Hepatectomy risk assessment with functional magnetic resonance imaging (HEPARIM)

Abstract

Background

Post hepatectomy liver failure (PHLF) remains a significant risk in patients undergoing curative liver resection for cancer, however currently available PHLF risk prediction investigations are not sufficiently accurate.

The Hepatectomy risk assessment with functional magnetic resonance imaging trial (HEPARIM) aims to establish if quantitative MRI biomarkers of liver function & perfusion can be used to more accurately predict PHLF risk and FLR function, measured against indocyanine green (ICG) liver function test.

Methods

HEPARIM is an observational cohort study recruiting patients undergoing liver resection of 2 segments or more, prior to surgery patients will have both Dynamic Gadoxetate-enhanced (DGE) liver MRI and ICG testing.

Day one post op ICG testing is repeated and R15 compared to the Gadoxetate Clearance (GC) of the future liver remnant (FLR-GC) as measure by preoperative DGE- MRI which is the primary outcome, and preoperative ICG R15 compared to GC of whole liver (WL-GC) as a secondary outcome.

Data will be collected from medical records, biochemistry, pathology and radiology reports and used in a multi-variate analysis to the value of functional MRI and derive multivariant prediction models for future validation.

Discussion

If successful, this test will potentially provide an efficient means to quantitatively assess FLR function and PHLF risk enabling surgeons to push boundaries of liver surgery further while maintaining safe practice and thereby offering chance of cure to patients who would previously been deemed inoperable. MRI has the added benefit of already being part of the routine diagnostic pathway and as such would have limited additional burden on patients time or cost to health care systems. (Hepatectomy Risk Assessment With Functional Magnetic Resonance Imaging - Full Text View - ClinicalTrials.gov, n.d.)

Trial registration

ClinicalTrials.gov, ClinicalTrials.gov NCT04705194 - Registered 12th January 2021 – Retrospectively registered

Metadata

Item Type:	Article
Authors/Creators:	Elsharif, M. Roche, M. Wilson, D. Basak, S. Rowe, I. Vijayanand, D. Feltbower, R. Treanor, D. Roberts, L. Guthrie, A. Prasad, R. Gilthorpe, M.S. Attia, M. Sourbron, S. https://orcid.org/0000-0002-3374-3973
Copyright, Publisher and Additional Information:	© 2021 The Author(s). Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Keywords:	Post hepatectomy liver failure; Risk assessment; Functional MRI; Gadoxetate; Indocyanine green; Future liver remnant
Dates:	Published: December 2021 Published (online): 23 October 2021 Accepted: 4 October 2021
Institution:	The University of Sheffield
Academic Units:	The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield)
Depositing User:	Symplectic Sheffield
Date Deposited:	04 Nov 2021 08:05
Last Modified:	04 Nov 2021 08:05
Status:	Published
Publisher:	BioMed Central
Refereed:	Yes
Identification Number:	10.1186/s12885-021-08830-4
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:180001

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Hepatectomy risk assessment with functional magnetic resonance imaging (HEPARIM)

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