Efficacy of a combination of gadolinium?ethoxybenzyl?diethylenetriamine pentaacetic acid enhanced MR T1 mapping and liver volume to standard liver volume ratio for estimation of liver function / 中华放射学杂志

ObjectiveTo investigate the feasibility of a combination of gadolinium?ethoxybenzyl?diethylenetriamine pentaacetic acid (Gd?EOB?DTPA) enhanced MR T1 mapping and liver volume to standard liver volume ratio in quantitative assessment of liver function. Methods Eighty patients who underwent Gd?EOB?DTPA enhanced MR T1 mapping were prospectively enrolled, and the Child?Pugh score and the model for end?stage liver (MELD) score were evaluated and grouped. Patients were divided into three groups according Child?pugh score as follows: normal liver function (NLF, n=26), liver cirrhosis with Child?Pugh A (LCA,n=30), liver cirrhosis with Child?Pugh B+C (LCB+LCC, n=24), and were also divided into two groups according MELD, MELD≤8 (n=57) and MELD≥9 (n=23). Variable flip angle T1 mapping sequences were performed before and 20 minutes after Gd?EOB?DTPA administration. T1pre, T1 post were measured on T1 maps and ΔT1 were calculated. The images of hepatobiliary phase were transferred to the workstation to measure liver volume (LV). Standard liver volume (SLV) were calculated with the heights and weights of patients, and then liver volume to standard liver volume ratio (LV/SLV) was calculated. One?way ANOVA was used to compared the indexes (T1 post, T1 post×LV/SLV, ΔT1, ΔT1×LV/SLV) in different liver function groups of NLF,LCA,LCB+LCC. The t tests were used to compare the indexes(T1post, T1post×LV/SLV, ΔT1, ΔT1×LV/SLV) in MELD≤8 and MELD≥9 groups. ROC curve analysis was used to compare the diagnostic performance of T1post, T1post×LV/SLV, ΔT1, ΔT1×LV/SLV. Results T1post, T1post×LV/SLV, ΔT1, ΔT1×LV/SLV showed significant difference between different liver function groups (P<0.05). All the indexes can distinguish different groups. Multiplied by LV/SLV,the AUC of ΔT1×LV/SLV were 0.902 in the MELD≤8 and MELD≥9,which was slightly higher than that of ΔT1 (AUC=0.886). The AUCs of ΔT1×LV/SLV were 0.771, 1.000, 0.924 in the NLF and LCA, NLF and LCB+LCC, LCA and LCB+LCC groups, which were slightly higher than that of ΔT1 (0.764, 0.992, 0.904). The AUCs of T1post, T1post×LV/SLV were 0.824, 0.789 in the MELD≤8 and MELD≥9, respectively. The AUCs of T1post in the NLF and LCA, NLF and LCB+LCC, LCA and LCB+LCC groups were 0.713,0.987,0.915, respectively, and the AUCs of T1post×LV/SLV were 0.687,0.973,0.871.The AUCs of T1post×LV/SLV had a slightly lower AUC amongthe different liver function groups than T1post. Conclusion Gd?EOB?DTPA enhanced MRI T1 mapping is useful for estimating liver function. T1 relaxation times and reduction rates of T1 relaxation times with a combination of the LV/SLV may more reliably estimate liver function.

Efficacy of a combination of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced MR T1 mapping and liver volume to standard liver volume ratio for estimation of liver function / 中华放射学杂志

Objective@#To investigate the feasibility of a combination of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MR T1 mapping and liver volume to standard liver volume ratio in quantitative assessment of liver function.@*Methods@#Eighty patients who underwent Gd-EOB-DTPA enhanced MR T1 mapping were prospectively enrolled, and the Child-Pugh score and the model for end-stage liver (MELD) score were evaluated and grouped. Patients were divided into three groups according Child-pugh score as follows: normal liver function (NLF, n=26), liver cirrhosis with Child-Pugh A (LCA,n=30), liver cirrhosis with Child-Pugh B+C (LCB+LCC, n=24), and were also divided into two groups according MELD, MELD≤8 (n=57) and MELD≥9 (n=23). Variable flip angle T1 mapping sequences were performed before and 20 minutes after Gd-EOB-DTPA administration. T1pre, T1 post were measured on T1 maps and ΔT1 were calculated. The images of hepatobiliary phase were transferred to the workstation to measure liver volume (LV). Standard liver volume (SLV) were calculated with the heights and weights of patients, and then liver volume to standard liver volume ratio (LV/SLV) was calculated. One-way ANOVA was used to compared the indexes (T1post, T1 post×LV/SLV, ΔT1, ΔT1×LV/SLV) in different liver function groups of NLF,LCA,LCB+LCC. The t tests were used to compare the indexes (T1post, T1post×LV/SLV, ΔT1, ΔT1×LV/SLV) in MELD≤8 and MELD≥9 groups. ROC curve analysis was used to compare the diagnostic performance of T1post, T1post×LV/SLV, ΔT1, ΔT1×LV/SLV.@*Results@#T1post, T1post×LV/SLV, ΔT1, ΔT1×LV/SLV showed significant difference between different liver function groups (P<0.05). All the indexes can distinguish different groups. Multiplied by LV/SLV,the AUC of ΔT1×LV/SLV were 0.902 in the MELD≤8 and MELD≥9,which was slightly higher than that of ΔT1 (AUC=0.886). The AUCs of ΔT1×LV/SLV were 0.771, 1.000, 0.924 in the NLF and LCA, NLF and LCB+LCC, LCA and LCB+LCC groups, which were slightly higher than that of ΔT1 (0.764, 0.992, 0.904). The AUCs of T1post, T1post×LV/SLV were 0.824, 0.789 in the MELD≤8 and MELD≥9, respectively. The AUCs of T1post in the NLF and LCA, NLF and LCB+LCC, LCA and LCB+LCC groups were 0.713,0.987,0.915, respectively, and the AUCs of T1post×LV/SLV were 0.687,0.973,0.871.The AUCs of T1post×LV/SLV had a slightly lower AUC amongthe different liver function groups than T1post.@*Conclusion@#Gd-EOB-DTPA enhanced MRI T1 mapping is useful for estimating liver function. T1 relaxation times and reduction rates of T1 relaxation times with a combination of the LV/SLV may more reliably estimate liver function.

