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Acute kidney injury after multiphase imaging for lesions detected on hepatocellular carcinoma surveillance in patients with cirrhosis
  1. Adnan Aman Khan1,
  2. Yousaf Bashir Hadi1,
  3. Jesse Martin Thompson1,
  4. Justin Thomas Kupec2
  1. 1Department of Medicine, West Virginia University School of Medicine, Morgantown, West Virginia, USA
  2. 2Section of Gastroenterology & Hepatology, West Virginia University, Morgantown, West Virginia, USA
  1. Correspondence to Dr Adnan Aman Khan; adnan.aman.khan{at}gmail.com

Abstract

Objective The risk difference between multiphase multidetector contrast-enhanced CT and MRI for developing acute kidney injury (AKI) has not been previously evaluated in patients with cirrhosis undergoing hepatocellular carcinoma (HCC) surveillance. We aimed to compare the rate of AKI after CT and MRI for evaluation of these lesions.

Design A retrospective chart review of all patients with cirrhosis who underwent either multiphase multidetector liver protocol CT or MRI for lesions detected on HCC screening was conducted at West Virginia University. The rate of AKI after imaging was compared between the two groups.

Results A total of 416 patients were included. Hepatitis C was the most common aetiology (34.6%) of cirrhosis. Thirty-six patients had chronic kidney disease at the time of imaging. CT imaging was conducted for 173 (41.5%) patients, while 58.5% underwent MRI. Nineteen (4.6%) patients developed AKI after imaging. The incidence of AKI was 2.89% for CT and 5.76% for MRI (p value = 0.25). Multivariate logistic regression analysis revealed that inpatient status (p value = 0.015) and Model for End-Stage Liver Disease score (p value = 0.02) were independently linked to the development of AKI following imaging, while the type of imaging modality was not.

Conclusions There is no difference in the risk of AKI after CT or MRI for evaluation of lesions identified on HCC surveillance. The rates of AKI after these imaging studies are low and are attributable to other aetiologies in most cases. We propose that the choice of imaging should be made based on availability, cost, and other patient-related and facility-related factors.

  • liver cirrhosis
  • hepatocellular carcinoma
  • screening
  • abdominal MRI
  • computer tomography
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors All authors contributed significantly and agree with the content of this manuscript. AAK assisted in conception, project design, data collection, and drafting the manuscript. YBH assisted in conception, project design, data collection, and drafting the manuscript. JMT assisted in statistical analysis and drafting the manuscript. JK assisted in conception, project design, data collection, and drafting the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Institutional Review Board of West Virginia University, protocol ID #1908661605.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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