Functional Liver Imaging Score (FLIS) as imaging parameter for predicting post-hepatectomy complications in patients with liver cirrhosis.

Abstract

Background: Liver dysfunction has been reported as a risk factor for predicting complications after hepatectomy. In patients with liver cirrhosis (LC) who underwent hepatectomy, a Functional Liver Imaging Score (FLIS), derived from gadoxetic acid-enhanced magnetic resonance imaging (MRI), has never been investigated as a predictor of clinically significant post-hepatectomy complications.

Purpose: To evaluate whether FLIS can predict post-hepatectomy complications in patients with LC.

Material and methods: A retrospective review was conducted of patients with LC who underwent gadoxetic acid-enhanced MRI and hepatectomy. Univariable and multivariable logistic regression was used to identify clinicopathological and radiologic findings associated with the development of major complication (Clavien-Dindo classification [CDC] ≥ III). Receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff value of FLIS for predicting CDC ≥ III.

Results: Of the finally included 106 patients (77 men; mean age = 62.5 ± 8.3 years), 12 patients had a CDC ≥ III. Multivariable analysis showed that only FLIS independently predicted post-hepatectomy complications (odds ratio = 0.02; P = 0.01). ROC analysis suggested the FLIS ≤ 4 was the optimal cutoff for predicting CDC ≥ III (AUC value = 0.94; sensitivity = 91.67%; specificity = 95.74%; positive likelihood ratio = 21.54; and negative likelihood ratio = 0.09).

Conclusion: In patients with LC, FLIS was an independent predictor of post-hepatectomy complications. FLIS showed excellent diagnostic performance in predicting post-hepatectomy complications.