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    Child-Pugh Classification using Magnetic Resonance Imaging using Gadoxetic Acid-based Contrast Agent Compared with Indocyanine Green and 99mTc-galactosyl-human Serum Albumin Liver Scintigraphy
    (Gunma University, 2019-08-01) ;
    Takahito Nakajima
    ;
    Kei Shibuya
    ;
    Suman Shrestha
    ;
    Hiromi Hirasawa
    This study evaluated liver function using gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) to improve assessment of patients with liver tumors compared to Child-Pugh classification (CPC). Materials and methods: The liver function of 59 patients was assessed to determine the indication for heavy ion therapy. Clinical and laboratory assessments, including 99mTc-GSA liver scintigraphy and indocyanine green retention index (ICGR15), were performed for liver function assessment. EOB-MRI was performed on T1W1 images both before and after Gd-EOB-DTPA administration and hepatobiliary phase images were acquired 20-min post-injection. Liver parenchymal enhancement ratio (LER) was measured based on liver-to-spleen (L/Sp) ratios calculating the average liver intensity divided by spleen intensity. Results: The mean LER values on MRI were 138.2±12.8 (133.9-142.5), 115.7±11.6 (110.0-121.5), and 93.2±15.8 (73.6-112.9) in CPC-A, -B and -C, respectively. From the correlation between the LER on MRI and ICGR15 and parameters of 99mTc-GSA liver scintigraphy, LER on MRI was highly significantly correlated with ICGR15 (r=-0.67; p<0.0001). Discussion: This study demonstrated that LER values on EOB-MRI could classify liver function and had high correlation with CPC and ICGR15.