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Use of blood oxygen level-dependent magnetic resonance imaging to detect acute cellular rejection post-liver transplantation

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

A Correction to this article was published on 23 June 2023

This article has been updated

Abstract

Objectives

Acute cellular rejection (ACR) is a major immune occurrence post-liver transplant that can cause abnormal liver function. Blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) can be used to evaluate liver disease, but it has not been utilized in the diagnosis of ACR post-liver transplant. Therefore, the purpose of this study is to evaluate the diagnostic performance of BOLD MRI and to monitor treatment response in recipients with ACR.

Methods

This prospective study was approved by the local institutional review board. Fifty-five recipients with highly suspected ACR were enrolled in this study. Each patient underwent hepatic BOLD MRI, blood biochemistry, and biopsy before treatment. Of 55 patients, 19 recipients with ACR received a follow-up MRI after treatment. After obtaining the R2* maps, five regions-of-interest were placed on liver parenchyma to estimate the mean R2* values for statistical analysis. Receiver operating characteristic curve (ROC) analysis was performed to assess the diagnostic performance of R2* values in detecting patients with ACR.

Results

The histopathologic results showed that 27 recipients had ACR (14 mild, 11 moderate, and 2 severe) and their hepatic R2* values were significantly lower than those of patients without ACR. ROC analysis revealed that the sensitivity and specificity of the R2* values for detection of ACR were 82.1% and 89.9%, respectively. Moreover, the R2* values and liver function in patients with ACR significantly increased after immunosuppressive treatment.

Conclusion

The non-invasive BOLD MRI technique may be useful for assessment of hepatic ACR and monitoring of treatment response after immunosuppressive therapy.

Key Points

• Patients with acute cellular rejection post-liver transplant exhibited significantly decreased R2* values in liver parenchyma.

• R2* values and liver function were significantly increased after immunosuppressive therapy.

• R2* values were constructive indicators in detecting acute cellular rejection due to their high sensitivity and specificity.

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Change history

Abbreviations

ACR:

Acute cellular rejection

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

BOLD :

Blood oxygenation level dependent

DDLT:

Deceased donor liver transplantation

LDLT :

Living donor liver transplantation

MRI :

Magnetic resonance imaging

PLT :

Platelet

RAI:

Rejection activity index

ROC:

Receiver operating characteristic

ROI:

Regions-of-interest

T-bil :

Total bilirubin

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Funding

The authors state that this work has not received any funding.

Author information

Author notes

  1. Yu-Fan Cheng

    Present address: Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan

Authors and Affiliations

  1. Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Hsien-Jen Chiang, Yi-Hsuan Chuang & Yu-Fan Cheng

  2. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Hsien-Jen Chiang

  3. Department of Medical Imaging and Radiological Sciences, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan

    Ming-Chung Chou & Chun-Wei Li

  4. Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Ming-Chung Chou

  5. Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan

    Ming-Chung Chou

  6. Liver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Chih-Che Lin & Chao-Long Chen

  7. Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Hock-Liew Eng

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The scientific guarantor of this publication is Yu-Fan Cheng.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.

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• prospective

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• performed at one institution

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The original online version of this article was revised: in the section 'Materials and Methods', the sentence "This prospective study was approved by the Chang Gung Medical Foundation Institutional review board (201701554B0) and informed consent was obtained from all patients" was corrected to "This prospective study was approved by the Chang Gung Medical Foundation Institutional review board (201700785B0) and informed consent was obtained from all patients.

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Chiang, HJ., Chou, MC., Chuang, YH. et al. Use of blood oxygen level-dependent magnetic resonance imaging to detect acute cellular rejection post-liver transplantation. Eur Radiol 32, 4547–4554 (2022). https://doi.org/10.1007/s00330-022-08574-0

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