Preoperative Remnant Liver Function Evaluation Using a Routine Clinical Dynamic Gd-EOB-DTPA-Enhanced MRI Protocol in Pat
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ORIGINAL ARTICLE – HEPATOBILIARY TUMORS
Preoperative Remnant Liver Function Evaluation Using a Routine Clinical Dynamic Gd-EOB-DTPA-Enhanced MRI Protocol in Patients with Hepatocellular Carcinoma Yajie Wang, B.E.1, Lin Zhang, M.D.2,3, Jia Ning, Ph.D.1, Xinjing Zhang, M.M.2, Xuesong Li, M.D.4, Leida Zhang, M.D.4, Geng Chen, M.D.5, Xihai Zhao, M.D.1, Xuedong Wang, M.D.2, Shizhong Yang, M.D.2, Chun Yuan, Ph.D.6, Jiahong Dong, M.D.2, and Huijun Chen, Ph.D.1 1
Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; 2Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Medicine, Tsinghua University, Beijing, China; 3Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, China; 4Institute of Hepatobiliary Surgery, Army Medical University, Chongqing, China; 5Department of Hepatobiliary Surgery, Daping Hospital, Army Medical University, Chongqing, China; 6Department of Radiology, University of Washington, Seattle, WA
ABSTRACT Background. To investigate the clinical feasibility of preoperative routine clinical dynamic Gd-EOB-DTPA-enhanced MRI alone to predict post-hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC). Methods. 116 patients with HCC who underwent liver resection in Southwest Hospital from 2014 through 2017 were selected in this retrospective cohort study. The remnant function (RF) of the liver RFUR and RFRE15 were calculated by the sum of the uptake rate (UR) or relative enhancement at 15 min (RE15) from dynamic Gd-EOBDTPA-enhanced MR images in the remnant liver regions, and standardized by standard liver volume (SLV) to generate sRFUR (standardized RFUR) and sRFRE15
Yajie Wang and Lin Zhang have contributed equally to this work.
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-09361-1) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 24 June 2020 Accepted: 15 September 2020 J. Dong, M.D. e-mail: [email protected] H. Chen, Ph.D. e-mail: [email protected]
(standardized RFRE15). Student’s t test or Mann–Whitney U test, logistic regression, and ROC analyses were used to test the associations of preoperative RFUR, sRFUR, RFRE15, sRFRE15, the remnant liver volume (RLV)/SLV, ICG retention rate at 15 min (ICG R15) and sRFICG-K [ICG clearance rate (ICG-K) 9 RLV/SLV] with PHLF. Results. 28 patients were found to have PHLF, who showed lower RFUR, sRFUR, RFRE15, sRFRE15, RLV/SLV, sRFICG-K, and higher ICG R15 than patients without PHLF (p \ 0.001 for all). After adjusting for clinical parameters, RFUR (p = 0.001), sRFUR (p = 0.001), RFRE15 (p = 0.002), or sRFRE15 (p = 0.003) was found to be independently significant indicator in multivariable logistic regression, respectively. RFUR (0.882) and sRFUR (0.882) had larger AUCs than RLV/SLV (0.731, p = 0.008; p = 0.005), ICG R15 (0.765, p = 0.039; p = 0.0
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