Noninvasive Monitoring of Liver Disease Regression after Hepatitis C Eradication Using Gadoxetic Acid-Enhanced MRI

Abstract EN

We evaluated changes in relative liver enhancement (RLE) obtained by gadoxetic acid-enhanced MRI (GA-MRI) in the hepatobiliary phase and changes in splenic volume (SV) after hepatitis C virus (HCV) eradication as well as their predictive value for the development of (further) hepatic decompensation during follow-up.

This retrospective study comprised 31 consecutive patients with HCV-induced advanced chronic liver disease who underwent GA-MRI before and after successful interferon-free treatment, as well as a cohort of 14 untreated chronic HCV-patients with paired GA-MRI.

RLE increased by 66% (20%–94%; P<0.001) from pre- to posttreatment, while SV decreased by −16% (−28% to −8%; P<0.001).

However, SV increased in 16% (5/31) of patients, the identical subjects who showed a decrease in RLE (GA-MRI-nonresponse).

We observed an inverse correlation between the changes in RLE and SV (ρ=−0.608; P<0.001).

In the untreated patients, there was a decrease in RLE by −11% (−25% to −3%; P=0.019) and an increase in SV by 23% (7%–43%; P=0.004) (both P<0.001 versus treated patients).

Interestingly, GA-MRI-nonresponse was associated with a substantially increased risk of (further) hepatic decompensation 2 years after the end of treatment: 80% versus 8%; P<0.001.

GA-MRI might distinguish between individuals at low and high risk of (further) hepatic decompensation (GA-MRI-nonresponse) after HCV eradication.

This could allow for individualized surveillance strategies.