Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany.
General Surgery, Otto Von Guericke University, Magdeburg, Germany.
Eur Radiol Exp. 2024 Jan 29;8(1):15. doi: 10.1186/s41747-023-00409-x.
To compare Gd-ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and Tc-labelled mebrofenin hepatobiliary scintigraphy (HBS) as imaging-based liver function tests after unilateral radioembolisation (RE) in patients with primary or secondary liver malignancies.
Twenty-three patients with primary or secondary liver malignancies who underwent Gd-EOB-DTPA-enhanced MRI within a prospective study (REVoluTion) were evaluated. REVoluTion was a prospective open-label, non-randomised, therapy-optimising study of patients undergoing right-sided or sequential RE for contralateral liver hypertrophy at a single centre in Germany. MRI and hepatobiliary scintigraphy were performed before RE (baseline) and 6 weeks after (follow-up). This exploratory subanalysis compared liver enhancement on hepatobiliary phase MRI normalised to the spleen (liver-to-spleen ratio (LSR)) and the muscle (liver-to-muscle ratio (LMR)) with mebrofenin uptake on HBS for the total liver (TL) and separately for the right (RLL) and left liver lobe (LLL).
Mebrofenin uptake at baseline and follow-up each correlated significantly with LSR and LMR on MRI for TL (≤ 0.013) and RLL (≤ 0.049). Regarding the LLL, mebrofenin uptake correlated significantly with LMR (baseline, p = 0.013; follow-up, p = 0.004), whereas with LSR, a borderline significant correlation was only seen at follow-up (p = 0.051; p = 0.046).
LSRs and LMR correlate with mebrofenin uptake in HBS. This study indicates that Gd-EOB-DTPA-enhanced MRI and Tc-labelled mebrofenin HBS may equally be used to assess an increase in contralateral liver lobe function after right-sided RE.
MRI may be a convenient and reliable method for assessing the future liver remnant facilitating treatment planning and monitoring of patients after RE-induced hypertrophy induction.
• Both MRI and HBS can assess liver function after RE. • Liver enhancement on MRI correlates with mebrofenin uptake on HBS. • MRI might be a convenient alternative for estimating future liver remnants after hypertrophy induction.
比较钆塞酸二乙三胺五乙酸（Gd-EOB-DTPA）增强磁共振成像（MRI）和 Tc 标记美罗芬尼肝胆闪烁显像（HBS）作为原发性或继发性肝癌单侧放射性栓塞（RE）后基于成像的肝功能测试。
对在一项前瞻性研究（REVoluTion）中接受 Gd-EOB-DTPA 增强 MRI 检查的 23 例原发性或继发性肝癌患者进行评估。REVoluTion 是德国一家中心进行的一项前瞻性开放标签、非随机、治疗优化的研究，对右侧或序贯 RE 进行的患者进行研究，以治疗对侧肝肥大。MRI 和肝胆闪烁显像在 RE 前（基线）和 6 周后（随访）进行。这项探索性亚分析比较了 MRI 肝胆期肝增强与脾脏（肝脾比（LSR））和肌肉（肝肌比（LMR））与 HBS 中美罗芬尼摄取的总肝（TL）以及右（RLL）和左肝叶（LLL）的关系。
美罗芬尼摄取在基线和随访时均与 MRI 上 TL（≤0.013）和 RLL（≤0.049）的 LSR 和 LMR 显著相关。对于 LLL，美罗芬尼摄取与 LMR 显著相关（基线，p=0.013；随访，p=0.004），而与 LSR 仅在随访时存在边缘显著相关性（p=0.051；p=0.046）。
LSRs 和 LMR 与 HBS 中美罗芬尼摄取相关。这项研究表明，Gd-EOB-DTPA 增强 MRI 和 Tc 标记美罗芬尼 HBS 可同样用于评估右侧 RE 后对侧肝叶功能的增加。
MRI 可能是一种方便可靠的方法，可用于评估剩余肝体积，为 RE 诱导肝肥大后的治疗计划和监测提供便利。
• MRI 和 HBS 均可评估 RE 后的肝功能。• MRI 上的肝增强与 HBS 中的美罗芬尼摄取相关。• MRI 可能是诱导肥大后估计剩余肝的一种方便替代方法。
