Stefanie Hectors¹, Mathilde Wagner¹, Octavia Bane¹, Aaron Fischman², Thomas Schiano³, and Bachir Taouli^1,4
1Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ²Department of Interventional Radiology, Icahn School of Medicine at Mount SInai, New York, NY, United States, ³Department of Internal Medicine, Icahn School of Medicine at Mount SInai, New York, NY, United States, ⁴Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States

The goal of this study was to assess whether DCE-MRI parameters and MR elastography-derived stiffness in liver and spleen can predict portal pressure. Liver time-to-peak (TTP), mean transit time (MTT), upslope and stiffness (LS) all significantly correlated with hepatic venous pressure gradient (HVPG) measurement. Sensitivity-specificity of LS for detection of HVPG≥5mmHg and HVPG≥10mmHg were 64%-91% and 71%-89% respectively, while combined LS and spleen TTP yielded the highest sensitivity-specificity (92%-86% for HVPG≥5mmHg, 100%-92% for HVPG≥10mmHg). These results indicate that combination of liver and spleen perfusion and stiffness metrics into a multiparametric analysis maximizes diagnostic performance for the prediction of portal pressure.

Chris Bradley¹, Eleanor F Cox¹, David Harman², Martin W James², Guru P Aithal², I Neil Guha², and Susan T Francis^1
1Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom, ²NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases, University of Nottingham, Nottingham, United Kingdom

We perform a longitudinal 3 year study to assess progression of disease in compensated cirrhosis (CC) using annual haemodynamic and structural MR measures, and compare with a healthy volunteer group. Longitudinal relaxation time (T₁) correlates with liver disease severity, and shows a small variance across years in stable, compensated cirrhosis. In contrast a large variance is shown for liver stiffness measures using Fibroscan®. MR measures correlate well with Enhanced Liver Fibrosis (ELF) scores. This study suggests that MR provides a sensitive technique to assess changes in pathophysiology of CC.

Alejandro Roldán-Alzate^1,2, Luis A Fernandez³, Oliver Wieben^2,4, and Scott B Reeder^2,4
1Mechanical Engineering, University of Wisconsin - Madison, Madison, WI, United States, ²Radiology, University of Wisconsin - Madison, Madison, WI, United States, ³Surgery, University of Wisconsin - Madison, Madison, WI, United States, ⁴Medical Physics, University of Wisconsin - Madison, Madison, WI, United States

The purpose of this study was to evaluate hemodynamic changes in the mesenteric and portal circulation of LDLT donors in response to surgical liver resection. Four living related liver donors were studied. Subjects were imaged using 4D Flow MRI before and after liver resection surgery. Highly patient-specific responses to each surgical procedure were found. The ability to quantify hemodynamic changes in the portal and mesenteric circulation non-invasively demonstrates that 4D flow MRI may be a suitable tool for both surgical planning of LDLT, and for improved understanding of the hemodynamic changes that occur in the liver remnant of the donor.

Satyam Ghodasara¹, Vikas Gulani², and Yong Chen^2
1Case Western Reserve University School of Medicine, Cleveland, OH, United States, ²Radiology, Case Western Reserve University, Cleveland, OH, United States

The dual-input two-compartment model was applied to liver perfusion data, and significant differences in perfusion parameters were found between normal hepatic parenchyma and focal lesions, and also between HCC and metastatic lesions. These findings support the possibility of using a two-compartment model with 3D free-breathing acquisitions, for lesion characterization.

Satyam Ghodasara¹, Yong Chen², Mark Griswold², Nicole Seiberlich³, and Vikas Gulani^2
1Case Western Reserve University School of Medicine, Cleveland, OH, United States, ²Radiology, Case Western Reserve University, Cleveland, OH, United States, ³Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States

To make free-breathing liver perfusion quantification feasible for a clinical timescale, acceleration of both non-Cartesian parallel imaging reconstruction and non-rigid image registration was performed with parallel computing techniques. Our results show massively increased speed (12 minutes compared to >22.5 hours for standard computations) with extremely minor differences in both image quality and perfusion quantification.

