Quantification of liver extracellular volume using dual-energy CT: utility for prediction of liver-related events in cirrhosis
- Bak, Seongjun; Kim, Ji Eun; Bae, Kyungsoo; Cho, Jae Min; Choi, Ho Cheol; Park, Mi Jung; Choi, Hye Young; Shin, Hwa Seon; Lee, Sang Min; Kim, Hyun Ok
- Issue Date
- Liver cirrhosis; Tomography; X-ray computed; Extracellular space; Iodine
- EUROPEAN RADIOLOGY, v.30, no.10, pp.5317 - 5326
- Journal Title
- EUROPEAN RADIOLOGY
- Start Page
- End Page
- Objectives To determine whether quantification of liver extracellular volume fraction (fECV) using dual-energy CT (DECT) allows prediction of liver-related events (LREs) in cirrhotic patients. Methods This retrospective study included 305 cirrhotic patients who underwent dual-source DECT imaging and had serum markers analyzed within 2 weeks of initial CT imaging. The fECV score was measured using an iodine map of equilibrium-phase images obtained 3 min after contrast injection at 100/140 Sn kVp. The association of the fECV score and serum markers with LREs was investigated. A risk model combining the fECV score (< 27 versus >= 27%) and serum albumin level (< 4 versus >= 4 g/dL) was constructed for LRE prediction. Results An increased fECV score (odds ratio, 1.27; 95% confidence interval (CI), 1.15, 1.40) was independently associated with decompensated cirrhosis at baseline (n = 85) along with the Model for End-Stage Liver Disease score (odds ratio, 1.32; 95% CI, 1.07, 1.63). Among patients with compensated cirrhosis, 10.5% (23 of 220) experienced LREs during the median follow-up period of 2.0 years (decompensation, n = 14; hepatocellular carcinoma, n = 9). The fECV score (hazard ratio, 1.40; 95% CI, 1.22, 1.62) and serum albumin level (hazard ratio, 0.26; 95% CI, 0.09, 0.73) were independent predictors of LRE. The mean times to LRE among the high (16.5 months, n = 18)-, intermediate (25.6 months, n = 44)-, and low (30.5 months, n = 158)-risk groups were significantly different (p < 0.001). Conclusions The fECV score derived from DECT allows prediction of LREs in cirrhotic patients.
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- College of Medicine > Department of Medicine > Journal Articles
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