Chenxi Liu1,2, Yan Sun3,4, Yao Yang1,2, Yuemin Feng1,2, Xiaoyu Xie1,2, Lingyu Qi1,2, Keke Liu5, Ximing Wang3,4, Qiang Zhu1,2, Xinya Zhao6,7. 1. Department of Gastroenterology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong province, China. 2. Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong province, China. 3. Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Province, 324#, Jing 5 Rd, Ji'nan, 250021, Shandong Province, China. 4. Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong province, China. 5. Shandong Academy of Clinical Medicine, Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong province, China. 6. Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Province, 324#, Jing 5 Rd, Ji'nan, 250021, Shandong Province, China. zhaoxinya2000@126.com. 7. Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong province, China. zhaoxinya2000@126.com.
Abstract
OBJECTIVES: To determine the value of gadobenate dimeglumine (Gd-BOPTA)-enhanced biliary imaging from the hepatobiliary phase in predicting hepatic decompensation and insufficiency for patients with cirrhosis. METHODS: This single-center retrospective study included 270 patients who underwent Gd-BOPTA-enhanced magnetic resonance imaging. The relative enhancement ratios of the biliary system (REB) and liver parenchyma (REL) in patients with normal liver function without underlying chronic liver disease and three groups of patients with Child-Pugh A, Child-Pugh B, and Child-Pugh C disease were measured. After a mean follow-up of 38.5 ± 22.5 months, prognostic factors were evaluated using the Cox proportional hazards regression model. Receiver operating characteristic (ROC) curve analyses were performed to assess the capacity of the REB and REL to predict the development of hepatic decompensation and insufficiency. RESULTS: During the follow-up period, nine of 79 patients with Child-Pugh A disease developed hepatic decompensation. The REB was a significant predictive factor (hazard ratio (HR) = 0.40 (0.19-0.84); p = 0.016), but the REL showed no association with hepatic decompensation. Moreover, the areas under the ROC curves (AUCs) were 0.83 and 0.52 for the REB and REL, respectively. Thirty-eight of 207 patients with cirrhosis developed hepatic insufficiency. The REB was a significant predictive factor (HR = 0.24 (0.13-0.46); p < 0.0001), but the REL did not show statistically significant association with hepatic insufficiency. The AUCs were 0.82 and 0.57 for the REB and REL, respectively. CONCLUSIONS: Gd-BOPTA-enhanced biliary imaging from the hepatobiliary phase was valuable in predicting hepatic decompensation and insufficiency for cirrhotic patients. KEY POINTS: • Gd-BOPTA-enhanced biliary imaging was a significant predictive factor for hepatic decompensation in patients with cirrhosis. • Gd-BOPTA-enhanced biliary imaging was a significant predictive factor for hepatic insufficiency in patients with cirrhosis. • Gd-BOPTA-enhanced biliary imaging showed superior predictive values for adverse clinical outcomes compared to liver parenchymal imaging at the hepatobiliary phase.
OBJECTIVES: To determine the value of gadobenate dimeglumine (Gd-BOPTA)-enhanced biliary imaging from the hepatobiliary phase in predicting hepatic decompensation and insufficiency for patients with cirrhosis. METHODS: This single-center retrospective study included 270 patients who underwent Gd-BOPTA-enhanced magnetic resonance imaging. The relative enhancement ratios of the biliary system (REB) and liver parenchyma (REL) in patients with normal liver function without underlying chronic liver disease and three groups of patients with Child-Pugh A, Child-Pugh B, and Child-Pugh C disease were measured. After a mean follow-up of 38.5 ± 22.5 months, prognostic factors were evaluated using the Cox proportional hazards regression model. Receiver operating characteristic (ROC) curve analyses were performed to assess the capacity of the REB and REL to predict the development of hepatic decompensation and insufficiency. RESULTS: During the follow-up period, nine of 79 patients with Child-Pugh A disease developed hepatic decompensation. The REB was a significant predictive factor (hazard ratio (HR) = 0.40 (0.19-0.84); p = 0.016), but the REL showed no association with hepatic decompensation. Moreover, the areas under the ROC curves (AUCs) were 0.83 and 0.52 for the REB and REL, respectively. Thirty-eight of 207 patients with cirrhosis developed hepatic insufficiency. The REB was a significant predictive factor (HR = 0.24 (0.13-0.46); p < 0.0001), but the REL did not show statistically significant association with hepatic insufficiency. The AUCs were 0.82 and 0.57 for the REB and REL, respectively. CONCLUSIONS:Gd-BOPTA-enhanced biliary imaging from the hepatobiliary phase was valuable in predicting hepatic decompensation and insufficiency for cirrhotic patients. KEY POINTS: • Gd-BOPTA-enhanced biliary imaging was a significant predictive factor for hepatic decompensation in patients with cirrhosis. • Gd-BOPTA-enhanced biliary imaging was a significant predictive factor for hepatic insufficiency in patients with cirrhosis. • Gd-BOPTA-enhanced biliary imaging showed superior predictive values for adverse clinical outcomes compared to liver parenchymal imaging at the hepatobiliary phase.
Authors: Beom Kyung Kim; Hyon-Suk Kim; Eun Jin Yoo; Eun Ji Oh; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Kwang-Hyub Han; Seung Up Kim; Young Nyun Park Journal: Hepatology Date: 2014-12 Impact factor: 17.425
Authors: Gennaro D'Amico; Alberto Morabito; Mario D'Amico; Linda Pasta; Giuseppe Malizia; Paola Rebora; Maria Grazia Valsecchi Journal: J Hepatol Date: 2017-10-27 Impact factor: 25.083
Authors: Siddharth Singh; Larissa L Fujii; Mohammad Hassan Murad; Zhen Wang; Sumeet K Asrani; Richard L Ehman; Patrick S Kamath; Jayant A Talwalkar Journal: Clin Gastroenterol Hepatol Date: 2013-08-15 Impact factor: 11.382
Authors: William M C Rosenberg; Michael Voelker; Robert Thiel; Michael Becka; Alastair Burt; Detlef Schuppan; Stefan Hubscher; Tania Roskams; Massimo Pinzani; Michael J P Arthur Journal: Gastroenterology Date: 2004-12 Impact factor: 22.682
Authors: Sisi Zhang; Lei Huo; Juan Zhang; Yayuan Feng; Yiping Liu; Yuxian Wu; Ningyang Jia; Wanmin Liu Journal: Front Oncol Date: 2022-08-30 Impact factor: 5.738