Assessment of liver function by gadoxetic acid avidity in MRI in a model of rapid liver regeneration in rats

Jan Heil; Mark Augath; Vartan Kurtcuoglu; Joachim Hohmann; Wolf O Bechstein; Pim Olthof; Andreas A Schnitzbauer; Petra Seebeck; Marc Schiesser; Martin Schläpfer; Beatrice Beck-Schimmer; Erik Schadde

doi:10.1016/j.hpb.2023.12.007

Assessment of liver function by gadoxetic acid avidity in MRI in a model of rapid liver regeneration in rats

HPB (Oxford). 2024 Apr;26(4):521-529. doi: 10.1016/j.hpb.2023.12.007. Epub 2023 Dec 21.

Authors

Affiliations

¹ Institute of Physiology, University of Zurich, Zurich, Switzerland; Goethe University Frankfurt, University Hospital, Department of General, Visceral, Transplant and Thoracic Surgery, Germany.
² Institute for Biomedical Engineering, ETH Zurich, Zurich, Switzerland.
³ The Interface Group, Institute of Physiology, University of Zurich, Zurich, Switzerland.
⁴ Department of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, Winterthur, Switzerland; Medical Faculty, University of Basel, Basel, Switzerland.
⁵ Goethe University Frankfurt, University Hospital, Department of General, Visceral, Transplant and Thoracic Surgery, Germany.
⁶ Department of Surgery, Erasmus MC, Rotterdam, the Netherlands; Department of Surgery, Amsterdam UMC, Amsterdam, the Netherlands.
⁷ Zurich Integrative Rodent Physiology (ZIRP), University of Zurich, Zurich, Switzerland.
⁸ Chirurgisches Zentrum Zürich (CZZ), Klinik Hirslanden Zurich, Zurich, Switzerland; Chirurgie Zentrum Zentralschweiz (CZZ) Hirslanden St. Anna, Lucerne, Switzerland.
⁹ Institute of Physiology, University of Zurich, Zurich, Switzerland; Institute of Anesthesiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
¹⁰ Institute of Physiology, University of Zurich, Zurich, Switzerland; Chirurgisches Zentrum Zürich (CZZ), Klinik Hirslanden Zurich, Zurich, Switzerland; Chirurgie Zentrum Zentralschweiz (CZZ) Hirslanden St. Anna, Lucerne, Switzerland; Department of Surgery, Rush University Medical Center Chicago, IL, USA. Electronic address: erik.schadde@icloud.com.

PMID: 38185541
DOI: 10.1016/j.hpb.2023.12.007

Abstract

Background: This animal study investigates the hypothesis of an immature liver growth following ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) by measuring liver volume and function using gadoxetic acid avidity in magnetic resonance imaging (MRI) in models of ALPPS, major liver resection (LR) and portal vein ligation (PVL).

Methods: Wistar rats were randomly allocated to ALPPS, LR or PVL. In contrast-enhanced MRI scans with gadoxetic acid (Primovist®), liver volume and function of the right median lobe (=future liver remnant, FLR) and the deportalized lobes (DPL) were assessed until post-operative day (POD) 5. Liver function_FLR/DPL was defined as the inverse value of time from injection of gadoxetic acid to the blood pool-corrected maximum signal intensity_FLR/DPL multiplied by the volume_FLR/DPL.

Results: In ALPPS (n = 6), LR (n = 6) and PVL (n = 6), volume_FLR and function_FLR increased proportionally, except on POD 1. Thereafter, function_FLR exceeded volume_FLR increase in LR and ALPPS, but not in PVL. Total liver function was significantly reduced after LR until POD 3, but never undercuts 60% of its pre-operative value following ALPPS and PVL.

Discussion: This study shows for the first time that functional increase is proportional to volume increase in ALPPS using gadoxetic acid avidity in MRI.

MeSH terms

Animals
Gadolinium DTPA*
Hepatectomy / methods
Ligation / methods
Liver / blood supply
Liver / diagnostic imaging
Liver / surgery
Liver Neoplasms* / surgery
Liver Regeneration*
Magnetic Resonance Imaging
Portal Vein / diagnostic imaging
Portal Vein / pathology
Portal Vein / surgery
Rats
Rats, Wistar

Substances

gadolinium ethoxybenzyl DTPA
Gadolinium DTPA