• Siwon Jang, Jeong Min Lee, Dong Ho Lee, Ijin Joo, Jeong Hee Yoon, Won Chang, and Joon Koo Han.
• Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea.
• J Magn Reson Imaging. 2017 Jun 1; 45 (6): 1627-1636.

PurposeTo demonstrate the negative relationship between liver stiffness (LS) values measured at preoperative magnetic resonance elastography (MRE) and the regeneration capacity of the remnant liver after major hepatectomy, in patients with hepatocellular carcinoma (HCC).Materials And MethodsThirty-eight patients with HCC (mean age, 57.1) who had undergone liver computed tomography (CT) and 1.5T MRE prior to right hepatectomy were included in this retrospective study. CT volumetric analysis of total functional liver (calculated by subtracting tumor volume from total liver volume), future liver remnant (FLR), and postoperative liver remnant (LR) were performed using a semiautomatic analysis program. The regeneration index was expressed as [(VLR -VFLR )/VFLR ] × 100, where VLR is the volume of the liver remnant and VFLR is the volume of the FLR. The relationship between degree of LS measured at MRE and the regeneration index was assessed using the Spearman correlation test.ResultsAverage LS value at MRE increased along with hepatic fibrosis (HF) stage (r = 0.604, P < 0.001). At MRE, a cutoff value greater than 2.46 kPa yielded 90.0% sensitivity and 100% specificity in identifying HF stage 2 or greater (area under the curve [AUC], 0.95). Mean VFLR and VLR were 477.1 ± 147.5 mL and 911.9 ± 188.8 mL, respectively. The regeneration index of the liver remnant was 102.1 ± 58.2%. LS values at MRE and calculated regeneration index after right hepatectomy showed moderate negative correlation (r = -0.361, P = 0.026).ConclusionLS values measured at MRE may serve as a postoperative predictor of liver regeneration in patients with liver cirrhosis and HCC.Level Of Evidence4 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1627-1636.© 2016 International Society for Magnetic Resonance in Medicine.

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