Skip to main content

Advertisement

SpringerLink
Log in

Imaging-based evaluation of liver function: comparison of 99mTc-mebrofenin hepatobiliary scintigraphy and Gd-EOB-DTPA-enhanced MRI

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To compare Gd-EOB-enhanced MRI and 99mTc-mebrofenin hepatobiliary scintigraphy (HBS) as imaging-based liver function tests for separate evaluation of right (RLL) and left liver lobe (LLL) function.

Methods

Fourteen patients underwent Gd-EOB-enhanced MRI and 99mTc-mebrofenin HBS after portal vein embolization within 24 h. Relative enhancement (RE) and hepatic uptake index (HUI) were determined from MRI; and T max, T 1/2 and mebrofenin uptake were determined from HBS, all values separately for RLL and LLL.

Results

Mebrofenin uptake correlated significantly with HUI and RE for both liver lobes. There was strong correlation of mebrofenin uptake with HUI for RLL (r 2 = 0.802, p = 0.001) and RE for LLL (r 2 = 0.704, p = 0.005) and moderate correlation with HUI for LLL (r 2 = 0.560, p = 0.037) and RE for RLL (r 2 = 0.620, p = 0.018). Correlating the percentage share of RLL function derived from MRI (with HUI) with the percentage of RLL function derived from mebrofenin uptake revealed a strong correlation (r 2 = 0.775, p = 0.002).

Conclusions

Both RE and HUI correlate with mebrofenin uptake in HBS. The results suggest that Gd-EOB-enhanced MRI and 99mTc-mebrofenin HBS may equally be used to separately determine right and left liver lobe function.

Key points

• Information about liver function can be acquired with routine Gd-EOB-MRI.

• Gd-EOB-MRI and 99m Tc-mebrofenin HBS show elevated function of non-embolized lobe.

• Gd-EOB-MRI and 99m Tc-mebrofenin HBS can determine lobar liver function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

FRL:

future remnant liver

Gd-EOB-DTPA:

gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid

HBS:

hepatobiliary scintigraphy

HUI:

hepatic uptake index

ICG:

indocyanine green

LLL:

left liver lobe

PVE:

portal vein embolization

RE:

relative enhancement

RLL:

right liver lobe

ROI:

region of interest

SI:

signal intensity

VIBE:

volume interpolated breath-hold examination

References

  1. Manizate F, Hiotis SP, Labow D, Roayaie S, Schwartz M (2010) Liver functional reserve estimation: state of the art and relevance for local treatments: the Western perspective. J Hepatobiliary Pancreatol Sci 4:385–388

    Article  Google Scholar 

  2. de Graaf W, van Lienden KP, van Gulik TM, Bennink RJ (2010) (99m)Tc-mebrofenin hepatobiliary scintigraphy with SPECT for the assessment of hepatic function and liver functional volume before partial hepatectomy. J Nucl Med 2:229–236

    Article  Google Scholar 

  3. Saito K, Ledsam J, Sourbron S et al (2012) Assessing liver function using dynamic Gd-EOB-DTPA-enhanced MRI with a standard 5-phase imaging protocol. J Magn Reson Imaging 37:1109–1114

    Article  PubMed  Google Scholar 

  4. Nilsson H, Nordell A, Vargas R, Douglas L, Jonas E, Blomqvist L (2009) Assessment of hepatic extraction fraction and input relative blood flow using dynamic hepatocyte-specific contrast-enhanced MRI. J Magn Reson Imaging 6:1323–1331

    Article  Google Scholar 

  5. de Graaf W, van Lienden KP, van den Esschert JW, Bennink RJ, van Gulik TM (2011) Increase in future remnant liver function after preoperative portal vein embolization. Br J Surg 6:825–834

    Article  Google Scholar 

  6. Erdogan D, Heijnen BH, Bennink RJ et al (2004) Preoperative assessment of liver function: a comparison of 99mTc-mebrofenin scintigraphy with indocyanine green clearance test. Liver Int 2:117–123

    Article  Google Scholar 

  7. Yamada A, Hara T, Li F et al (2011) Quantitative evaluation of liver function with use of gadoxetate disodium-enhanced MR imaging. Radiology 3:727–733

    Article  Google Scholar 

  8. Geisel D, Lüdemann L, Keuchel T et al (2013) Increase in left liver lobe function after preoperative right portal vein embolisation assessed with gadolinium-EOB-DTPA MRI. Eur Radiol 9:2555–2560

