Preoperative gadoxetic acid–enhanced MRI for predicting microvascular invasion in patients with single hepatocellular carcinoma
[Display omitted] •MR imaging features were independent predictors for microvascular invasion of HCC.•MR imaging findings can be used as a biomarker for microvascular invasion of HCC.•A combination of MR imaging findings is associated with early recurrence of HCC. This study aimed to identify preope...
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| Veröffentlicht in: | Journal of hepatology Jg. 67; H. 3; S. 526 - 534 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
Netherlands
Elsevier B.V
01.09.2017
Elsevier Science Ltd |
| Schlagworte: | |
| ISSN: | 0168-8278, 1600-0641, 1600-0641 |
| Online-Zugang: | Volltext |
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| Abstract | [Display omitted]
•MR imaging features were independent predictors for microvascular invasion of HCC.•MR imaging findings can be used as a biomarker for microvascular invasion of HCC.•A combination of MR imaging findings is associated with early recurrence of HCC.
This study aimed to identify preoperative magnetic resonance (MR) imaging biomarkers for predicting microvascular invasion (MVI), to determine their diagnostic performance and to evaluate whether they are associated with early recurrence after surgery for single hepatocellular carcinoma (HCC).
The study included 197 patients with surgically resected HCC (≤5cm) who underwent preoperative gadoxetic acid–enhanced MR imaging. Significant MR imaging findings for predicting MVI were identified by univariate and multivariate analyses. Early recurrence rates (<2years) were analyzed with respect to significant imaging findings for predicting MVI.
Three MR imaging features were independently associated with MVI: arterial peritumoral enhancement (odds ratio [OR]=5.184; 95% confidence interval [CI]: 2.228, 12.063; p<0.001), non-smooth tumor margin (OR=3.555; 95% CI: 1.627, 7.769; p=0.001), and peritumoral hypointensity on hepatobiliary phase (HBP) (OR=4.705; 95% CI: 1.671, 13.246; p=0.003). When two of three findings were combined, the specificity was 92.5% (124/134). When all three findings were satisfied, the specificity was 99.3% (133/134). Early recurrence rates were significantly higher in patients with single HCC, with two or three significant MR imaging findings, compared to those with none (27.9% vs. 12.6%, respectively, p=0.030).
A combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on HBP, can be used as a preoperative imaging biomarker for predicting MVI, with specificity >90%, and is associated with early recurrence after surgery of single HCC.
Lay summary: A combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on hepatobiliary phase, can be used as a preoperative imaging biomarker for predicting microvascular invasion, with specificity >90%, and is associated with early recurrence after curative resection of single HCC. |
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| AbstractList | Background & Aims This study aimed to identify preoperative magnetic resonance (MR) imaging biomarkers for predicting microvascular invasion (MVI), to determine their diagnostic performance and to evaluate whether they are associated with early recurrence after surgery for single hepatocellular carcinoma (HCC). Methods The study included 197 patients with surgically resected HCC (≤5 cm) who underwent preoperative gadoxetic acid–enhanced MR imaging. Significant MR imaging findings for predicting MVI were identified by univariate and multivariate analyses. Early recurrence rates (<2 years) were analyzed with respect to significant imaging findings for predicting MVI. Results Three MR imaging features were independently associated with MVI: arterial peritumoral enhancement (odds ratio [OR] = 5.184; 95% confidence interval [CI]: 2.228, 12.063; p <0.001), non-smooth tumor margin (OR = 3.555; 95% CI: 1.627, 7.769; p = 0.001), and peritumoral hypointensity on hepatobiliary phase (HBP) (OR = 4.705; 95% CI: 1.671, 13.246; p = 0.003). When two of three findings were combined, the specificity was 92.5% (124/134). When all three findings were satisfied, the specificity was 99.3% (133/134). Early recurrence rates were significantly higher in patients with single HCC, with two or three significant MR imaging findings, compared to those with none (27.9% vs. 12.6%, respectively, p = 0.030). Conclusions A combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on HBP, can be used as a preoperative imaging biomarker for predicting MVI, with specificity >90%, and is associated with early recurrence after surgery of single HCC. This study aimed to identify preoperative magnetic resonance (MR) imaging biomarkers for predicting microvascular invasion (MVI), to determine their diagnostic performance and to evaluate whether they are associated with early recurrence after surgery for single hepatocellular carcinoma (HCC). The study included 197 patients with surgically resected HCC (≤5cm) who underwent preoperative