Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer.

The risk of poor post-operative outcome and the benefits of surgical resection as a curative therapy require careful assessment by the clinical care team for patients with primary and secondary liver cancer. Advances in surgical techniques have improved patient outcomes but identifying which individ...

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Main Authors: Damian J Mole, Jonathan A Fallowfield, Ahmed E Sherif, Timothy Kendall, Scott Semple, Matt Kelly, Gerard Ridgway, John J Connell, John McGonigle, Rajarshi Banerjee, J Michael Brady, Xiaozhong Zheng, Michael Hughes, Lucile Neyton, Joanne McClintock, Garry Tucker, Hilary Nailon, Dilip Patel, Anthony Wackett, Michelle Steven, Fenella Welsh, Myrddin Rees, HepaT1ca Study Group
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0238568&type=printable
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author Damian J Mole
Jonathan A Fallowfield
Ahmed E Sherif
Timothy Kendall
Scott Semple
Matt Kelly
Gerard Ridgway
John J Connell
John McGonigle
Rajarshi Banerjee
J Michael Brady
Xiaozhong Zheng
Michael Hughes
Lucile Neyton
Joanne McClintock
Garry Tucker
Hilary Nailon
Dilip Patel
Anthony Wackett
Michelle Steven
Fenella Welsh
Myrddin Rees
HepaT1ca Study Group
author_facet Damian J Mole
Jonathan A Fallowfield
Ahmed E Sherif
Timothy Kendall
Scott Semple
Matt Kelly
Gerard Ridgway
John J Connell
John McGonigle
Rajarshi Banerjee
J Michael Brady
Xiaozhong Zheng
Michael Hughes
Lucile Neyton
Joanne McClintock
Garry Tucker
Hilary Nailon
Dilip Patel
Anthony Wackett
Michelle Steven
Fenella Welsh
Myrddin Rees
HepaT1ca Study Group
author_sort Damian J Mole
collection DOAJ
description The risk of poor post-operative outcome and the benefits of surgical resection as a curative therapy require careful assessment by the clinical care team for patients with primary and secondary liver cancer. Advances in surgical techniques have improved patient outcomes but identifying which individual patients are at greatest risk of poor post-operative liver performance remains a challenge. Here we report results from a multicentre observational clinical trial (ClinicalTrials.gov NCT03213314) which aimed to inform personalised pre-operative risk assessment in liver cancer surgery by evaluating liver health using quantitative multiparametric magnetic resonance imaging (MRI). We combined estimation of future liver remnant (FLR) volume with corrected T1 (cT1) of the liver parenchyma as a representation of liver health in 143 patients prior to treatment. Patients with an elevated preoperative liver cT1, indicative of fibroinflammation, had a longer post-operative hospital stay compared to those with a cT1 within the normal range (6.5 vs 5 days; p = 0.0053). A composite score combining FLR and cT1 predicted poor liver performance in the 5 days immediately following surgery (AUROC = 0.78). Furthermore, this composite score correlated with the regenerative performance of the liver in the 3 months following resection. This study highlights the utility of quantitative MRI for identifying patients at increased risk of poor post-operative liver performance and a longer stay in hospital. This approach has the potential to inform the assessment of individualised patient risk as part of the clinical decision-making process for liver cancer surgery.
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spelling doaj-art-efe9d90ff055482e9e64951c38de830b2025-08-20T03:25:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011512e023856810.1371/journal.pone.0238568Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer.Damian J MoleJonathan A FallowfieldAhmed E SherifTimothy KendallScott SempleMatt KellyGerard RidgwayJohn J ConnellJohn McGonigleRajarshi BanerjeeJ Michael BradyXiaozhong ZhengMichael HughesLucile NeytonJoanne McClintockGarry TuckerHilary NailonDilip PatelAnthony WackettMichelle StevenFenella WelshMyrddin ReesHepaT1ca Study GroupThe risk of poor post-operative outcome and the benefits of surgical resection as a curative therapy require careful assessment by the clinical care team for patients with primary and secondary liver cancer. Advances in surgical techniques have improved patient outcomes but identifying which individual patients are at greatest risk of poor post-operative liver performance remains a challenge. Here we report results from a multicentre observational clinical trial (ClinicalTrials.gov NCT03213314) which aimed to inform personalised pre-operative risk assessment in liver cancer surgery by evaluating liver health using quantitative multiparametric magnetic resonance imaging (MRI). We combined estimation of future liver remnant (FLR) volume with corrected T1 (cT1) of the liver parenchyma as a representation of liver health in 143 patients prior to treatment. Patients with an elevated preoperative liver cT1, indicative of fibroinflammation, had a longer post-operative hospital stay compared to those with a cT1 within the normal range (6.5 vs 5 days; p = 0.0053). A composite score combining FLR and cT1 predicted poor liver performance in the 5 days immediately following surgery (AUROC = 0.78). Furthermore, this composite score correlated with the regenerative performance of the liver in the 3 months following resection. This study highlights the utility of quantitative MRI for identifying patients at increased risk of poor post-operative liver performance and a longer stay in hospital. This approach has the potential to inform the assessment of individualised patient risk as part of the clinical decision-making process for liver cancer surgery.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0238568&type=printable
spellingShingle Damian J Mole
Jonathan A Fallowfield
Ahmed E Sherif
Timothy Kendall
Scott Semple
Matt Kelly
Gerard Ridgway
John J Connell
John McGonigle
Rajarshi Banerjee
J Michael Brady
Xiaozhong Zheng
Michael Hughes
Lucile Neyton
Joanne McClintock
Garry Tucker
Hilary Nailon
Dilip Patel
Anthony Wackett
Michelle Steven
Fenella Welsh
Myrddin Rees
HepaT1ca Study Group
Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer.
PLoS ONE
title Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer.
title_full Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer.
title_fullStr Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer.
title_full_unstemmed Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer.
title_short Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer.
title_sort quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0238568&type=printable
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