Hepatobiliary phase in cirrhotic patients with different Model for End-stage Liver Disease score: comparison of the performance of gadoxetic acid to gadobenate dimeglumine

Federica Vernuccio, Giuseppe Brancatelli, Angelo Vanzulli, Bruno Tuscano, Claudia Khouri Chalouhi, Piergiorgio Duca, Francesca Rini

Risultato della ricerca: Article

1 Citazione (Scopus)

Abstract

Objectives: The purpose of this study was to compare the performance of gadobenate dimeglumine–enhanced MRI and gadoxetic acid–enhanced MRI in the hepatobiliary phase (HBP) in cirrhotic patients with different degrees of liver dysfunction. Methods: In this retrospective cross-sectional study, we analyzed the unenhanced phase and the HBP of 131 gadobenate dimeglumine–enhanced MRI examinations (gadobenate dimeglumine group) and 127 gadoxetic acid–enhanced MRI examinations (gadoxetic acid group) performed in 249 cirrhotic patients (181 men and 68 women; mean age, 64.8 years) from August 2011 to April 2017. For each MRI, the contrast enhancement index of the liver parenchyma was calculated and correlated to the Model For End-Stage Liver Disease (MELD) score (multiple linear regression analysis). A qualitative analysis of the adequacy of the HBP, adjusted for the MELD score (logistic regression analysis), was performed. Results: The contrast enhancement index was inversely related (r = − 0.013) with MELD score in both gadoxetic acid and gadobenate dimeglumine group. At the same MELD score, the contrast enhancement index in the gadoxetic acid group was increased by a factor of 0.23 compared to the gadobenate dimeglumine group (p < 0.001), and the mean odds ratio to have an adequate HBP with gadoxetic acid compared to gadobenate dimeglumine was 3.64 (p < 0.001). The adequacy of the HBP in the gadoxetic acid group compared to the gadobenate dimeglumine group increased with the increase of the MELD score (exp(b)interaction = 1.233; p = 0.011). Conclusion: In cirrhotic patients, the hepatobiliary phase obtained with gadoxetic acid–enhanced MRI is of better quality in comparison to gadobenate dimeglumine–enhanced MRI, mainly in patients with high MELD score. Key Points: • In cirrhotic patients, the adequacy of the hepatobiliary phase with gadoxetic acid–enhanced MRI is better compared to gadobenate dimeglumine–enhanced MRI. • Gadoxetic acid–enhanced MRI should be preferred to gadobenate dimeglumine–enhanced MRI in cirrhotic patients with MELD score > 10, if the hepatobiliary phase is clinically indicated. • In patients with high MELD score (> 15), the administration of the hepatobiliary agent could be useless; even though, if it is clinically indicated, we recommend to use gadoxetic acid given the higher probability of obtaining clinically relevant information.
Lingua originaleEnglish
pagine (da-a)3090-3099
Numero di pagine10
RivistaEuropean Radiology
Volume29
Stato di pubblicazionePublished - 2019

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End Stage Liver Disease
Regression Analysis
gadolinium ethoxybenzyl DTPA
gadobenic acid
Liver Diseases
Linear Models
Cross-Sectional Studies
Logistic Models
Odds Ratio
Liver

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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Hepatobiliary phase in cirrhotic patients with different Model for End-stage Liver Disease score: comparison of the performance of gadoxetic acid to gadobenate dimeglumine. / Vernuccio, Federica; Brancatelli, Giuseppe; Vanzulli, Angelo; Tuscano, Bruno; Khouri Chalouhi, Claudia; Duca, Piergiorgio; Rini, Francesca.

In: European Radiology, Vol. 29, 2019, pag. 3090-3099.

