Clinical utility of gadoxetate disodium-enhanced hepatic MRI for stereotactic body radiotherapy of hepatocellular carcinoma

To investigate the utility of gadoxetate disodium-enhanced hepatic MRI (EOB-MRI) for stereotactic body radiotherapy (SBRT) to treat hepatocellular carcinoma (HCC). We divided 30 HCC patients who underwent SBRT into group A (no change in their Child-Pugh score 6 months post-SBRT) and group B (increased score 6 months post-SBRT). EOB-MRI was performed before and 6 months after SBRT. We calculated the liver-spleen contrast (LSC) ratio for each radiation dose area on hepatobiliary phase scans (LSCbefore using images obtained before SBRT and LSCafter using images acquired after SBRT) and the weighted LSC (W-LSC) as: [(mean LSCbefore (0-30 Gy) x liver volume (0-30 Gy) + mean LSCbefore (30 Gy-) x liver volume (30 Gy-))/total liver volume]. Then we compared the W-LSC, percentage of the liver volume exposed to > 20 Gy (V20), and mean liver dose in the two groups. The LSCafter at 48, 40, and 30 Gy to the liver was statistically lower than the unirradiated area of the liver (p < 0.01). Univariate analysis showed that only W-LSC was significantly associated with group B (p = 0.02). W-LSC was a useful parameter for predicting changes in hepatic function after SBRT.