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Yasokawa K, Kanki A, Nakamura H, Sotozono H, Ueda Y, Maeba K, Kido A, Higaki A, Hayashida M, Yamamoto A, Tamada T. Changes in pancreatic exocrine function, fat and fibrosis in diabetes mellitus: analysis using MR imaging. Br J Radiol 2023; 96:20210515. [PMID: 36961451 PMCID: PMC10161908 DOI: 10.1259/bjr.20210515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 01/03/2023] [Accepted: 02/08/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE To evaluate the relationships between hemoglobin A1c (HbA1c) levels with exocrine pancreatic function using cine-dynamic magnetic resonance cholangiopancreatography (MRCP) and the pancreatic parenchyma using fat-suppressed T1 mapping and the proton density fat fraction (PDFF). METHODS Patients who underwent 3T-MRI and HbA1c measurement were retrospectively recruited. MRI included cine-dynamic MRCP with a spatially selective inversion-recovery (SS-IR) pulse, fat-suppressed Look-Locker T1 mapping and multiecho 3D Dixon-based PDFF mapping. The pancreatic exocrine secretion grade on cine-dynamic MRCP, T1 values, and PDFF were analyzed in non-diabetic (n = 32), pre-diabetic (n = 44) and diabetic (n = 23) groups defined using HbA1c. RESULTS PDFF was weakly correlation with HbA1c (ρ = 0.30, p = 0.002). No correlations were detected between HbA1c and secretion grade (ρ = - 0.16, p = 0.118) or pancreatic parenchymal T1 (ρ = 0.13, p = 0.19). The secretion grade was comparable between the three groups. The T1 value was higher in diabetic (T1 = 1006.2+/- 224.8 ms) than in non-diabetic (T1 = 896.2+/- 86.3 ms, p = 0.010) and pre-diabetic (T1 = 870.1+/- 91.7 ms, p < 0.010) patients. The PDFF was higher in diabetic (FF = 11.8+/- 8.7 %) than in non-diabetic (FF = 6.8+/- 4.2 %, p = 0.014) patients. CONCLUSION Pancreatic exocrine function, T1, and FF showed no correlation with HbA1c. Pancreatic T1 and fat fraction is increased in patients with Type 2 diabetes mellitus. ADVANCES IN KNOWLEDGE This study demonstrates unaffected exocrine function in pre-diabetes and diabetes and confirms that pancreatic parenchymal T1 and FF are increased in patients with diabetes.
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Affiliation(s)
- Kazuya Yasokawa
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Akihiko Kanki
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Hiroki Nakamura
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Hidemitsu Sotozono
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yu Ueda
- MR Clinical Science, Philips Japan, Tokyo, Japan
| | - Kiyoka Maeba
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Ayumu Kido
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Atsushi Higaki
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Minoru Hayashida
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Akira Yamamoto
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Tsutomu Tamada
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
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Altinmakas E, Bane O, Hectors SJ, Issa R, Carbonell G, Abboud G, Schiano TD, Thung S, Fischman A, Kelly MD, Friedman SL, Kennedy P, Taouli B. Performance of native and gadoxetate-enhanced liver and spleen T 1 mapping for noninvasive diagnosis of clinically significant portal hypertension: preliminary results. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:3758-3769. [PMID: 36085378 DOI: 10.1007/s00261-022-03645-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE In this preliminary study, our aim was to assess the utility of quantitative native-T1 (T1-pre), iron-corrected T1 (cT1) of the liver/spleen and T1 mapping of the liver obtained during hepatobiliary phase (T1-HBP) post-gadoxetate disodium, compared to spleen size/volume and APRI (aspartate aminotransferase-to-platelet ratio index) for noninvasive diagnosis of clinically significant portal hypertension [CSPH, defined as hepatic venous pressure gradient (HVPG) ≥ 10 mm Hg]. METHODS Forty-nine patients (M/F: 27/22, mean age 53y) with chronic liver disease, HVPG measurement and MRI were included. Breath-held T1 and cT1 measurements were obtained using an inversion recovery Look-Locker sequence and a T2* corrected modified Look-Locker sequence, respectively. Liver T1-pre (n = 49), spleen T1 (obtained pre-contrast, n = 47), liver and spleen cT1 (both obtained pre-contrast, n = 30), liver T1-HBP (obtained 20 min post gadoxetate disodium injection, n = 36) and liver T1 uptake (ΔT1, n = 36) were measured. Spleen size/volume and APRI were also obtained. Spearman correlation coefficients were used to assess the