T2 mapping in gadoxetic acid-enhanced MRI: utility for predicting decompensation and death in cirrhosis

Abstract

Objectives To determine whether T2 mapping in liver MRI can predict decompensation and death in cirrhotic patients. Methods This retrospective study included 292 cirrhotic patients who underwent gadoxetic acid-enhanced MRI, including T1 and T2 mapping at 10-min hepatobiliary phase by using the Look-Locker and radial turbo spin-echo sequences, respectively. T1 and T2 values of the liver and spleen were measured. The association of MR parameters and serum markers with decompensation and death was investigated. Risk models combining T2(Liver), serum albumin level, and Model for End-Stage Liver Disease (MELD) score were created for predicting decompensation (T2(Liver), < 49.3 versus >= 49.3 ms) and death (< 57.4 versus >= 57.4 ms). Results In patients with compensated cirrhosis at baseline and in the full patient cohort, 9.6% (19 of 197) and 5.1% (15 of 292) developed decompensation and died during the mean follow-up periods of 18.7 and 19.2 months, respectively. A prolonged T2(Liver) (hazard ratio (HR), 2.59; 95% confidence interval (CI), 1.26, 5.31) was independently predictive of decompensation along with the serum albumin level (HR, 0.28; 95% CI, 0.12, 0.68) and MELD score (HR, 1.34; 95% CI, 1.08, 1.66). T2(Liver) (HR, 2.61; 95% CI, 1.19, 5.72) and serum albumin level (HR, 0.46; 95% CI, 0.19, 1.14) were independent predictors of death. The mean times to decompensation (12.9 versus 29.2 months) and death (16.5 versus 29.6 months) were significantly different between the high- and low-risk groups (p < 0.001). Conclusion T2(Liver) from T2 mapping can predict decompensation and death in patients with cirrhosis.