gadoxetic acid-enhanced MR imaging. Significant MR imaging findings for predicting MVI were identified by univariate and multivariate analyses. Early recurrence rates (<2years) were analyzed with respect to significant imaging findings for predicting MVI. Three MR imaging features were independently associated with MVI: arterial peritumoral enhancement (odds ratio [OR]=5.184; 95% confidence interval [CI]: 2.228, 12.063; p<0.001), non-smooth tumor margin (OR=3.555; 95% CI: 1.627, 7.769; p=0.001), and peritumoral hypointensity on hepatobiliary phase (HBP) (OR=4.705; 95% CI: 1.671, 13.246; p=0.003). When two of three findings were combined, the specificity was 92.5% (124/134). When all three findings were satisfied, the specificity was 99.3% (133/134). Early recurrence rates were significantly higher in patients with single HCC, with two or three significant MR imaging findings, compared to those with none (27.9% vs. 12.6%, respectively, p=0.030). A combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on HBP, can be used as a preoperative imaging biomarker for predicting MVI, with specificity >90%, and is associated with early recurrence after surgery of single HCC. Lay summary: A combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on hepatobiliary phase, can be used as a preoperative imaging biomarker for predicting microvascular invasion, with specificity >90%, and is associated with early recurrence after curative resection of single HCC. Graphical abstract [Display omitted] •MR imaging features were independent predictors for microvascular invasion of HCC.•MR imaging findings can be used as a biomarker for microvascular invasion of HCC.•A combination of MR imaging findings is associated with early recurrence of HCC. This study aimed to identify preoperative magnetic resonance (MR) imaging biomarkers for predicting microvascular invasion (MVI), to determine their diagnostic performance and to evaluate whether they are associated with early recurrence after surgery for single hepatocellular carcinoma (HCC). The study included 197 patients with surgically resected HCC (≤5cm) who underwent preoperative gadoxetic acid–enhanced MR imaging. Significant MR imaging findings for predicting MVI were identified by univariate and multivariate analyses. Early recurrence rates (<2years) were analyzed with respect to significant imaging findings for predicting MVI. Three MR imaging features were independently associated with MVI: arterial peritumoral enhancement (odds ratio [OR]=5.184; 95% confidence interval [CI]: 2.228, 12.063; p<0.001), non-smooth tumor margin (OR=3.555; 95% CI: 1.627, 7.769; p=0.001), and peritumoral hypointensity on hepatobiliary phase (HBP) (OR=4.705; 95% CI: 1.671, 13.246; p=0.003). When two of three findings were combined, the specificity was 92.5% (124/134). When all three findings were satisfied, the specificity was 99.3% (133/134). Early recurrence rates were significantly higher in patients with single HCC, with two or three significant MR imaging findings, compared to those with none (27.9% vs. 12.6%, respectively, p=0.030). A combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on HBP, can be used as a preoperative imaging biomarker for predicting MVI, with specificity >90%, and is associated with early recurrence after surgery of single HCC. Lay summary: A combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on hepatobiliary phase, can be used as a preoperative imaging biomarker for predicting microvascular invasion, with specificity >90%, and is associated with early recurrence after curative resection of single HCC. This study aimed to identify preoperative magnetic resonance (MR) imaging biomarkers for predicting microvascular invasion (MVI), to determine their diagnostic performance and to evaluate whether they are associated with early recurrence after surgery for single hepatocellular carcinoma (HCC).BACKGROUND & AIMSThis study aimed to identify preoperative magnetic resonance (MR) imaging biomarkers for predicting microvascular invasion (MVI), to determine their diagnostic performance and to evaluate whether they are associated with early recurrence after surgery for single hepatocellular carcinoma (HCC).The study included 197 patients with surgically resected HCC (≤5cm) who underwent preoperative gadoxetic acid-enhanced MR imaging. Significant MR imaging findings for predicting MVI were identified by univariate and multivariate analyses. Early recurrence rates (<2years) were analyzed with respect to significant imaging findings for predicting MVI.METHODSThe study included 197 patients with surgically resected HCC (≤5cm) who underwent preoperative gadoxetic acid-enhanced MR imaging. Significant MR imaging findings for predicting MVI were identified by univariate and multivariate analyses. Early recurrence rates (<2years) were analyzed with respect to significant imaging findings for predicting MVI.Three MR imaging features were independently associated with MVI: arterial peritumoral enhancement (odds ratio [OR]=5.184; 95% confidence interval [CI]: 2.228, 12.063; p<0.001), non-smooth tumor margin (OR=3.555; 95% CI: 1.627, 7.769; p=0.001), and peritumoral hypointensity on hepatobiliary phase (HBP) (OR=4.705; 95% CI: 1.671, 13.246; p=0.003). When two of three findings were combined, the specificity was 92.5% (124/134). When all three findings were satisfied, the specificity was 99.3% (133/134). Early recurrence rates were significantly higher in patients with single HCC, with two or three significant MR imaging findings, compared to those with none (27.9% vs. 12.6%, respectively, p=0.030).RESULTSThree MR imaging features were independently associated with MVI: arterial peritumoral enhancement (odds ratio [OR]=5.184; 95% confidence interval [CI]: 2.228, 12.063; p<0.001), non-smooth tumor margin (OR=3.555; 95% CI: 1.627, 7.769; p=0.001), and peritumoral hypointensity on hepatobiliary phase (HBP) (OR=4.705; 95% CI: 1.671, 13.246; p=0.003). When two of three findings were combined, the specificity was 92.5% (124/134). When all three findings were satisfied, the specificity was 99.3% (133/134). Early recurrence rates were significantly higher in patients with single HCC, with two or three significant MR imaging findings, compared to those with none (27.9% vs. 12.6%, respectively, p=0.030).A combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on HBP, can be used as a preoperative imaging biomarker for predicting MVI, with specificity >90%, and is associated with early recurrence after surgery of single HCC. Lay summary: A combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on hepatobiliary phase, can be used as a preoperative imaging biomarker for predicting microvascular invasion, with specificity >90%, and is associated with early recurrence after curative resection of single HCC.CONCLUSIONSA combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on HBP, can be used as a preoperative imaging biomarker for predicting MVI, with specificity >90%, and is associated with early recurrence after surgery of single HCC. Lay summary: A combination of two or more of the following; arterial peritumoral enhancement, non-smooth tumor margin, and peritumoral hypointensity on hepatobiliary phase, can be used as a preoperative imaging biomarker for predicting microvascular invasion, with specificity >90%, and is associated with early recurrence after curative resection of single HCC. |
| Author | Lee, Ji Eun Sinn, Dong Hyun Park, Cheol Keun Lee, Sunyoung Kim, Seong Hyun |
| Author_xml | – sequence: 1 givenname: Sunyoung surname: Lee fullname: Lee, Sunyoung organization: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul, Republic of Korea – sequence: 2 givenname: Seong Hyun surname: Kim fullname: Kim, Seong Hyun email: kshyun@skku.edu organization: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul, Republic of Korea – sequence: 3 givenname: Ji Eun surname: Lee fullname: Lee, Ji Eun organization: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul, Republic of Korea – sequence: 4 givenname: Dong Hyun surname: Sinn fullname: Sinn, Dong Hyun organization: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, 81 Ilwon-Ro, Gangnam-gu, Seoul, Republic of Korea – sequence: 5 givenname: Cheol Keun surname: Park fullname: Park, Cheol Keun organization: Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, 81 Ilwon-Ro, Gangnam-gu, Seoul, Republic of Korea |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28483680$$D View this record in MEDLINE/PubMed |
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| Keywords | Biomarkers Hepatocellular carcinoma Gadoxetic acid Magnetic resonance imaging Microvascular invasion |
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•MR imaging features were independent predictors for microvascular invasion of HCC.•MR imaging findings can be used as a biomarker for... Graphical abstract This study aimed to identify preoperative magnetic resonance (MR) imaging biomarkers for predicting microvascular invasion (MVI), to determine their diagnostic... Background & Aims This study aimed to identify preoperative magnetic resonance (MR) imaging biomarkers for predicting microvascular invasion (MVI), to... |
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| SubjectTerms | Adult Aged Biomarkers Carcinoma, Hepatocellular - blood supply Carcinoma, Hepatocellular - diagnostic imaging Carcinoma, Hepatocellular - pathology Contrast Media Female Gadolinium DTPA Gadoxetic acid Gastroenterology and Hepatology Hepatocellular carcinoma Humans Image Enhancement Liver cancer Liver Neoplasms - blood supply Liver Neoplasms - diagnostic imaging Liver Neoplasms - pathology Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Microvascular invasion Microvasculature Middle Aged Neoplasm Invasiveness NMR Nuclear magnetic resonance Retrospective Studies Surgery |
| Title | Preoperative gadoxetic acid–enhanced MRI for predicting microvascular invasion in patients with single hepatocellular carcinoma |
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