correlation between each of liver/spleen T1/cT1 parameters, spleen size/volume and APRI with HVPG. ROC analysis was performed to determine the performance of measured parameters for diagnosis of CSPH. RESULTS There were 12/49 (24%) patients with CSPH. Liver T1-pre (r = 0.287, p = 0.045), liver T1-HBP (r = 0.543, p = 0.001), liver ΔT1 (r = - 0.437, p = 0.008), spleen T1 (r = 0.311, p = 0.033) and APRI (r = 0.394, p = 0.005) were all significantly correlated with HVPG, while liver cT1, spleen cT1 and spleen size/volume were not. The highest AUCs for the diagnosis of CSPH were achieved with liver T1-HBP, liver ΔT1 and spleen T1: 0.881 (95%CI 0.76-1.0, p = 0.001), 0.852 (0.72-0.98, p = 0.002) and 0.781 (0.60-0.95, p = 0.004), respectively. CONCLUSION Our preliminary results demonstrate the potential of liver T1 mapping obtained during HBP post gadoxetate disodium for the diagnosis of CSPH. These results require further validation.
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Affiliation(s)
- Emre Altinmakas
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Koc University School of Medicine, Istanbul, Turkey
| | - Octavia Bane
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefanie J Hectors
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rayane Issa
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
| | - Guillermo Carbonell
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Virgen de La Arrixaca University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Ghadi Abboud
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Thomas D Schiano
- Icahn School of Medicine at Mount Sinai, Recanati/Miller Transplantation Institute, New York, NY, USA
| | - Swan Thung
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aaron Fischman
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
| | | | - Scott L Friedman
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul Kennedy
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bachir Taouli
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA. .,BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Wang F, Yang Q, Zhang Y, Liu J, Liu M, Zhu J. 3D variable flip angle T1 mapping for differentiating benign and malignant liver lesions at 3T: comparison with diffusion weighted imaging. BMC Med Imaging 2022; 22:146. [PMID: 35982406 PMCID: PMC9389795 DOI: 10.1186/s12880-022-00873-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Different methods have been used to improve the imaging diagnosis of focal liver lesions (FLL). Among them, magnetic resonance imaging (MRI) has received more attention since it provides significant amount of information without radiation exposure. However, atypical imaging characteristics of FLL on MRI may complicate the differential diagnosis between benign and malignant FLL. This study aimed to compare the diagnostic value of T1 mapping and diffusion-weighted imaging (DWI) for differentiating of benign and malignant FLLs. METHODS This retrospective study enrolled 294 FLLs, including 150 benign and 144 malignant lesions. Whole liver T1 mapping sequences were obtained before and 2 min after the administration of Gd-DTPA to acquire native T1 and enhanced T1 and ΔT1%. Additionally, DWI sequence was conducted to generate apparent diffusion coefficient (ADC) maps. These quantitative parameters were compared using one-way analysis of variance, and the diagnostic accuracy of T1 mapping and ADC for FLLs was calculated by area under the curve (AUC). RESULTS Significant differences were observed regarding the native T1, enhanced T1, ΔT1%, and ADC between benign and malignant FLLs. Furthermore, the sensitivity and specificity of the parameters are as follows: native T1 0.797/0.702 (cut off value 1635.5 ms); enhanced T1, 0.911/0.976 (cutoff value 339.2 ms); ΔT1%, 0.901/0.905 (cutoff value 70.8%); and ADC, 0.975/0.952 (cutoff value 1.21 × 10-3 mm2/s). The ideal cutoff values for native T1 and ADC in identifying cyst and haemangioma were 2422.9 ms (AUC 0.990, P < 0.01) and 2.077 × 10-3 mm2/s (AUC 0.949, P < 0.01), respectively, with a sensitivity and specificity of 0.963/1 and 0.852/0.892, respectively. ADC was significantly positively correlated with T1 and ΔT1%, and significantly negatively correlated with enhanced T1. CONCLUSION The 3D Variable flip angle T1 mapping technique with Gd-DTPA has a high clinical potential for identifying benign and malignant FLLs. The enhanced T1 and ΔT1% values have similar diagnostic accuracy compared with DWI in evaluating FLLs. Native T1 shows better performance than DWI in distinguishing benign liver lesions, specifically, cysts, and haemangioma.
