Laboratory indicators combined with liver function scores for predicting suboptimal hepatobiliary phase imaging during gadoxetic acid-enhanced MRI

BackgroundSuboptimal hepatobiliary-phase (HBP) enhancement may limit the diagnostic quality of gadoxetic acid-enhanced MRI. We investigated whether routinely available laboratory indicators and liver function scores could identify patients at increased risk of suboptimal HBP imaging.MethodsThis retrospective study included 555 patients with focal liver lesions who underwent gadoxetic acid-enhanced MRI, including 460 with good and 95 with suboptimal HBP image quality. Associations between laboratory indicators, liver function scores, and HBP image quality were evaluated using correlation and logistic regression analyses. Model discrimination, calibration, internal validation, and potential clinical utility were assessed using ROC analysis, bootstrap resampling, calibration analysis, and decision-curve analysis.ResultsThe ALBI score (OR=2.391, 95% CI: 1.364–4.190), GGT (OR=1.003, 95% CI: 1.001–1.004), TBA (OR=1.010, 95% CI: 1.003–1.017), and Hb (OR=0.982, 95% CI: 0.971–0.993) were independently associated with suboptimal HBP imaging. The combined model yielded an AUC of 0.758 (95% CI: 0.701–0.816), with 63.16% sensitivity and 78.70% specificity. Bootstrap internal validation that repeated the entire model-development procedure yielded a mean AUC optimism of 0.044 and an optimism-corrected AUC of 0.714, indicating that moderate discrimination was retained after correction for model-development optimism. The apparent and optimism-corrected Brier scores were 0.116 and 0.128, respectively.ConclusionsA model combining the ALBI score, GGT, TBA, and Hb showed moderate discrimination for suboptimal HBP imaging. These routinely available indicators may assist pre-MRI risk stratification, but external validation is required before clinical implementation.