    Article  Google Scholar 

  9. Neuhaus P, Thelen A, Jonas S et al (2012) Oncological superiority of hilar en bloc resection for the treatment of hilar cholangiocarcinoma. Ann Surg Oncol 5:1602–1608

    Article  Google Scholar 

  10. Klatskin G (1965) Adenocarcinoma of the hepatic duct at its bifurcation within the porta hepatis: an unusual tumor with distinctive clinical and pathological features. Am J Med 2:241–256

    Article  Google Scholar 

  11. Neuhaus P, Jonas S, Bechstein WO et al (1999) Extended resections for hilar cholangiocarcinoma. Ann Surg 6:808–818, discussion 819

    Article  Google Scholar 

  12. Dinant S, Gerhards MF, Rauws EAJ, Busch ORC, Gouma DJ, van Gulik TM (2006) Improved outcome of resection of hilar cholangiocarcinoma (Klatskin tumor). Ann Surg Oncol 6:872–880

    Article  Google Scholar 

  13. Agrawal S, Belghiti J (2011) Oncologic resection for malignant tumors of the liver. Ann Surg 4:656

    Article  Google Scholar 

  14. Jonas S, Benckert C, Thelen A, Lopez-Hänninen E, Rösch T, Neuhaus P (2008) Radical surgery for hilar cholangiocarcinoma. Eur J Surg Oncol 3:263

    Article  Google Scholar 

  15. Ekman M, Fjälling M, Holmberg S, Person H (1992) IODIDA clearance rate: a method for measuring hepatocyte uptake function. Transplant Proc 1:387–388

    Google Scholar 

  16. Ekman M, Fjälling M, Friman S, Carlson S, Volkmann R (1996) Liver uptake function measured by IODIDA clearance rate in liver transplant patients and healthy volunteers. Nucl Med Commun 3:235–242

    Article  Google Scholar 

  17. de Graaf W, Bennink RJ, Veteläinen R, van Gulik TM (2010) Nuclear imaging techniques for the assessment of hepatic function in liver surgery and transplantation. J Nucl Med 5:742–752

    Article  Google Scholar 

  18. Bennink RJ, Dinant S, Erdogan D et al (2004) Preoperative assessment of postoperative remnant liver function using hepatobiliary scintigraphy. J Nucl Med 6:965–971

    Google Scholar 

  19. de Graaf W, Bennink RJ, Heger M, Maas A, de Bruin K, van Gulik TM (2011) Quantitative assessment of hepatic function during liver regeneration in a standardized rat model. J Nucl Med 2:294–302

    Article  Google Scholar 

  20. Nilsson H, Blomqvist L, Douglas L, Nordell A, Jonas E (2010) Assessment of liver function in primary biliary cirrhosis using Gd-EOB-DTPA-enhanced liver MRI. HPB (Oxford) 8:567–576

    Article  Google Scholar 

  21. Shimizu J, Dono K, Gotoh M et al (1999) Evaluation of regional liver function by gadolinium-EOB-DTPA-enhanced MR imaging. Dig Dis Sci 7:1330–1337

    Article  Google Scholar 

  22. Geisel D, Lüdemann L, Wagner C et al (2013) Evaluation of gadolinium-EOB-DTPA uptake after portal vein embolization: value of an increased flip angle. Acta Radiol 55(2):149–154

    Article  PubMed  Google Scholar 

  23. Gschwend S, Ebert W, Schultze-Mosgau M, Breuer J (2011) Pharmacokinetics and imaging properties of Gd-EOB-DTPA in patients with hepatic and renal impairment. Invest Radiol 9:556–566

    Article  Google Scholar 

  24. Bennink RJ, Tulchinsky M, de Graaf W, Kadry Z, van Gulik TM (2012) Liver function testing with nuclear medicine techniques is coming of age. Semin Nucl Med 2:124–137

    Article  Google Scholar 

  25. Kim HJ, Kim BS, Kim MJ et al (2012) Enhancement of the liver and pancreas in the hepatic arterial dominant phase: comparison of hepatocyte-specific MRI contrast agents, gadoxetic acid and gadobenate dimeglumine, on 3 and 1.5 tesla MRI in the same patient. J Magn Reson Imaging. doi:10.1002/jmri.23874

    Google Scholar 

  26. Wang H, Cao Y (2012) Correction of arterial input function in dynamic contrast-enhanced MRI of the liver. J Magn Reson Imaging 2:411–421

    Article  Google Scholar 

  27. Kim T, Murakami T, Hasuike Y et al (1997) Experimental hepatic dysfunction: evaluation by MRI with Gd-EOB-DTPA. J Magn Reson Imaging 4:683–688

