ArticleEuropean radiology2023
Relative enhancement index can be used to quantify liver function in cirrhotic patients that undergo gadoxetic acid-enhanced MRI.
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 11 citations in OpenAlex.
- Do hepatic and biliary functional data from gadoxetate-enhanced MRI add value in predicting outcomes in primary sclerosing cholangitis (PSC)?European radiology · 2026Article
- Beyond morphology: functional imaging of the liver with gadoxetic acid-enhanced magnetic resonance imaging.Abdominal radiology (New York) · 2026Review
- Quantitative Assessment of Liver Function Using the Liver Enhancement Ratio on Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Chronic Liver Disease.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Article
- Preoperative evaluation of post-hepatectomy liver failure in hepatocellular carcinoma based on gadoxetic acid-enhanced MRI.Frontiers in oncology · 2026Article
- Dual-input dual-compartmental uptake and efflux model based on Gd-EOB-DTPA-enhanced MRI for simultaneously assessing liver function and fibrosis.Translational gastroenterology and hepatology · 2026Article
- Application of the three-phase T1-derived model in staging liver fibrosis in chronic hepatitis: a comparative study with magnetic resonance elastography.Abdominal radiology (New York) · 2025Article
- Liver function estimation using multiphase hepatic CT: diagnostic performance of iodine-uptake and volumetric parameters.European radiology · 2025Article
- Non-invasive assessment of liver function in cirrhosis using iodine density difference between the portal vein and hepatic vein on spectral CT: correlation with Child-Pugh grades.BMC medical imaging · 2025Article
- Magnetic resonance-derived hepatic uptake index improves the identification of patients at risk of severe post-hepatectomy liver failure.The British journal of surgery · 2025Observational
- Radiomic analysis using T1 mapping in gadoxetic acid disodium-enhanced MRI for liver function assessment.BMC medical imaging · 2025Article
- Evaluation of liver function using hepatocyte uptake and T1 mapping indices in gadoxetic acid-enhanced magnetic resonance imaging: correlation with the albumin-bilirubin grading system.Quantitative imaging in medicine and surgery · 2025Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo evaluate MRI with gadoxetic acid to quantify liver function in cirrhotic patients using the relative enhancement index (REI) compared with Child-Pugh score (CPS), MELD score, and indocyanine green plasma disappearance rate (ICG-PDR) and to establish cutoffs for REI to stratify cirrhotic patients into good and poor liver function groups.
methodsWe prospectively evaluated 60 cirrhotic patients and calculated CPS, MELD score, ICG-PDR, and REI for each patient. Spearman's correlation coefficient was used to assess correlation between REI, CPS, MELD, and ICG-PDR. Good and poor liver function groups were created by k-means clustering algorithm using CPS, MELD, and ICG-PDR. ROC curve analysis was performed and optimal cutoff was identified for group differentiation.
resultsGood correlations were found between REI and other liver function biomarkers: REI and CPS (rho = - 0.816; p < 0.001); REI and MELD score (rho = - 0.755; p < 0.001); REI and ICG-PDR (rho = 0.745; p < 0.001)]. REI correlation was stronger for patients with Child-Pugh A (rho = 0.642, p = 0.002) and B (rho = 0.798, p < 0.001) than for those with Child-Pugh C (rho = 0.336, p = 0.148). REI is significantly lower in patients with poor liver function (p < 0.001). ROC curve showed an AUC 0.94 to discriminate patients with poor liver function (REI cutoff < 100; 100% sensitivity; 76% specificity).
conclusionsREI is a valuable non-invasive index for liver function quantification that has good correlations with other liver function biomarkers. REI can be easily calculated and can be used to estimate liver function in clinical practice in the routine evaluation of cirrhotic patients that undergo MR imaging with gadoxetic acid contrast. KEY POINTS: • REI is a valuable non-invasive index for liver function quantification that has good correlations with other liver function biomarkers. • REI can be easily calculated in the routine evaluation of cirrhotic patients that undergo gadoxetic acid-enhanced MRI. • The REI enables stratification of cirrhotic patients into good and poor liver function groups and can be used as additional information, together with morphological and focal liver lesion evaluation.
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