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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/32658

    標題: Gadoxetic acid-enhanced magnetic resonance imaging can predict the pathologic stage of solitary hepatocellular carcinoma
    作者: Chou, Yi-Chen
    Lao, I-Ha
    Hsieh, Pei-Ling
    Su, Ying-Ying
    Mak, Chee-Wai
    Ding-Ping Sun(孫定平)
    Sheu, Ming-Jen
    Kuo, Hsing-Tao
    Chen, Tzu-Ju
    Ho, Chung-Han
    Kuo, Yu-Ting
    貢獻者: Chi Mei Med Ctr, Dept Med Imaging
    Natl Sun Yat Sen Univ, Biomed Sci
    Kaohsiung Med Univ, Sch Med, Coll Med
    Chi Mei Med Ctr, Dept Surg
    Chia Nan Univ Pharm & Sci, Dept Food Sci & Technol
    Chi Mei Med Ctr, Div Gastroenterol & Hepatol, Dept Internal Med
    Chia Nan Univ Pharm & Sci, Dept Med Chem
    Chia Nan Univ Pharm & Sci, Dept Senior Citizen Serv Management
    Chi Mei Med Ctr, Dept Pathol
    Chung Hwa Univ Med Technol, Dept Optometry
    Natl Sun Yat Sen Univ, Inst Biomed Sci
    Chi Mei Med Ctr, Dept Med Res
    Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm
    Kaohsiung Med Univ Hosp, Dept Med Imaging
    Kaohsiung Med Univ, Dept Radiol, Coll Med, Fac Med
    關鍵字: Tumor invasiveness
    Gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid
    Contrast agent
    Magnetic resonance imaging
    Hepatocellular carcinoma
    日期: 2019-06
    上傳時間: 2020-07-29 13:54:04 (UTC+8)
    摘要: BACKGROUND Although important for determining long-term outcome, pathologic stage of hepatocellular carcinoma (HCC) is difficult to predict before surgery. Current state-of-the-art magnetic resonance imaging (MRI) using gadoxetic acid provides many imaging features that could potentially be used to classify single HCC as pT1 or pT2. AIM To determine which gadoxetic acid-enhanced MRI (EOB-MRI) findings predict pathologic stage T2 in patients with solitary HCC (cT1). METHODS Pre-operative EOB-MRI findings were reviewed in a retrospective cohort of patients with solitary HCC. The following imaging features were examined: Hyperintensity in unenhanced T2-weighted images, hypointensity in unenhanced T1-weighted images, arterial enhancement, corona enhancement, washout appearance, capsular appearance, hypointensity in the tumor tissue during the hepatobiliary (HB) phase, peritumoral hypointensity in the HB phase, hypointense rim in the HB phase, intratumoral fat, hyperintensity on diffusion-weighted imaging, hypointensity on apparent diffusion coefficient map, mosaic appearance, nodule-in-nodule appearance, and the margin (smooth or irregular). Surgical pathology was used as the reference method for tumor staging. Univariate and multivariate analyses were performed to identify predictors of microvascular invasion or satellite nodules. RESULTS There were 39 (34.2%; 39 of 114) and 75 (65.8%; 75 of 114) pathological stage T2 and T1 HCCs, respectively. Large tumor size (>= 2.3 cm) and two MRI findings, i.e., corona enhancement [odds ratio = 2.67; 95% confidence interval: 1.101-6.480] and peritumoral hypointensity in HB phase images (odds ratio = 2.203; 95% confidence interval: 0.961-5.049) were associated with high risk of pT2 HCC. The positive likelihood ratio was 6.25 (95% confidence interval: 1.788-21.845), and sensitivity of EOB-MRI for detecting pT2 HCC was 86.2% when two or three of these MRI features were present. Small tumor size and hypointense rim in the HB phase were regarded as benign features. Small HCCs with hypointense rim but not associated with aggressive features were mostly pT1 lesions (specificity, 100%). CONCLUSION Imaging features on EOB-MRI could potentially be used to predict the pathologic stage of solitary HCC (cT1) as pT1 or pT2.
    關聯: World Journal of Gastroenterology, v.25, n.21, pp.2636-2649
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