Risultato della ricerca: Article

@article{b7a25ab1873c45ca8b3a43699adf5624,
title = "Hepatobiliary phase in cirrhotic patients with different Model for End-stage Liver Disease score: comparison of the performance of gadoxetic acid to gadobenate dimeglumine",
abstract = "Objectives: The purpose of this study was to compare the performance of gadobenate dimeglumine–enhanced MRI and gadoxetic acid–enhanced MRI in the hepatobiliary phase (HBP) in cirrhotic patients with different degrees of liver dysfunction. Methods: In this retrospective cross-sectional study, we analyzed the unenhanced phase and the HBP of 131 gadobenate dimeglumine–enhanced MRI examinations (gadobenate dimeglumine group) and 127 gadoxetic acid–enhanced MRI examinations (gadoxetic acid group) performed in 249 cirrhotic patients (181 men and 68 women; mean age, 64.8&nbsp;years) from August 2011 to April 2017. For each MRI, the contrast enhancement index of the liver parenchyma was calculated and correlated to the Model For End-Stage Liver Disease (MELD) score (multiple linear regression analysis). A qualitative analysis of the adequacy of the HBP, adjusted for the MELD score (logistic regression analysis), was performed. Results: The contrast enhancement index was inversely related (r = − 0.013) with MELD score in both gadoxetic acid and gadobenate dimeglumine group. At the same MELD score, the contrast enhancement index in the gadoxetic acid group was increased by a factor of&nbsp;0.23 compared to the gadobenate dimeglumine group (p < 0.001), and the mean odds ratio to have an adequate HBP with gadoxetic acid compared to gadobenate dimeglumine was 3.64 (p < 0.001). The adequacy of the HBP in the gadoxetic acid group compared to the gadobenate dimeglumine group increased with the increase of the MELD score (exp(b)interaction = 1.233; p = 0.011). Conclusion: In cirrhotic patients, the hepatobiliary phase obtained with gadoxetic acid–enhanced MRI is of better quality in comparison to gadobenate dimeglumine–enhanced MRI, mainly in patients with high MELD score. Key Points: • In cirrhotic patients, the adequacy of the hepatobiliary phase with gadoxetic acid–enhanced MRI is better compared to gadobenate dimeglumine–enhanced MRI. • Gadoxetic acid–enhanced MRI should be preferred to gadobenate dimeglumine–enhanced MRI in cirrhotic patients with MELD score > 10, if the hepatobiliary phase is clinically indicated. • In patients with high MELD score (> 15), the administration of the hepatobiliary agent could be useless; even though, if it is clinically indicated, we recommend to use gadoxetic acid given the higher probability of obtaining clinically relevant information.",
author = "Federica Vernuccio and Giuseppe Brancatelli and Angelo Vanzulli and Bruno Tuscano and {Khouri Chalouhi}, Claudia and Piergiorgio Duca and Francesca Rini",
year = "2019",
language = "English",
volume = "29",
pages = "3090--3099",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Hepatobiliary phase in cirrhotic patients with different Model for End-stage Liver Disease score: comparison of the performance of gadoxetic acid to gadobenate dimeglumine