Manil Chouhan¹, Rajiv Ramasawmy², Alan Bainbridge³, Adrienne Campbell-Washburn², Jack Wells², Shonit Punwani¹, Rajeshwar Mookerjee⁴, Simon Walker-Samuel², Mark Lythgoe², and Stuart Taylor^1
1UCL Centre for Medical Imaging, University College London, London, United Kingdom, ²UCL Centre for Advanced Biomedical Imaging, University College London, London, United Kingdom, ³Department of Medical Physics, University College London Hospitals NHS Trust, London, United Kingdom, ⁴UCL Institute for Liver and Digestive Health, University College London, London, United Kingdom

Non-invasive preclinical liver perfusion measurements could be used to develop biomarkers and assess new treatments for liver disease and primary/secondary malignant liver lesions.  ASL can provide regional hepatic perfusion maps, and in this study we compare FAIR ASL tissue perfusion measurements with caval subtraction phase-contrast MRI, a validated method for measuring total liver blood flow, to demonstrate ASL overestimation but encouraging agreement between both methods.

Jeong Hee Yoon¹, Jeong Min Lee¹, Eun Ju Kim², Tomoyuki Okuaki³, and Joon Koo Han^1
1Radiology, Seoul National University Hospital, Seoul, Korea, Republic of, ²Philips Healthcare, Seoul, Korea, Republic of, ³Philips Healthcare, Tokyo, Japan

Liver signal intensity on hepatobiliary phase at gadoxetic acid-enhanced liver MRI has been reported to be useful to estimate global and regional liver function quantitatively. However, simple MR signal measurement is often suffering from its sensitivity of MR field inhomogeneity and non-linear relationship with contrast medium concentration. Herein, we investigated of B1 correction effect on T1 map and compared its diagnostic performance to assess liver function according to Child-Pugh classification. In addition, we attempted to investigate risk assessment capability of B1 corrected T1 map for long-term clinical outcome in patients with cirrhosis.

Jia Xu¹, Xuan Wang¹, Yan You², Qin Wang¹, Hui Liu³, Jing Lei¹, Huadan Xue¹, and Zhengyu Jin^1
1Department of Radiology, Peking Union Medical College Hospital, Beijing, China, People's Republic of, ²Department of Pathology, Peking Union Medical College Hospital, Beijing, China, People's Republic of,³Siemens Ltd. China, Shanghai, China, People's Republic of

To evaluate regional liver function preoperatively is of great value in planning surgical management. Our Aim is to investigate the potential of Gd-EOB-DTPA enhanced MRI in evaluating hepatic function in rats with liver fibrosis. Parameters calculated from Gd-EOB-DTPA enhanced MRI exhibited moderate to high correlation with plasma indocyanine green retention rate at 15 minutes after intravenous injection of ICG (ICG R15) in rats with liver fibrosis, indicating its potential in liver function evaluation. 

Tomoyuki Okuaki¹, Kosuke Morita², Tomohiro Namimoto³, Morikatsu Yoshida³, Shinya Shiraishi³, Masanori Komi², Yasuyuki Yamashita³, and Marc Van Cauteren^1
1Philips Healthcare, Tokyo, Japan, ²Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan, ³Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

The hepatocyte fraction (HeF) is based on simple pharmacokinetics, and can quantitatively estimate the fraction of hepatocytes. In this study, the HeF, liver-spleen contrast ratio and delta T1 value were compared to the results of ^99mTc-GSA scintigraphy using the blood clearance index (HH15) and receptor index (LHL15). The correlation coefficients of the HH15 were 0.602, 0.544 and 0.773, respectively, and of the LHL15 were 0.612, 0.670 and 0.762, respectively. The HeF quantification showed the highest correlation with the ^99mTc-GSA, proving it to be useful for a robust evaluation of liver function, compared to conventional imaging based quantitative methods.

Akira Yamada¹, Yasunari Fujinaga¹, Yoshihiro Kitoh², Takeshi Suzuki¹, Daisuke Komatsu¹, Aya Shiobara², Yasuo Adachi², Atsushi Nozaki³, Yuji Iwadate³, Kazuhiko Ueda¹, and Masumi Kadoya^1
1Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan, ²Division of Radiology, Shinshu University Hospital, Matsumoto, Japan, ³GE Healthcare Japan, Hino, Japan

Variable quantitative hepatic imaging biomarkers including pharmacokinetic parameters of hemodynamics and hepatocellular uptake function, R2* and fat fraction, apparent diffusion coefficient (ADC), liver stiffness were obtained from the patients with chronic hepatitis using MR imaging. The change and interrelation of these imaging biomarkers in the course of chronic hepatitis were evaluated quantitatively. Portal venous inflow and hepatocellular uptake function correlated well with liver stiffness, meanwhile, ADC showed weak correlation. Arterial compensation, decreased blood flow speed and volume were observed in the patients with decreased portal venous inflow. No significant correlation was observed between liver stiffness and R2* or fat fraction.