Measurement of regional liver function with dynamic gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging

Background: Assessing regional liver function is crucial in patients scheduled for liver resection to support risk assessment and anticipate post-hepatectomy liver failure [PHLF].The aim of the work: This study aimed to determine the utility of gadoxetic acid-enhanced MRI as a non-invasive, imaging-based method for evaluating regional liver function.Patients and Methods: In this retrospective analysis, 36 patients who underwent serial gadoxetic acid-enhanced MRI scans were included. Imaging was performed prior to and after portal vein embolization [PVE], as well as following extended right hemihepatectomy. Signal intensity [SI] and relative enhancement [RE] during the hepatobiliary phase were measured to determine the most reliable indicator of regional hepatic function.Results: A notable reduction in relative enhancement of the right liver lobe [RLL] was observed 14 days [RE = 0.49, P < 0.005] and 28 days post-PVE [RE = 0.50, P = 0.005], compared to pre-PVE levels [RE = 0.64]. Conversely, the left liver lobe [LLL] exhibited a significant increase in RE 28 days post-PVE [RE = 0.70] compared to baseline [RE = 0.62, P = 0.040]. Pearson correlation analysis demonstrated a significant positive relationship between LiMAx values and RE in the RLL before PVE [r = 0.452, P < 0.05], as well as in the LLL both pre-PVE [r = 0.399, P < 0.05] and postoperatively [r = 0.488, P < 0.05].Conclusion: Gadoxetic acid-enhanced MRI offers a reliable, imaging-based approach to assess regional liver function and can effectively estimate the functional reserve of hepatic segments.