European Radiology

, Volume 28, Issue 10, pp 4243–4253 | Cite as

Quantitative correlation between uptake of Gd-BOPTA on hepatobiliary phase and tumor molecular features in patients with benign hepatocellular lesions

  • Edouard ReizineEmail author
  • Giuliana Amaddeo
  • Frederic Pigneur
  • Laurence Baranes
  • François Legou
  • Sebastien Mulé
  • Benhalima Zegai
  • Vincent Roche
  • Alexis Laurent
  • Alain Rahmouni
  • Julien Calderaro
  • Alain Luciani



The purpose of our study was to correlate the quantitative analysis of benign hepatocellular tumor uptake on delayed hepatobiliary phase (HBP) imaging with the quantitative level of OATP expression.


This single-center retrospective study, which took place between September 2009 and March 2015, included 20 consecutive patients with a proven pathologic and immunohistochemical (IHC) diagnosis of FNH or HCA, including quantification of the OATP expression. The patients underwent Gd-BOPTA-enhancement MRI, including an HBP. The analysis of HBP uptake was performed using the liver-to-lesion contrast enhancement ratio (LLCER). Mean LLCER and OATP expressions were compared between FNH and HCA, and the expression of OATP was correlated with the LLCER value.


Of the 23 benign hepatocellular tumors, 9 (39%) were FNH and 14 (61%) were HCA, including 6 inflammatory, 2 HNF1a inactivated, 3 β-catenin-mutated and 3 unclassified HCAs. On HBP, 100% of the FNH appeared hyper- or isointense, and 79% of the adenomas appeared hypointense. The mean OATP expression of FNH (46.67 ± 26.58%) was significantly higher than that of HCA (22.14 ± 30.74%) (p = 0.0273), and the mean LLCER of FNH (10.66 ± 7.403%) was significantly higher than that of HCA (-13.5 ± 12.25%) (p < 0.0001). The mean LLCER of β-catenin-mutated HCA was significantly higher than that of other HCAs (p = 0.011). Significant correlation was found between the OATP expression and LLCER values (r = 0.661; p = 0.001).


In benign hepatocellular tumors, the quantitative analysis of hepatobiliary contrast agent uptake on HBP is correlated with the level of OATP expression and could be used as an imaging biomarker of the molecular background of HCA and FNH.

Key Points

• Gd-BOPTA uptake on HBP correlates with the OATP level in benign hepatocellular tumors

• FNH and β-catenin-mutated HCA showed an increased lesion-to-liver contrast enhancement ratio (LLCER)

• Increased LLCER may be explained by activation of the Wnt β-catenin pathway


Focal nodular hyperplasia Adenoma Liver neoplasms Organic anion transporters Contrast media 



C-reactive protein


Focal nodular hyperplasia


Glutamine synthetase


Hepatobiliary phase


Hepatocellular adenoma




Liver fatty acid binding protein


Liver-to-lesion contrast enhancement ratio


Organic anion transporting polypeptide


Serum amyloid A


Signal intensity


Volumetric interpolated breath-hold examination



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Prof. Alain Luciani.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in the Journal of Magnetic Resonance Imaging by Roux et al. (J MRI, Apr 2015) focusing on imaging analysis of HBP-MRI using a quantitative approach.


• retrospective

• cross-sectional study

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Edouard Reizine
    • 1
    Email author
  • Giuliana Amaddeo
    • 2
    • 3
    • 4
  • Frederic Pigneur
    • 1
  • Laurence Baranes
    • 1
  • François Legou
    • 1
  • Sebastien Mulé
    • 1
  • Benhalima Zegai
    • 1
  • Vincent Roche
    • 1
  • Alexis Laurent
    • 3
    • 4
    • 5
  • Alain Rahmouni
    • 1
    • 3
  • Julien Calderaro
    • 3
    • 4
    • 6
  • Alain Luciani
    • 1
    • 3
    • 4
  1. 1.Imagerie MedicaleAP-HP, Groupe Henri Mondor Albert ChenevierCréteilFrance
  2. 2.Hepatology DepartmentAP-HP, Groupe Henri Mondor Albert ChenevierCreteilFrance
  3. 3.Faculté de MédecineUniversite Paris Est CreteilCreteilFrance
  4. 4.INSERM Unit U 955CreteilFrance
  5. 5.Liver SurgeryAP-HP, Groupe Henri Mondor Albert ChenevierCreteilFrance
  6. 6.PathologyAP-HP, Groupe Henri Mondor Albert ChenevierCreteilFrance

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