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Affiliation(s)
- Fei Wang
- Department of Medical Imaging, Anqing Hospital Affiliated to Anhui Medical University, 352 Renmin Road, Anqing, 246000, China
| | - Qing Yang
- Department of Medical Imaging, Anqing Hospital Affiliated to Anhui Medical University, 352 Renmin Road, Anqing, 246000, China
| | - Yupei Zhang
- Department of Medical Imaging, Anqing Hospital Affiliated to Anhui Medical University, 352 Renmin Road, Anqing, 246000, China
| | - Jun Liu
- Department of Medical Imaging, Anqing Hospital Affiliated to Anhui Medical University, 352 Renmin Road, Anqing, 246000, China
| | - Mengxiao Liu
- Siemens Healthcare Ltd., Shanghai, 201318, China
| | - Juan Zhu
- Department of Medical Imaging, Anqing Hospital Affiliated to Anhui Medical University, 352 Renmin Road, Anqing, 246000, China.
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Li J, Cao B, Bi X, Chen W, Wang L, Du Z, Zhang X, Yu X. Evaluation of liver function in patients with chronic hepatitis B using Gd-EOB-DTPA-enhanced T1 mapping at different acquisition time points: a feasibility study. Radiol Med 2021; 126:1149-1158. [PMID: 34105102 DOI: 10.1007/s11547-021-01382-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 05/25/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE This study aimed to explore the impact of different acquisition times on the evaluation of liver function levels in chronic hepatitis B using Gd-EOB-DTPA-enhanced T1 positioning technology under 3.0 Tesla magnetic resonance imaging (MRI). METHODS A total of 146 patients with chronic hepatitis B (CHB) were classified into four groups as follows: chronic hepatitis B without liver cirrhosis (CH, 22 cases), liver cirrhosis with Child-Pugh classification A (LCA 63 cases), Child-Pugh B (LCB 47 cases) and Child-Pugh C (LCC 14 cases). Normal liver function (NLF) group was composed of 23 persons who had healthy liver and no medical histories of hepatitis. T1 mapping images were performed before and after administration of Gd-EOB-DPTA using Look-Locker sequence. Changes in T1 relaxation time (T1rt), the reduction rate of T1 relaxation time (ΔT1) and the increase in T1 relaxation rate (ΔR1) of liver over time (at 5, 10, 15 and 20 min) were investigated and compared among all five groups using a one-way analysis of variance (ANOVA). The Spearman's rank correlation coefficient (r) was used to show the correlations of these parameters in different liver function groups. RESULTS In the NLF, CH, LCA and LCB groups, postT1 gradually decreased, while the ΔT1 and ΔR1 gradually increased with time. The parameters were compared between different liver function levels at the same time point, and the differences were statistically significant except for NLF-CH, NLF-LCA and CH-LCA. There was no significant difference in the area under the ROC curve of other parameters at 10, 15 and 20 min. At each time point, no correlation was found between preT1rt and the degrees of liver function. PostT1rt was positively correlated with liver function classification, while ΔT1 and ΔR1 were negatively correlated with liver function classification. CONCLUSION Gd-EOB-DTPA-enhanced T1 mapping magnetic resonance imaging is beneficial to assess liver function. Using the Gd-EOB-DTPA to enhance T1 mapping imaging to assess liver function can shorten the observation time of the hepatobiliary period and 10 min after enhancement may be the best time point.