    Article  Google Scholar 

  28. Nishie A, Asayama Y, Ishigami K et al (2012) MR prediction of liver fibrosis using a liver-specific contrast agent: superparamagnetic iron oxide versus Gd-EOB-DTPA. J Magn Reson Imaging 3:664–671

    Article  Google Scholar 

  29. Morris-Stiff G, Gomez D, Prasad R (2009) Quantitative assessment of hepatic function and its relevance to the liver surgeon. J Gastrointest Surg 2:374–385

    Article  Google Scholar 

  30. Tajima T, Takao H, Akai H et al (2010) Relationship between liver function and liver signal intensity in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging. J Comput Assist Tomogr 3:362–366

    Article  Google Scholar 

  31. Norén B, Forsgren MF, Dahlqvist Leinhard O et al (2012) Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA. Eur Radiol 23:174–181

    Article  PubMed  Google Scholar 

  32. Dahlqvist Leinhard O, Dahlström N, Kihlberg J et al (2012) Quantifying differences in hepatic uptake of the liver specific contrast agents Gd-EOB-DTPA and Gd-BOPTA: a pilot study. Eur Radiol 3:642–653

    Article  Google Scholar 

  33. Verloh N, Haimerl M, Zeman F et al (2014) Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla. Eur Radiol 24:1013–1019

    Article  CAS  PubMed  Google Scholar 

  34. Yoneyama T, Fukukura Y, Kamimura K et al (2014) Efficacy of liver parenchymal enhancement and liver volume to standard liver volume ratio on Gd-EOB-DTPA-enhanced MRI for estimation of liver function. Eur Radiol 4:857–865

    Article  Google Scholar 

  35. Kukuk GM, Schaefer SG, Fimmers R et al (2014) Hepatobiliary magnetic resonance imaging in patients with liver disease: correlation of liver enhancement with biochemical liver function tests. Eur Radiol 10:2482–2490

    Article  Google Scholar 

  36. Geisel D, Lüdemann L, Gebauer B et al (2014) Optimized separation of left and right liver lobe in dynamic (99m)Tc-mebrofenin hepatobiliary scintigraphy using a hybrid SPECT-CT scanner. Ann Nucl Med 28:897–902

    Article  CAS  PubMed  Google Scholar 

  37. Ringe KI, Husarik DB, Sirlin CB, Merkle EM (2010) Gadoxetate disodium-enhanced MRI of the liver: part 1, protocol optimization and lesion appearance in the noncirrhotic liver. AJR Am J Roentgenol 1:13–28

    Article  Google Scholar 

  38. Cruite I, Schroeder M, Merkle EM, Sirlin CB (2010) Gadoxetate disodium-enhanced MRI of the liver: part 2, protocol optimization and lesion appearance in the cirrhotic liver. AJR Am J Roentgenol 1:29–41

    Article  Google Scholar 

  39. Michaely HJ, Morelli JN, Budjan J et al (2013) CAIPIRINHA-Dixon-TWIST (CDT)-volume-interpolated breath-hold examination (VIBE): a new technique for fast time-resolved dynamic 3-dimensional imaging of the abdomen with high spatial resolution. Invest Radiol 8:590–597

    Article  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Dominik Geisel. The authors of this manuscript declare relationships with the following companies: Bayer AG. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Dominik Geisel, Vera Fröling, Bernhard Gebauer & Timm Denecke

  2. Department of Nuclear Medicine, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Vera Fröling, Vikas Prasad & Timm Denecke

  3. Department of Medical Physics, Essen University Hospital, Hufelandstraße 55, 45147, Essen, Germany

    Lutz Lüdemann

  4. Department of General, Visceral and Thoracic Surgery, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Maciej Malinowski, Martin Stockmann, Annekathrin Baron & Daniel Seehofer

Authors
  1. Dominik Geisel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lutz Lüdemann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vera Fröling
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maciej Malinowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Martin Stockmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Annekathrin Baron
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bernhard Gebauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Daniel Seehofer
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Vikas Prasad
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Timm Denecke
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dominik Geisel.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Geisel, D., Lüdemann, L., Fröling, V. et al. Imaging-based evaluation of liver function: comparison of 99mTc-mebrofenin hepatobiliary scintigraphy and Gd-EOB-DTPA-enhanced MRI. Eur Radiol 25, 1384–1391 (2015). https://doi.org/10.1007/s00330-014-3536-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-014-3536-8

Keywords

Search

Navigation