Evaluation of Remnant Liver Function Using Primovist-enhanced MRI Before Resection/Ablation of Hepatocellular Carcinoma
Evaluation of Remnant Liver Function Using Primovist-enhanced MRI Before Resection/Ablation of Hepatocellular Carcinoma
The purpose of this study is to determine whether the global and segmental hepatic uptake and
 excretion of Gd-EOB-DTPA on Gd-EOB-DTPA-enhanced liver MRI correlates with standard liver
 function test results in the patients with Hepatocellular Carcinoma (HCC) before major
 hepatic resection or radiofrequency ablation (RFA).
1. Preoperative/RFA assessment of remnant liver function is important for avoiding
 posthepatectomy liver failure. However, the function of the future remnant is decreased
 in patients with chronic liver disease or cirrhosis, compared to that of healthy
 patients with an equal volume. Therefore, volume-based estimation of hepatic reserve
 function is inadequate for patients with hepatic dysfunction.

 2. Standard clinical liver function tests, such as ICG clearance rate or Child-Pugh score,
 provides measurements of the global hepatic function, but cannot evaluate the functional
 distribution in the liver. Gd-EOB-DTPA (Gadoxetic acid, Primovist®, Bayer Schering)
 enhanced MRI has been recently demonstrated to have the potential to be an imaging-based
 liver function test, with the possibility to detect functional differences on a regional
 or even segmental level.

 3. Gd-EOB-DTPA-enhanced liver MRI may be able to assess not only global but also segmental
 liver function in patients with hepatocellular carcinoma (HCC) who have a relatively
 high risk for developing liver failure after surgical resection due to coexistent
 hepatic damage by chronic viral hepatitis and/or cirrhosis preoperatively.

 The purpose of this study is to determine whether the global and segmental hepatic uptake and
 excretion of Gd-EOB-DTPA on Gd-EOB-DTPA-enhanced liver MRI correlates with standard liver
 function test results in the patients with HCC before major hepatic resection/RFA.
Inclusion Criteria:

 1. Patients with the diagnosis of HCC based on noninvasive diagnostic criteria of HCC
 proposed by 2010 AASLD

 2. Surgical resection of hepatic resection greater than 2 Couinaud segments (including
 total hepatectomy for transplantation) or radiofrequency ablation is planned

 3. Patients who provided the informed consent

 Exclusion Criteria:

 1. Patients younger than 18 yrs old

 2. Patients who received hepatic surgery prior to this study

 3. Patients who underwent TACE or RFA for greater than 2 segments within 3 months prior
 to this study

 4. Patients who received radiation treatment including the liver or systemic chemotherapy

 5. Patients who underwent contrast enhanced liver MRI within 3 days prior to this study

 6. Patients with severe renal dysfunction (Cr .2.5 mg/dL or GFR < 30mL/min)

 7. Patients with hypersensitivity to gadolinium

 8. Patients with uncorrectable hypokalemia

 9. Pregnant women, or reproductive age women who will not agree with contraception during
 this study period.

 10. Patients with mental disorder which will interfere with voluntary agreement

 11. Patients who have any contraindication to MRI (cardiac pacemaker, ferromagnetic
 implants, etc.)

 12. Any other condition which, in the opinion of the Investigator, would make the patient
 unsuitable for enrollment or could interfere with the completion of the study.