Evaluation of gadolinium-EOB-DTPA Uptake After Portal Vein Embolization: Value of an Increased Flip Angle

Acta Radiol. 2014 Mar;55(2):149-54. doi: 10.1177/0284185113495833. Epub 2013 Aug 1.

Abstract

Background: The optimal sequence for Gd-EOB-DTPA uptake measurement in the liver with the purpose of liver function measurement is still not defined.

Purpose: To prospectively evaluate the effect of an increased flip angle (FA) of a T1-weighted fat-saturated 3D sequence for the measurement of hepatocyte uptake of Gd-EOB-DTPA magnetic resonance imaging (MRI) after right portal vein embolization (PVE).

Material and methods: Ten patients who received a PVE prior to an extended hemihepatectomy were examined 14 days after PVE using Gd-EOB-DTPA enhanced MRI of the liver using the standard FA of 10° and the increased FA of 30°.

Results: Relative enhancement of the right liver lobe (RLL) was 0.52 ± 0.12 for 10° and 1.41 ± 0.39 for 30°. Relative enhancement of the left liver lobe (LLL) was 0.58 ± 0.11 for 10° and 2.05 ± 0.61 for 30°. Relative enhancement of the RLL was significantly higher for 30° than for 10° (P = 0.009) and significantly higher in the 30° than in the 10° sequences (P = 0.005) for the LLL.

Conclusion: A flip angle of 30° increases the contrast between liver partitions with and without portal venous embolization. Thereby, the sensitivity for differences in uptake intensity is increased. This could be of value for a more exact determination of differences in regional liver function and, consequently, the estimation of the future remnant liver function.

Keywords: Gd-EOB-DTPA; MRI; flip angle; liver function; portal vein embolization.

MeSH terms

  • Adult
  • Aged
  • Cholangiocarcinoma / diagnosis*
  • Cholangiocarcinoma / therapy
  • Contrast Media / pharmacokinetics*
  • Embolization, Therapeutic*
  • Female
  • Gadolinium DTPA / pharmacokinetics*
  • Hepatectomy
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / therapy
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Portal Vein
  • Prospective Studies
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA