Abstract
Purpose
To assess the accuracy of gadobenate-enhanced MRI for predicting microvascular invasion (MVI) in patients operated for hepatocellular carcinoma (HCC).
Methods
The 164 patients who met the inclusion criteria were assigned to one of two groups: the MVI-positive group and the MVI-negative group. Imaging results were compared between the two groups using the Kruskal test, chi-square test, independent sample t test, and logistic regression analysis.
Results
Differences in the capsule (p = 0.037) and margin (p = 0.004) of the tumor, rim enhancement (p = 0.002), peritumoral enhancement in the arterial phase (p < 0.001), and peritumoral hypointensity in the hepatobiliary phase (HBP) (p < 0.001) were statistically significant. The results of multivariate analysis identified rim enhancement in the arterial phase (odds ratio (OR) = 2.115; 95% confidence interval (CI), 1.002–4.464; p = 0.049) and peritumoral hypointensity in the HBP (OR = 5.836; 95% CI, 2.442–13.948; p < 0.001) as independent risk factors for MVI. Use of the two predictors in combination identified 32.79% (20/61) of HCCs with MVI with a specificity of 95.15% (98/103).
Conclusions
Rim enhancement in the arterial phase and peritumoral hypointensity in the HBP were identified as independent risk factors for MVI in patients with HCC.
Key Points
• Rim enhancement in the arterial phase and peritumoral hypointensity in the hepatobiliary phase were independent risk factors for microvascular invasion in patients with HCC.
• Use of the two predictors in combination had a sensitivity of 32.79% and a specificity of 95.15% for predicting microvascular invasion.
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Abbreviations
- ADC:
-
Apparent diffusion coefficient
- AFP:
-
Alpha-fetoprotein
- DCE:
-
Dynamic contrast-enhanced
- Gd-BOPTA:
-
Gadobenate dimeglumine
- HBP:
-
Hepatobiliary phase
- HCC:
-
Hepatocellular carcinoma
- MVI:
-
Microvascular invasion
- PIVKA-II:
-
Protein Induced by Vitamin K Absence or Antagonist-II
- SI:
-
Signal intensity
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Acknowledgments
We would like to thank the whole study team at 4 hospitals, for continuous support.
Funding
This study has received funding from the Natural Science Foundation of Guangdong Province (2018A030313951), the Foundation of President of Nanfang Hospital (2017C011), the National Science and Technology Major Project (2018ZX10302207-004), the China Medical Research Fund of Guangdong Province (A2017496).
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The scientific guarantor of this publication is Chenguang Wang.
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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
Professor Cairong Zhu kindly provided statistical advice for this manuscript.
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Written informed consent was not required for this study because Gd-BOPTA had been widely used in MRI scan as a contrast agent.
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Institutional Review Board approval was obtained.
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• retrospective
• diagnostic study
• performed at one institution
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Zhang, L., Yu, X., Wei, W. et al. Prediction of HCC microvascular invasion with gadobenate-enhanced MRI: correlation with pathology. Eur Radiol 30, 5327–5336 (2020). https://doi.org/10.1007/s00330-020-06895-6
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DOI: https://doi.org/10.1007/s00330-020-06895-6