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Affiliation(s)
- Jiamin Li
- Department of Medical Imaging, Zhuhai People's Hospital, Zhuhai Hospital Affiliated With Jinan University, Zhuhai, 519000, Guangdong, People's Republic of China
| | - Boling Cao
- Department of Medical Imaging, Zhuhai People's Hospital, Zhuhai Hospital Affiliated With Jinan University, Zhuhai, 519000, Guangdong, People's Republic of China
| | - Xinjun Bi
- Department of Radiology, Affiliated Matern and Child Care Hospital of Nantong University, Nantong, 226000, Jiangsu, People's Republic of China
| | - Weipeng Chen
- Department of Medical Imaging, Zhuhai People's Hospital, Zhuhai Hospital Affiliated With Jinan University, Zhuhai, 519000, Guangdong, People's Republic of China
| | - Lanjing Wang
- Department of Medical Imaging, Zhuhai People's Hospital, Zhuhai Hospital Affiliated With Jinan University, Zhuhai, 519000, Guangdong, People's Republic of China
| | - Zhongli Du
- Department of Medical Imaging, Zhuhai People's Hospital, Zhuhai Hospital Affiliated With Jinan University, Zhuhai, 519000, Guangdong, People's Republic of China
| | - Xueqin Zhang
- Department of Radiology, Affiliated Nantong Hospital 3 of Nantong University, Nantong, 226000, Jiangsu, People's Republic of China.
| | - Xiangrong Yu
- Department of Medical Imaging, Zhuhai People's Hospital, Zhuhai Hospital Affiliated With Jinan University, Zhuhai, 519000, Guangdong, People's Republic of China.
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Waterton JC. Survey of water proton longitudinal relaxation in liver in vivo. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 34:779-789. [PMID: 33978944 PMCID: PMC8578172 DOI: 10.1007/s10334-021-00928-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/05/2021] [Accepted: 04/27/2021] [Indexed: 12/13/2022]
Abstract
Objective To determine the variability, and preferred values, for normal liver longitudinal water proton relaxation rate R1 in the published literature. Methods Values of mean R1 and between-subject variance were obtained from literature searching. Weighted means were fitted to a heuristic and to a model. Results After exclusions, 116 publications (143 studies) remained, representing apparently normal liver in 3392 humans, 99 mice and 249 rats. Seventeen field strengths were included between 0.04 T and 9.4 T. Older studies tended to report higher between-subject coefficients of variation (CoV), but for studies published since 1992, the median between-subject CoV was 7.4%, and in half of those studies, measured R1 deviated from model by 8.0% or less. Discussion The within-study between-subject CoV incorporates repeatability error and true between-subject variation. Between-study variation also incorporates between-population variation, together with bias from interactions between methodology and physiology. While quantitative relaxometry ultimately requires validation with phantoms and analysis of propagation of errors, this survey allows investigators to compare their own R1 and variability values with the range of existing literature. Supplementary Information The online version contains supplementary material available at 10.1007/s10334-021-00928-x.
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Affiliation(s)
- John Charles Waterton
- Centre for Imaging Sciences, Division of Informatics Imaging and Data Sciences, School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9PL, UK. .,Bioxydyn Ltd, Rutherford House, Manchester Science Park, Pencroft Way, Manchester, M15 6SZ, UK.
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Wang Q, Liu H, Zhu Z, Sheng Y, Du Y, Li Y, Liu J, Zhang J, Xing W. Feasibility of T1 mapping with histogram analysis for the diagnosis and staging of liver fibrosis: Preclinical results. Magn Reson Imaging 2020; 76:79-86. [PMID: 33242591 DOI: 10.1016/j.mri.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/10/2020] [Accepted: 11/14/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare the diagnostic accuracy of parameters derived from the histogram analysis of precontrast, 10-min hepatobiliary phase (HBP) and 20-min HBP T1 maps for staging liver fibrosis (LF). METHODS LF was induced in New Zealand white rabbits by subcutaneous injections of carbon tetrachloride for 4-16 weeks (n = 120), and 20 rabbits injected with saline served as controls. Precontrast, 10-min and 20-min HBP modified Look-Locker inversion recovery (MOLLI) T1 mapping was performed. Histogram analysis of T1 maps was performed, and the mean, median, skewness, kurtosis, entropy, inhomogeneity and 10th/25th/75th/90th percentiles of T1native, T110min and T120min were derived. Quantitative histogram parameters were compared. For significant parameters, further receiver operating characteristic (ROC) analyses were performed to evaluate the potential diagnostic performance in differentiating LF stages. RESULTS Finally, 17, 20, 21, 21 and 20 rabbits were included for the F0, F1, F2, F3, and F4 pathological grades of fibrosis, respectively. The mean/75th of T1native, entropy of T110min and entropy/mean/median/10th of T120min demonstrated a significant good correlation with the LF stage (|r| = 0.543-0.866, all P < 0.05). The 75th of T1native, entropy10min, and entropy20min were the three most reliable imaging markers in reflecting the stage of LF. The area under the ROC curve of entropy20min was larger than that of entropy10min (P < 0.05 for LF ≥ F2, ≥F3, and ≥ F4) and the 75th of T1native (P < 0.05 for LF ≥ F2 and ≥ F3) for staging LF. CONCLUSION Magnetic resonance histogram analysis of T1 maps, particularly the entropy derived from 20-min HBP T1 mapping, is promising for predicting the LF stage.
