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Oecal, Osman; Peynircioglu, Bora; Loewe, Christian; Delden, Otto van; Vandecaveye, Vincent; Gebauer, Bernhard; Zech, Christoph J.; Sengel, Christian; Bargellini, Irene; Iezzi, Roberto; Benito, Alberto; Schutte, Kerstin; Gasbarrini, Antonio; Seidensticker, Ricarda; Wildgruber, Moritz; Pech, Maciej; Malfertheiner, Peter; Ricke, Jens und Seidensticker, Max (2021): Correlation of liver enhancement in gadoxetic acid-enhanced MRI with liver functions: a multicenter-multivendor analysis of hepatocellular carcinoma patients from SORAMIC trial. In: European Radiology, Bd. 32, Nr. 2: S. 1320-1329

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Abstract

Objectives To evaluate the correlation between liver enhancement on hepatobiliary phase and liver function parameters in a multicenter, multivendor study. Methods A total of 359 patients who underwent gadoxetic acid-enhanced MRI using a standardized protocol with various scanners within a prospective multicenter phase II trial (SORAMIC) were evaluated. The correlation between liver enhancement on hepatobiliary phase normalized to the spleen (liver-to-spleen ratio, LSR) and biochemical laboratory parameters, clinical findings related to liver functions, liver function grading systems (Child-Pugh and Albumin-Bilirubin [ALBI]), and scanner characteristics were analyzed using uni- and multivariate analyses. Results There was a significant positive correlation between LSR and albumin (rho = 0.193;p < 0.001), platelet counts (rho = 0.148;p = 0.004), and sodium (rho = 0.161;p = 0.002);and a negative correlation between LSR and total bilirubin (rho = -0.215;p < 0.001) and AST (rho = -0.191;p < 0.001). Multivariate analysis confirmed independent significance for each of albumin (p = 0.022), total bilirubin (p = 0.045), AST (p = 0.031), platelet counts (p = 0.012), and sodium (p = 0.006). The presence of ascites (1.47 vs. 1.69, p < 0.001) and varices (1.55 vs. 1.69, p = 0.006) was related to significantly lower LSR. Similarly, patients with ALBI grade 1 had significantly higher LSR than patients with grade 2 (1.74 +/- 0.447 vs. 1.56 +/- 0.408, p < 0.001);and Child-Pugh A patients had a significantly higher LSR than Child-Pugh B (1.67 +/- 0.44 vs. 1.49 +/- 0.33, p = 0.021). Also, LSR was negatively correlated with MELD-Na scores (rho = -0.137;p = 0.013). However, one scanner brand was significantly associated with lower LSR (p < 0.001). Conclusions The liver enhancement on the hepatobiliary phase of gadoxetic acid-enhanced MRI is correlated with biomarkers of liver functions in a multicenter cohort. However, this correlation shows variations between scanner brands.

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