Observational studyThe British journal of surgery2025
Magnetic resonance-derived hepatic uptake index improves the identification of patients at risk of severe post-hepatectomy liver failure.
Observational study in The British journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Imaging biomarkers of liver hypertrophy after portal vein embolization in patients with liver tumors: cholestasis, arterial hyperperfusion, and splenic response.Abdominal radiology (New York) · 2026Article
- MRI-Derived Evaluation of Liver Function and Its Extension to K-Edge Photon-Counting CT: Focus on Gadolinium-Based Functional Biliary Imaging.Diagnostics (Basel, Switzerland) · 2026Review
- Pharmacokinetic modelling of MRI-based liver function for risk assessment in primary sclerosing cholangitis: a prospective pilot study.European radiology experimental · 2026Article
- Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) as a double-edged sword: leveraging imaging evaluation to maximize benefits and mitigate risks.Insights into imaging · 2026Review
- Preoperative gut microbiota combined with machine learning for predicting post-hepatectomy liver failure in HBV-related hepatocellular carcinoma: a pilot study.Frontiers in cellular and infection microbiology · 2026Article
- Preoperative evaluation of post-hepatectomy liver failure in hepatocellular carcinoma based on gadoxetic acid-enhanced MRI.Frontiers in oncology · 2026Article
- Enhancing future liver remnant hypertrophy: innovative preoperative strategies and emerging technologies.Translational gastroenterology and hepatology · 2026Review
- Leveraging artificial intelligence to validate traditional biomarkers and drug targets in liver cancer recovery: a mini review.Frontiers in pharmacology · 2025Review
Corrections and comments
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Authors and funding
21 authors.
Funding
Abstract
backgroundPost-hepatectomy liver failure (PHLF) is a leading cause of mortality after major liver resection. Accurate preoperative risk assessment is essential, yet current methods have limitations. Gadoxetic acid-enhanced MRI (Gd-EOB MRI) enables both morphological and functional evaluation of the liver. The aim of this study was to evaluate the efficacy of the hepatic uptake index (HUI) obtained from routine preoperative Gd-EOB MRI for identifying patients at risk of severe PHLF.
methodsThis observational retrospective multicentre study included 292 patients who underwent major hepatectomy between 2010 and 2020 in Sweden, Denmark, and Finland. Preoperative Gd-EOB MRI was performed for each patient and the HUI, hepatic uptake index of the standardized future liver remnant (sFLR-HUI), and Model for End-Stage Liver Disease Version 3 (MELD 3) score were evaluated. Statistical analyses included logistic regression and receiver operating characteristic (ROC) curve assessment to determine cut-off values and discriminative accuracies for severe PHLF (International Study Group of Liver Surgery grades B and C).
resultsAmong the 292 patients, 25 (8.6%) developed severe PHLF. Patients with severe PHLF had significantly lower HUI and sFLR-HUI values (P < 0.001). The HUI demonstrated superior discriminative performance for severe PHLF (area under the curve (AUC) 0.758) compared with volume-only assessments, such as the standardized future liver remnant (sFLR) (AUC 0.628). Combining the HUI with the MELD 3 score improved performance further (AUC 0.803).
conclusionThe HUI obtained from routine Gd-EOB MRI outperforms volume-based biomarkers (sFLR) for identification of patients at risk of severe PHLF. Incorporating image-derived functional assessments, such as the HUI, with independent biomarkers, such as the MELD 3 score, may optimize preoperative risk stratification for severe PHLF and improve outcomes after major hepatectomy.
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