Noninvasive monitoring of liver disease regression after hepatitis C eradication using gadoxetic acid-enhanced MRI
Güngören, Fatma Zeynep
Hodge, Jacqueline C.
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CitationHaider, L., Mandorfer, M., Güngören, F. Z., Reiberger, T., Bastati, N., Hodge, J. ... Ba-Ssalamah, A. (2018). Noninvasive monitoring of liver disease regression after hepatitis C eradication using gadoxetic acid-enhanced MRI. Contrast Media & Molecular Imaging. https://dx.doi.org/10.1155/2018/8489709
We evaluated changes in relative liver enhancement (RLE) obtained by gadoxetic acid-enhanced MRI (GA-MRI) in the hepatobiliary phase and changes in splenic volume (SV) after hepatitis C virus (HCV) eradication as well as their predictive value for the development of (further) hepatic decompensation during follow-up. This retrospective study comprised 31 consecutive patients with HCV-induced advanced chronic liver disease who underwent GA-MRI before and after successful interferon-free treatment, as well as a cohort of 14 untreated chronic HCV-patients with paired GA-MRI. RLE increased by 66% (20%-94%; P <0.001) from pre- to posttreatment, while SV decreased by -16% (-28% to -8%; P <0.001). However, SV increased in 16% (5/31) of patients, the identical subjects who showed a decrease in RLE (GA-MRI-nonresponse). We observed an inverse correlation between the changes in RLE and SV (rho =-0.608; P <0.001). In the untreated patients, there was a decrease in RLE by -11% (-25% to -3%; P = 0.019) and an increase in SV by 23% (7%-43%; P = 0.004) (both P <0.001 versus treated patients). Interestingly, GA-MRI-nonresponse was associated with a substantially increased risk of (further) hepatic decompensation 2 years after the end of treatment: 80% versus 8%; P < 0.001. GA-MRI might distinguish between individuals at low and high risk of (further) hepatic decompensation (GA-MRI-nonresponse) after HCV eradication. This could allow for individualized surveillance strategies.