Clinical Impact of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging on Living Donor Liver Transplant.

Abstract

BACKGROUND:

Gadolinium-ethoxybenzyl-diethylene triamine pentaacetic acid (Gd-EOB-DTPA) is a newer magnetic resonance contrast that has the combined effect of conventional and liver-specific contrast. The use of Gd-EOB-DTPA may aid in management of patients with hepatocellular carcinoma (HCC) undergoing living donor liver transplant (LDLT).

MATERIALS AND METHODS:

We retrospectively reviewed all HCC patients who received LDLT with Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) as part of a pretransplant evaluation between October 2012 and October 2016. The detection rate and impact on decision making were assessed between multidetector-row computed tomography (MDCT) and Gd-EOB-DTPA-enhanced MRI with pathology of the explanted liver being the reference standard.

RESULTS:

We analyzed 25 patients with 80 nodules. Gd-EOB-DTPA-enhanced MRI showed superior detection rate for HCCs than MDCT (76.1% vs 35.8%). Among the 25 patients, 16 had additional HCCs detected by Gd-EOB-DTPA-enhanced MRI, which led to changes in therapeutic decisions in 11 patients. The recurrence rate and mortality rate were 4% (1 of 25). In the same period in our institution, the mortality rate was 13.9% (25 of 180) for those who did not receive Gd-EOB-DTPA-enhanced MRI as part of the pretransplant evaluation.

CONCLUSIONS:

The use of Gd-EOB-DTPA-enhanced MRI can aid in characterization of indeterminate nodules and detect more HCCs and thus more adequate downstaging and pretransplant neoadjuvant treatment ensue, which may lower the recurrence rate after LDLT.

• Authors: Yueh-Sheng Chen, Wei-Xiong Lim, An-Ni Lin, Chao-Long Chen, Leung-Chit Leo Tsang, Chun-Yen Yu, Hsien-Wen Hsu, Yi-Hsuan Chuang, Yu-Fan Cheng, Hsin-You Ou
• Journal: Transplantation proceedings (Transplant Proc) Vol. 54 Issue 2 Pg. 386-390 (Mar 2022) ISSN: 1873-2623 [Electronic] United States
• PMID: 35022135 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Chemical References

• Contrast Media
• gadolinium ethoxybenzyl DTPA
• Gadolinium DTPA

Topics

• Carcinoma, Hepatocellular (diagnostic imaging, surgery)
• Contrast Media
• Gadolinium DTPA
• Humans
• Liver Neoplasms (diagnostic imaging, surgery)
• Liver Transplantation
• Living Donors
• Magnetic Resonance Imaging (methods)
• Retrospective Studies