,771 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 59 Downloads / 170 Views
ORIGINAL ARTICLE
Efficiency of regional functional liver volume assessment using Gd‑EOB‑DTPA‑enhanced magnetic resonance imaging for hepatocellular carcinoma with portal vein tumor thrombus Kenichiro Araki1 · Norifumi Harimoto1 · Takahiro Yamanaka1 · Norihiro Ishii1 · Mariko Tsukagoshi1 · Takamichi Igarashi1 · Akira Watanabe1 · Norio Kubo1 · Yoshito Tsushima2 · Ken Shirabe1 Received: 4 February 2020 / Accepted: 17 May 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose We investigated whether functional future remnant liver volume (fFRLV), assessed using gadolinium-ethoxybenzyldiethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI), could evaluate regional liver function in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) and help establish the indication for hepatectomy. Methods The subjects of this study were 12 patients with PVTT [PVTT(+) group] and 58 patients without PVTT [PVTT(−) group], from among 191 patients who underwent hepatectomy of more than one segment for HCC. We calculated the liverto-muscle ratio (LMR) in the remnant liver, using EOB-MRI and fFRLV. Preoperative factors and surgical outcome were compared between the groups. The LMR of the area occluded by PVTT was compared with that of the non-occluded area. Results The indocyanine green retention rate at 15 min (ICG-R15) and liver fibrosis indices were increased in the PVTT(+) group, but the surgical outcomes of patients in this group were acceptable, with no liver failure, no mortality, and no differences from those in the PVTT(−) group. The fFRLV in the PVTT(+) group was not significantly different from that in the PVTT(−) group (p = 0.663). The LMR was significantly lower in the occluded area than in the non-occluded area (p = 0.004), indicating decreased liver function. Conclusion Assessing fFRLV using EOB-MRI could be useful for evaluating regional liver function and establishing operative indications for HCC with PVTT. Keywords EOB-MRI · Functional liver volume · Portal vein tumor thrombus · Regional liver functional reserve
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00595-020-02062-y) contains supplementary material, which is available to authorized users. * Norifumi Harimoto [email protected] 1
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3‑39‑22 Showa‑machi, Maebashi, Gunma 371‑8511, Japan
Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Gunma, Japan
2
Vascular invasion is an important prognostic factor in patients with hepatocellular carcinoma (HCC), which tends to spread through the portal veins [1]. The median survival of untreated patients with portal vein tumor thrombus (PVTT) has been reported as only 2.7 months, and even those who received effective treatment have survived for a median of just 6.4–20.0 months [2–6]. Hepatic resectio
Data Loading...
