Gadoxetic acid-enhanced magnetic resonance imaging can predict the pathologic stage of solitary hepatocellular carcinoma

doi:10.3748/wjg.v25.i21.2636

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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 Hepatobiliary Contrast agent Magnetic resonance imaging Hepatocellular carcinoma
日期:	2019-06
上傳時間:	2020-07-29 13:54:04 (UTC+8)
出版者:	BAISHIDENG PUBLISHING GROUP INC
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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