Japanese Journal of Radiology

, Volume 31, Issue 7, pp 480–490

Hypervascular hepatocellular carcinomas showing hyperintensity on hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance imaging: a possible subtype with mature hepatocyte nature

Authors

    • Department of RadiologyKanazawa University Hospital
  • Osamu Matsui
    • Department of RadiologyKanazawa University Hospital
  • Azusa Kitao
    • Department of RadiologyKanazawa University Hospital
  • Ryuichi Kita
    • Department of Gastroenterology and HepatologyOsaka Red Cross Hospital
  • Kazuto Kozaka
    • Department of RadiologyKanazawa University Hospital
  • Wataru Koda
    • Department of RadiologyKanazawa University Hospital
  • Satoshi Kobayashi
    • Department of RadiologyKanazawa University Hospital
  • Toshifumi Gabata
    • Department of RadiologyKanazawa University Hospital
  • Hiroko Ikeda
    • Department of Diagnostic PathologyKanazawa University Hospital
  • Yasuni Nakanuma
    • Department of Human PathologyKanazawa University Graduate School of Medicine
Original Article

DOI: 10.1007/s11604-013-0224-6

Cite this article as:
Yoneda, N., Matsui, O., Kitao, A. et al. Jpn J Radiol (2013) 31: 480. doi:10.1007/s11604-013-0224-6

Abstract

Purpose

We evaluated molecular features of hypervascular hepatocellular carcinoma (HCC) that shows iso- or hyperintensity (hyperintense HCC) in the hepatobiliary phase (HB phase) of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI).

Materials and methods

We investigated 89 surgically resected cases. Patients were divided into two groups according to the signal intensity in the HB phase of EOB-MRI: hyperintense HCCs (n = 18) and hypointense HCCs (n = 71). We performed immunohistochemical staining for uptake transporter of gadoxetic acid: organic anion transporter polypeptides (OATP8); tumor markers: alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist II (PIVKA-II); hepatic stem cell markers: epithelial cell adhesion molecule (EpCAM), cytokeratin 19 (CK19), and neural cell adhesion molecule (NCAM); biliary marker: CK7; hepatocyte marker: hepatocyte paraffin 1 (HepPar1); markers of HCC differentiation: glypican-3; signaling: beta-catenin, and the respective grade was semiquantitatively determined.

Results

Histopathologically, hyperintense HCCs showed significantly weaker expression of AFP (p < 0.05), PIVKA-II (p < 0.01), EpCAM (p < 0.005), glypican-3 (p < 0.005) relative to the hypointense HCCs, whereas OATP8 (p < 0.0001), HepPar1 (p < 0.05), and beta-catenin (p < 0.001) were overexpressed in hyperintense HCCs compared with hypointense HCCs.

Conclusion

Hyperintense HCC expressed OATP8 and showed a feature of mature hepatocytes with a weak expression of stem cell characteristics immunohistochemically. In addition, this type of HCC demonstrated a weaker expression of the poorer prognosis markers including, AFP, PIVKA-II, EpCAM, CK19, and glypican-3.

Keywords

OATP8Gadoxetic acidHCCParadoxical uptakePrognosis

Abbreviations

MR

Magnetic resonance

EOB-MRI

Gadoxetic acid-enhanced magnetic resonance imaging

HB phase

Hepatobiliary phase

HCC

Hepatocellular carcinoma

OATP

Organic anion transporter polypeptides

HNF

Hepatocyte nuclear factor

AFP

Alpha-fetoprotein

PIVKA-II

Protein induced by vitamin K absence or antagonist II

NCAM

Neural cell adhesion molecule

HepPar1

Hepatocyte paraffin 1

Copyright information

© Japan Radiological Society 2013