Validation of functional liver imaging scores derived on gadoxetic acid-enhanced MRI in hepatocellular carcinoma patients.

Background and aim: To investigate the correlation of the functional liver imaging scores (FLIS) and the scoring system in hepatocellular carcinoma (HCC) patients.

Materials and methods: Between April 2015 and December 2022, the HCC patients who underwent gadoxetic acid-enhanced MRI were analyzed. Three parameters on hepatobiliary phase images were evaluated for FLIS: liver parenchymal enhancement, biliary excretion, and signal intensity of the portal vein. The correlation between Child-Turcotte-Pugh (CTP) classification, the albumin-bilirubin (ALBI) grade, and Fibrosis-4 (F-4) score, and FLIS were analyzed. Receiver operating characteristic curve analysis was performed to demonstrate the cut-off value of FLIS for differentiating between CTP classification and ALBI grade.

Results: We retrospectively analyzed 178 HCC patients (144 men, 34 women; mean age, 65.9 years). A moderate negative correlation was present between CTP classification and ALBI grade, and FLIS (r=-0.596 and r=-0.513, respectively). FLIS ≤3 was determined as the most optimal criterion for differentiating CTP A or B patients from CTP C patients.

Conclusion: This study showed that the FLIS is a simple, non-invasive imaging marker for the assessment of liver function in HCC patients.