Gadoxetate MRI biliary enhancement ratio predicts 2-year adverse outcomes in PSC

In PSC, gadoxetate MRI REPD <4.64 predicted 2-year adverse events (sens 70%, spec 63%), adding independent value beyond Mayo Risk Score in a retrospective cohort (n=73).

• Retrospective case-controlled study of 73 PSC patients (42M/31F, mean age 41.9y) with gadoxetate-enhanced MRI.
• ANALI non-gadolinium score >3 predicted liver transplantation within 2 years (sensitivity 87.5%, specificity 74.2%; p=0.0003).
• REPD measurement is challenging in routine practice, limiting utility outside drug trials; study is retrospective and small.

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