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Affiliation(s)
- Qing Wang
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China.
| | - HaiFeng Liu
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China
| | - ZuHui Zhu
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China
| | - Ye Sheng
- Department of Interventional Radiology, Third Affiliated Hospital of Soochow University & Changzhou First People's Hospital, Changzhou, Jiangsu 213200, China
| | - YaNan Du
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China
| | - YuFeng Li
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China
| | - JianHong Liu
- Department of Pathology, The Third People's Hospital of Changzhou, Changzhou, Jiangsu 213200, China
| | | | - Wei Xing
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou & Changzhou First People's Hospital, Jiangsu 213200, China.
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Quantification of liver function using gadoxetic acid-enhanced MRI. Abdom Radiol (NY) 2020; 45:3532-3544. [PMID: 33034671 PMCID: PMC7593310 DOI: 10.1007/s00261-020-02779-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/20/2020] [Accepted: 09/21/2020] [Indexed: 02/06/2023]
Abstract
The introduction of hepatobiliary contrast agents, most notably gadoxetic acid (GA), has expanded the role of MRI, allowing not only a morphologic but also a functional evaluation of the hepatobiliary system. The mechanism of uptake and excretion of gadoxetic acid via transporters, such as organic anion transporting polypeptides (OATP1,3), multidrug resistance-associated protein 2 (MRP2) and MRP3, has been elucidated in the literature. Furthermore, GA uptake can be estimated on either static images or on dynamic imaging, for example, the hepatic extraction fraction (HEF) and liver perfusion. GA-enhanced MRI has achieved an important role in evaluating morphology and function in chronic liver diseases (CLD), allowing to distinguish between the two subgroups of nonalcoholic fatty liver diseases (NAFLD), simple steatosis and nonalcoholic steatohepatitis (NASH), and help to stage fibrosis and cirrhosis, predict liver transplant graft survival, and preoperatively evaluate the risk of liver failure if major resection is planned. Finally, because of its noninvasive nature, GA-enhanced MRI can be used for long-term follow-up and post-treatment monitoring. This review article aims to describe the current role of GA-enhanced MRI in quantifying liver function in a variety of hepatobiliary disorders.
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Theilig D, Tsereteli A, Elkilany A, Raabe P, Lüdemann L, Malinowski M, Stockmann M, Pratschke J, Hamm B, Denecke T, Geisel D. Gd-EOB-DTPA-enhanced MRI T1 relaxometry as an imaging-based liver function test compared with 13C-methacetin breath test. Acta Radiol 2020; 61:291-301. [PMID: 31324131 DOI: 10.1177/0284185119861314] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) can be used as an imaging-based liver function test. This study aims to further corroborate its validity. Purpose To compare Gd-EOB-DTPA-enhanced MRI as an imaging-based liver function test with the 13C-methacetin breath test. Material and Methods Fifty-three patients who underwent Gd-EOB-DTPA-enhanced MRI T1 relaxometry before and 20 min after intravenous Gd-EOB-DTPA administration as well as a 13C-methacetin breath test (LiMAx test) were retrospectively analyzed. T1 relaxation times of liver parenchyma, total liver volume (TLV), and functional liver volume (FLV) were determined. Pearson correlations, multiple linear regression analysis, and receiver operating characteristic curve analysis were performed with indices derived from T1 relaxometry, liver volumetry, and laboratory parameters to identify the best predictor of liver function as determined by the LiMAx test. Results T1 reduction rate (T1 RR), T1 RR × TLV, T1 RR × FLV, and T1 relaxation time 20 min after intravenous Gd-EOB administration showed a statistically significant correlation with LiMAx and discriminatory capacity between patients with LiMAx of > and < 315 µg/kg/h. Of the indices investigated, T1 RR showed the best discriminatory capacity and proved to be the only statistically significant parameter in multiple linear regression analysis. Conclusion Gd-EOB-DTPA-enhanced MRI as an imaging-based liver function test also correlates with the LiMAx test which in turn reflects cytochrome P450 function. The T1 reduction rate of the liver on Gd-EOB-DTPA-enhanced MRI allows prediction of liver function as determined by the LiMAx test both for 1.5 and 3.0 T.
