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Development and validation of a predictor of insufficient enhancement during the hepatobiliary phase of Gd-EOB-DTPA-enhanced magnetic resonance imaging.

Authors
  • Cui, Enming1, 2, 3
  • Long, Wansheng1, 3
  • Luo, Liangping1, 2
  • Hu, Maoqing3
  • Huang, Liebin3
  • Chen, Xiangmeng3
  • 1 1 Jinan University, Guangzhou, Guangdong, PR China. , (China)
  • 2 2 Department of Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, PR China. , (China)
  • 3 3 Department of Radiology, Jiangmen Central Hospital, Jiangmen, Guangdong, PR China. , (China)
Type
Published Article
Journal
Acta radiologica (Stockholm, Sweden : 1987)
Publication Date
Oct 01, 2017
Volume
58
Issue
10
Pages
1174–1181
Identifiers
DOI: 10.1177/0284185116687170
PMID: 28090793
Source
Medline
Keywords
License
Unknown

Abstract

Background Insufficient enhancement of liver parenchyma negatively affects diagnostic accuracy of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI). Currently, there is no reliable method for predicting insufficient enhancement during the hepatobiliary phase (HBP) in Gd-EOB-DTPA-enhanced MRI. Purpose To develop a predictor for insufficient enhancement of liver parenchyma during HBP in Gd-EOB-DTPA-enhanced MRI. Material and Methods In order to formulate a HBP enhancement test (HBP-ET), clinical factors associated with relative enhancement ratio (RER) of liver parenchyma were retrospectively determined from the datasets of 156 patients (Development group) who underwent Gd-EOB-DTPA-enhanced MRI between November 2012 and May 2015. The independent clinical factors were identified by Pearson's correlation and multiple stepwise regression analysis; the performance of HBP-ET was compared to Child-Pugh score (CPS), Model for End-stage Liver Disease score (MELD), and total bilirubin (TBIL) using receiver operating characteristic (ROC) curve analysis. The datasets of 52 patients (Validation group), which were examined between June 2015 and Oct 2015, were applied to validate the HBP-ET. Results Six biochemical parameters independently influenced RER and were used to develop HBP-ET. The mean HBP-ET score of patients with insufficient enhancement was significantly higher than that of patients with sufficient enhancement ( P < 0.001) in both the Development and Validation groups. HBP-ET (area under the curve [AUC] = 0.895) had better performance in predicting insufficient enhancement than CPS (AUC = 0.707), MELD (AUC = 0.798), and TBIL (AUC = 0.729). Conclusion The HBP-ET is more accurate than routine indicators in predicting insufficient enhancement during HBP, which is valuable to aid clinical decisions.

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