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Contrast-enhanced magnetic resonance imaging perfusion can predict microvascular invasion in patients with hepatocellular carcinoma (between 1 and 5 cm)

  • Special Section: Quantitative Imaging
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the role of perfusion parameters with MR imaging of the liver in diagnosing MVI in hepatocellular carcinoma (HCC) (between 1 and 5 cm).

Materials and methods

This retrospective study was approved by the institutional review board. In 80 patients with 43 MVI( +) and 42 MVI( −) HCC, whole-liver perfusion MR imaging with Cartesian k-space undersampling and compressed sensing reconstruction was performed after injection of 0.1 mmol/kg gadopentetate dimeglumine. Parameters derived from a dual-input single-compartment model of arterial flow (Fa), portal venous flow (Fp), total blood flow (Ft = Fa + Fp), arterial fraction (ART), distribution volume (DV), and mean transit time (MTT) were measured. The significant parameters between the two groups were included to correlate with the presence of MVI at simple and multiple regression analysis.

Results

In MVI-positive HCC, Fp was significantly higher than in MVI-negative HCC, whereas the reverse was seen for ART (p < 0.001). Tumor size (β = 1.2, p = 0.004; odds ratio, 3.20; 95% CI 1.45, 7.06), Fp (β = 1.1, p = 0.004; odds ratio, 3.09; 95% CI 1.42, 6.72), and ART (β =  − 3.1, p = 0.001; odds ratio, 12.13; 95% CI 2.85, 51.49) were independent risk factors for MVI. The AUC value of the combination of all three metrics was 0.931 (95% CI 0.855, 0.975), with sensitivity of 97.6% and specificity of 76.2%.

Conclusion

The combination of Fp, ART, and tumor size demonstrated a higher diagnostic accuracy compared with each parameter used individually when evaluating MVI in HCC (between 1 and 5 cm).

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Acknowledgements

This work received funding from 1. National Natural Science Foundation of China (Grant Number 91859107) and 2. Shanghai Science and Technology Committee (Grant Number 18DZ1930102).

Author information

Author notes

  1. Lifang Wu and Chun Yang have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Xuhui, 200032, Shanghai, China

    Lifang Wu

  2. Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, No. 180, Fenglin Road, Xuhui, 200032, Shanghai, China

    Chun Yang, Shengxiang Rao, Pengju Xu, Wei Feng, Caizhong Chen & Mengsu Zeng

  3. Shanghai Medical College, Fudan University, No. 138, Yixueyuan Road, Xuhui, 200032, Shanghai, China

    Alice Halim

  4. Department of Pathology, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Xuhui, 200032, Shanghai, China

    Yuan Ji

  5. Shanghai United Imaging Healthcare Co., Ltd. No. 2258, Chengbei Road, Jiading, 201807, Shanghai, China

    Jiayu Zhu

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  1. Lifang Wu
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Wu, L., Yang, C., Halim, A. et al. Contrast-enhanced magnetic resonance imaging perfusion can predict microvascular invasion in patients with hepatocellular carcinoma (between 1 and 5 cm). Abdom Radiol 47, 3264–3275 (2022). https://doi.org/10.1007/s00261-022-03423-6

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  • DOI: https://doi.org/10.1007/s00261-022-03423-6

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