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Affiliation(s)
- Dorothea Theilig
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Berlin, Germany
| | - Ana Tsereteli
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Berlin, Germany
| | - Aboelyazid Elkilany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Berlin, Germany
| | - Philip Raabe
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Berlin, Germany
| | - Lutz Lüdemann
- Department of Medical Physics, Essen University Hospital, Essen, Germany
| | - Maciej Malinowski
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of General, Visceral and Transplantation Surgery, Berlin, Germany
| | - Martin Stockmann
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of General, Visceral and Transplantation Surgery, Berlin, Germany
| | - Johann Pratschke
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of General, Visceral and Transplantation Surgery, Berlin, Germany
| | - Bernd Hamm
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Berlin, Germany
| | - Timm Denecke
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Berlin, Germany
| | - Dominik Geisel
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Berlin, Germany
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Qin X, Yang T, Huang Z, Long L, Zhou Z, Li W, Gao Y, Wang M, Zhang X. Hepatocellular carcinoma grading and recurrence prediction using T 1 mapping on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging. Oncol Lett 2019; 18:2322-2329. [PMID: 31404322 PMCID: PMC6676719 DOI: 10.3892/ol.2019.10557] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 05/23/2019] [Indexed: 12/13/2022] Open
Abstract
The aim of the present study was to explore the value of T1 mapping on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for grading hepatocellular carcinoma (HCC) and predicting its recurrence rate. A retrospective study was performed that included 75 patients (66 men and 9 women; mean age, 52.89 years; age range, 23-79 years) with HCC who had undergone Gd-EOB-DTPA-enhanced MRI with T1 mapping before surgery. The T1 relaxation time of the 81 lesions and non-tumorous liver parenchyma in 75 patients with HCC were measured before Gd-EOB-DTPA was injected and then at 5, 10 and 20 min after administration, respectively. T1[lesion (L)-hepatic parenchyma (H)]/H (%) was calculated as the increment rate of the T1 value in the lesions relative to the non-tumorous liver parenchyma. One-way analysis of variance and Spearman's correlation analysis was used to compare the differences and relationship of T1 mapping values among the three grades of HCC. A total of 81 lesions were divided into well-differentiated HCC (grades I; n=21), moderately differentiated HCC (grades II; n=40) and poorly differentiated HCC (grades III; n=20) according to the histopathology. The T1(L-H)/H (%) value among grades I, II and III HCC on pre-contrast results and on post-contrast results at the 5-, 10- and 20-min hepatobiliary phase (HBP) were significantly different (P<0.05), and T1(L-H)/H (%) was correlated with the histological grade of HCC at each time point (r=0.637, r=0.554, r=0.499 and r=0.560, respectively, P<0.001). A total of 41 recurrence cases [grade I (n=5), grade II (n=23) and grade III (n=13)] were verified by imaging (CT, MRI or ultrasound) or reoperation. Patients with grade III and grade II HCC had higher recurrence rates compared with that in patients with grade I HCC (P<0.05; median recurrence times were 258 days, 605 days and undefined, respectively). According to the optimal cut-off point for the T1(L-H)/H (%) of the three grades of HCC, patients with HCC in the low T1(L-H)/H (%) value group (≤155.15%) had lower cumulative recurrence rates compared with that in the medium (T1(L-H)/H (%) >155.15% and T1(L-H)/H (%) ≤241.20%) and high (T1(L-H)/H (%) >241.20%) value groups at the 20-min HBP (P<0.05; median recurrence times were undefined, 530 days and 447 days, respectively). These results indicate that the parameters of T1 mapping would be beneficial for predicting the grading and recurrence of HCC.