Estimation of Standard Liver Volume Using CT Volume, Body Composition, and Abdominal Geometry Measurements

PURPOSE: The present study developed formulas for estimation of standard liver volume (SLV) with high accuracy for the Korean population. MATERIALS AND METHODS: SLV estimation formulas were established using gender-balanced and gender-unbalanced measurements of anthropometric variables, body composition variables, and abdominal geometry of healthy Koreans (n=790). Total liver volume excluding blood volume, was measured based on CT volumetry. RESULTS: SLV estimation formulas as preferred in various conditions of data availability were suggested in the present study. The suggested SLV estimation formulas in the present study were found superior to existing formulas, with an increased accuracy of 4.0–217.5 mL for absolute error and 0.2–18.7% for percentage of absolute error. CONCLUSION: SLV estimation formulas using gender-balanced measurements showed better performance than those using gender-unbalanced measurements. Inclusion of body composition and abdominal geometry variables contributed to improved performance of SLV estimation.

Calculation of standard liver volume in Korean adults with analysis of confounding variables

BACKGROUNDS/AIMS: Standard liver volume (SLV) is an important parameter that has been used as a reference value to estimate the graft matching in living donor liver transplantation (LDLT). This study aimed to determine a reliable SLV formula for Korean adult patients as compared with the 15 SLV formulae from other studies and further estimate SLV formula by gender and body mass index (BMI). METHODS: Computed tomography liver volumetry was performed in 1,000 living donors for LDLT and regression formulae for SLV was calculated. Individual donor data were applied to the 15 previously published SLV formulae, as compared with the SLV formula derived in this study. Analysis for confounding variables of BMI and gender was also performed. RESULTS: Two formulae, "SLV (ml)=908.204xBSA-464.728" with DuBois body surface area (BSA) formula and "SLV (ml)=893.485xBSA-439.169" with Monsteller BSA formula, were derived by using the profiles of the 1,000 living donors included in the study. Comparison with other 15 other formulae, all except for Chouker formula showed the mean volume percentage errors of 4.8-5.4%. The gender showed no significant effect on total liver volume (TLV), but there was a significant increase in TLV as BMI increased. CONCLUSIONS: Our study suggested that most SLV formulae showed a crudely applicable range of SLV estimation for Korean adults. Considering the volume error in estimating SLV, further SLV studies with larger population from multiple centers should be performed to enhance its predictability. Our results suggested that classifying SLV formulae by BMI and gender is unnecessary.

Evaluation of standard liver volume formulas by right liver living donor liver transplantation / 中华普通外科杂志

Objective To evaluate the suitability of reported standard liver volume formulae for Chinese adults based on the practice of 216 cases of living donor liver transplantation in our transplantation center. Methods The graft volume was preoperatively estimated in 179 adult-to-adult right liver living donors by two methods: first, the radiological right liver volume by computed tomography (CT) and second,calculated graft volume obtained by reported standard liver volume formula and the percentage of the right liver volume ( given by CT). Both results were compared to the actual graft volume measured during surgery.Results The mean percentage of right liver volume was 55.4% (SD 5.41%). The results of Urata、Heinemann、Vauthey、 Lee、 Yoshizumi formula were significantly larger than the actual right liver volume (P ＜0. 01 ). The result of Sheung-tat Fan was less than the actual right liver volume, there was statistical ESLV =334. 024 + 11. 508 × BW, is most suitable to estimate adult Chinese donor's right liver volume.