A new formula to calculate the resection limit in hepatectomy based on Gd-EOB-DTPA-enhanced magnetic resonance imaging.
Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular
/ diagnostic imaging
Contrast Media
Female
Gadolinium DTPA
Hepatectomy
/ methods
Humans
Image Enhancement
Liver
/ diagnostic imaging
Liver Cirrhosis
/ diagnostic imaging
Liver Neoplasms
/ diagnostic imaging
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Reproducibility of Results
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
01
09
2018
accepted:
26
12
2018
entrez:
26
1
2019
pubmed:
27
1
2019
medline:
19
11
2019
Statut:
epublish
Résumé
Dynamic magnetic resonance imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (EOB-MRI) can be used not only to detect liver tumors but also to estimate liver function. The aim of this study was to establish a new EOB-MRI-based formula to determine the resection limit in patients undergoing hepatectomy. Twenty-eight patients with a normal liver (NL group) and five with an unresectable cirrhotic liver (UL group) who underwent EOB-MRI were included. Standardized liver function (SLF) was calculated based on the signal intensity (SI), the volume of each subsegment (S1-S8), and body surface area. A formula defining the resection limit was devised based on the difference in the SLF values of patients in the NL and UL groups. The formula was validated in 50 patients who underwent EOB-MRI and hepatectomy. The average SLF value in the NL and UL groups was 2038 and 962 FV/m2, respectively. The difference (1076 FV/m2) was consistent with a 70% in resection volume. Thus, the resection limit for hepatectomy was calculated as a proportion of 70%: 70×(SLF-962)/1076 (%). The one patient who underwent hepatectomy over the resection limit died due to liver failure. In other 49 patients, in whom the resection volume was less than the resection limit, procedures were safely performed. Our formula for resection limit based on EOB-MRI can improve the safety of hepatectomy.
Sections du résumé
BACKGROUND AND AIM
Dynamic magnetic resonance imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (EOB-MRI) can be used not only to detect liver tumors but also to estimate liver function. The aim of this study was to establish a new EOB-MRI-based formula to determine the resection limit in patients undergoing hepatectomy.
METHODS
Twenty-eight patients with a normal liver (NL group) and five with an unresectable cirrhotic liver (UL group) who underwent EOB-MRI were included. Standardized liver function (SLF) was calculated based on the signal intensity (SI), the volume of each subsegment (S1-S8), and body surface area. A formula defining the resection limit was devised based on the difference in the SLF values of patients in the NL and UL groups. The formula was validated in 50 patients who underwent EOB-MRI and hepatectomy.
RESULTS
The average SLF value in the NL and UL groups was 2038 and 962 FV/m2, respectively. The difference (1076 FV/m2) was consistent with a 70% in resection volume. Thus, the resection limit for hepatectomy was calculated as a proportion of 70%: 70×(SLF-962)/1076 (%). The one patient who underwent hepatectomy over the resection limit died due to liver failure. In other 49 patients, in whom the resection volume was less than the resection limit, procedures were safely performed.
CONCLUSIONS
Our formula for resection limit based on EOB-MRI can improve the safety of hepatectomy.
Identifiants
pubmed: 30682046
doi: 10.1371/journal.pone.0210579
pii: PONE-D-18-25705
pmc: PMC6347147
doi:
Substances chimiques
Contrast Media
0
gadolinium ethoxybenzyl DTPA
0
Gadolinium DTPA
K2I13DR72L
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0210579Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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