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Affiliation(s)
- Xiali Qin
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Tengfei Yang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Zhongkui Huang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Liling Long
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Zhipeng Zhou
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Wenmei Li
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Yinjuan Gao
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Mengzhu Wang
- Department of Magnetic Resonance Scientific Marketing, Siemens Healthineers, Guangzhou, Guangdong 510620, P.R. China
| | - Xiaoyong Zhang
- Department of Magnetic Resonance Scientific Marketing, Siemens Healthineers, Guangzhou, Guangdong 510620, P.R. China
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T1 mapping for liver function evaluation in gadoxetic acid–enhanced MR imaging: comparison of look-locker inversion recovery and B1 inhomogeneity–corrected variable flip angle method. Eur Radiol 2019; 29:3584-3594. [DOI: 10.1007/s00330-018-5947-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 10/27/2018] [Accepted: 12/04/2018] [Indexed: 02/06/2023]
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Li J, Wan B, Liu S. Advances in Assessing Preoperative Liver Function with Gd-EOB-DTPA Dynamic Contrast Enhanced MRI. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ym.2019.31004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Noda Y, Goshima S, Tsuji Y, Kajita K, Kawada H, Kawai N, Tanahashi Y, Matsuo M. Correlation of quantitative pancreatic T 1 value and HbA1c value in subjects with normal and impaired glucose tolerance. J Magn Reson Imaging 2018; 49:711-718. [PMID: 30430688 DOI: 10.1002/jmri.26242] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Signal intensity on T1 -weighted images (T1 WI) is associated with pancreatic fibrosis and HbA1c levels. PURPOSE To evaluate the feasibility of the pancreatic T1 value for assessment of subjects with normal and impaired glucose tolerance (IGT). STUDY TYPE A prospective single-institution study. POPULATION In all, 95 consecutive patients with a known or suspected pancreatic disease. FIELD STRENGTH/SEQUENCES 3T/fast pancreatic T1 mapping using a modified Look-Locker sequence. ASSESSMENT Following the American Diabetes Association criteria, patients were classified into three groups, as follows: no-diabetes subject, HbA1c < 5.7%; prediabetes, 5.7% ≤ HbA1c < 6.5%; and type 2 diabetes mellitus (T2DM), HbA1c ≥ 6.5%. Pancreatic T1 value and signal intensity ratio (SIR = SIpancreas /SImuscle ) using T1 WI were compared with the HbA1c values. STATISTICAL TESTS Quantitative data were assessed with one-way analysis of variance, Fisher's and Mann-Whitney U tests, and receiver-operating characteristic analysis. RESULTS The pancreatic T1 value was significantly longer in T2DM than in no-diabetes and prediabetes subjects (P < 0.05) and was significantly longer in prediabetes than in no-diabetes subjects (P < 0.05). The mean pancreatic T1 value was significantly lower in the low-value group (HbA1c < 5.7%) (906.3 msec) compared with the high-value group (HbA1c ≥ 6.5%) (993.8 msec) (P < 0.0001). SIR on T1 WI was significantly higher in the low-value group compared with the high-value group (P = 0.029). The sensitivities, specificities, and area under the receiver-operating characteristic curve (AUCs) for differentiating the low- and high-value groups were 74.1%, 83.8%, and 0.82 in the pancreatic T1 values and 77.8%, 54.4%, and 0.63 in SIR on T1 WI, respectively. The specificity (P < 0.0001) and AUC (P = 0.0020) were significantly higher in the pancreatic T1 values than in SIR on T1 WI. DATA CONCLUSION Pancreatic T1 value has the potential of being an imaging biomarker for the assessment of IGT. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:711-718.
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Affiliation(s)
| | | | - Yusuke Tsuji
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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