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. 2018 May 16;28(11):4748–4756. doi: 10.1007/s00330-018-5487-y

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© The Author(s) 2018

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Fig. 2 — Imaging example of a 62-year-old male patient (weight 100 kg) with colorectal liver metastases in the right liver lobe, scheduled for a right hepatectomy. Volume analysis (a–d) exhibited a future liver remnant (FLR) of 757 ml. MRI revealed a mean relative enhancement of the future liver remnant (remnantRLE)—extracted from axial T1-weighted gradient echo MRI scans with fat suppression before (e) and 20 min (f) after intravenous injection of gadoxetic acid—of 0.66. As a result of the reduced uptake of the gadoxetic acid with reduced remnantRLE, the calculated functionalFLR was only 5 ml/kg. Postoperatively, the patient suffered from post-hepatectomy liver failure grade A, according to the grading system of the International Study Group of Liver Surgery (ISGLS)