AU - Vernuccio, Federica

AU - Brancatelli, Giuseppe

AU - Vanzulli, Angelo

AU - Tuscano, Bruno

AU - Khouri Chalouhi, Claudia

AU - Duca, Piergiorgio

AU - Rini, Francesca

PY - 2019

Y1 - 2019

N2 - Objectives: The purpose of this study was to compare the performance of gadobenate dimeglumine–enhanced MRI and gadoxetic acid–enhanced MRI in the hepatobiliary phase (HBP) in cirrhotic patients with different degrees of liver dysfunction. Methods: In this retrospective cross-sectional study, we analyzed the unenhanced phase and the HBP of 131 gadobenate dimeglumine–enhanced MRI examinations (gadobenate dimeglumine group) and 127 gadoxetic acid–enhanced MRI examinations (gadoxetic acid group) performed in 249 cirrhotic patients (181 men and 68 women; mean age, 64.8&nbsp;years) from August 2011 to April 2017. For each MRI, the contrast enhancement index of the liver parenchyma was calculated and correlated to the Model For End-Stage Liver Disease (MELD) score (multiple linear regression analysis). A qualitative analysis of the adequacy of the HBP, adjusted for the MELD score (logistic regression analysis), was performed. Results: The contrast enhancement index was inversely related (r = − 0.013) with MELD score in both gadoxetic acid and gadobenate dimeglumine group. At the same MELD score, the contrast enhancement index in the gadoxetic acid group was increased by a factor of&nbsp;0.23 compared to the gadobenate dimeglumine group (p < 0.001), and the mean odds ratio to have an adequate HBP with gadoxetic acid compared to gadobenate dimeglumine was 3.64 (p < 0.001). The adequacy of the HBP in the gadoxetic acid group compared to the gadobenate dimeglumine group increased with the increase of the MELD score (exp(b)interaction = 1.233; p = 0.011). Conclusion: In cirrhotic patients, the hepatobiliary phase obtained with gadoxetic acid–enhanced MRI is of better quality in comparison to gadobenate dimeglumine–enhanced MRI, mainly in patients with high MELD score. Key Points: • In cirrhotic patients, the adequacy of the hepatobiliary phase with gadoxetic acid–enhanced MRI is better compared to gadobenate dimeglumine–enhanced MRI. • Gadoxetic acid–enhanced MRI should be preferred to gadobenate dimeglumine–enhanced MRI in cirrhotic patients with MELD score > 10, if the hepatobiliary phase is clinically indicated. • In patients with high MELD score (> 15), the administration of the hepatobiliary agent could be useless; even though, if it is clinically indicated, we recommend to use gadoxetic acid given the higher probability of obtaining clinically relevant information.

AB - Objectives: The purpose of this study was to compare the performance of gadobenate dimeglumine–enhanced MRI and gadoxetic acid–enhanced MRI in the hepatobiliary phase (HBP) in cirrhotic patients with different degrees of liver dysfunction. Methods: In this retrospective cross-sectional study, we analyzed the unenhanced phase and the HBP of 131 gadobenate dimeglumine–enhanced MRI examinations (gadobenate dimeglumine group) and 127 gadoxetic acid–enhanced MRI examinations (gadoxetic acid group) performed in 249 cirrhotic patients (181 men and 68 women; mean age, 64.8&nbsp;years) from August 2011 to April 2017. For each MRI, the contrast enhancement index of the liver parenchyma was calculated and correlated to the Model For End-Stage Liver Disease (MELD) score (multiple linear regression analysis). A qualitative analysis of the adequacy of the HBP, adjusted for the MELD score (logistic regression analysis), was performed. Results: The contrast enhancement index was inversely related (r = − 0.013) with MELD score in both gadoxetic acid and gadobenate dimeglumine group. At the same MELD score, the contrast enhancement index in the gadoxetic acid group was increased by a factor of&nbsp;0.23 compared to the gadobenate dimeglumine group (p < 0.001), and the mean odds ratio to have an adequate HBP with gadoxetic acid compared to gadobenate dimeglumine was 3.64 (p < 0.001). The adequacy of the HBP in the gadoxetic acid group compared to the gadobenate dimeglumine group increased with the increase of the MELD score (exp(b)interaction = 1.233; p = 0.011). Conclusion: In cirrhotic patients, the hepatobiliary phase obtained with gadoxetic acid–enhanced MRI is of better quality in comparison to gadobenate dimeglumine–enhanced MRI, mainly in patients with high MELD score. Key Points: • In cirrhotic patients, the adequacy of the hepatobiliary phase with gadoxetic acid–enhanced MRI is better compared to gadobenate dimeglumine–enhanced MRI. • Gadoxetic acid–enhanced MRI should be preferred to gadobenate dimeglumine–enhanced MRI in cirrhotic patients with MELD score > 10, if the hepatobiliary phase is clinically indicated. • In patients with high MELD score (> 15), the administration of the hepatobiliary agent could be useless; even though, if it is clinically indicated, we recommend to use gadoxetic acid given the higher probability of obtaining clinically relevant information.

UR - http://hdl.handle.net/10447/366862

UR - http://www.link.springer.de/link/service/journals/00330/index.htm

M3 - Article

VL - 29

SP - 3090

EP - 3099

JO - European Radiology

JF - European Radiology

SN - 0938-7994

ER -