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Predicting Liver Function Reserve Using Tomoelastography in Patients With Hepatocellular Carcinoma

By: Amy MacDonald, MS
Posted: Friday, September 30, 2022

The liver is a viscoelastic structure, and change in viscosity is closely associated with the status of liver disease. Fuhua Yan, MD, PhD, of the Shanghai Jiao Tong University School of Medicine, China, and colleagues designed a prospective study to assess liver viscosity as a measure of liver function reserve in patients with hepatocellular carcinoma. The study authors, who reported their work in Insights into Imaging, used the new technique of tomoelastography, a multifrequency magnetic resonance elastography, to predict remaining liver function.

This purpose of the study was to examine correlations between liver mechanics, as measured by tomoelastography, and liver function reserve, as evaluated by the more commonly used indocyanine green clearance (ICG) test. Additionally, the authors sought to develop a tomoelastography prediction model of liver function reserve, to help clinicians with presurgical patient assessment.

A total of 156 patients with suspected hepatocellular carcinoma were enrolled and examined preoperatively using tomoelastography. Of these patients, 15-minute ICG retention (ICG-R15) rates were obtained in 69 patients to assess liver function reserves. Shear wave speed, a measure of tissue stiffness, and loss angle, a measure of fluidity, were then quantified using tomoelastography in these patients. Both parameters were correlated with the ICG-R15 rates. A presurgical prediction model based on logistic regression for major hepatectomy tolerance was then created.

Research on the use of multifrequency magnetic resonance elastography to evaluate liver function in patients with hepatocellular carcinoma remains scarce. According to the investigators, these data demonstrate that liver stiffness and fluidity, as quantified by tomoelastography, were correlated with liver function, paving the way for tomoelastography to be considered a noninvasive clinical tool for use in treating hepatocellular carcinoma. The authors reported that additional studies with postoperative follow-up are warranted.

Disclosure: The authors reported no conflicts of interests.

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