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The expression of transporter OATP2/OATP8 decreases in undetectable hepatocellular carcinoma by Gd-EOB-MRI in the explanted cirrhotic liver

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Abstract

Purpose

The aim of this study is to evaluate the detectability of hepatocellular carcinoma (HCC) in the explanted cirrhotic liver using gadoxetic acid-enhanced magnetic resonance imaging (Gd-EOB-MRI) and the degree of organic anion transporter OATP2/OATP8 (OATP1B1/1B3) HCC which could not be preoperatively detected by multi-detector computed tomography (MD-CT) and Gd-EOB-MRI.

Methods

Eleven patients (HBV 3, HCV 7, nonBnonC 1) out of 145 recipients of liver transplantation were analyzed. The detectability by each imaging modality and the expression of OATP2/OATP8 of HCC were analyzed using the whole liver thin sliced histological and immunohistochemical examination retrospectively.

Results

The imaging examination detected 17 lesions of HCC by MDCT and/or Gd-EOB-MRI. Only one lesion detected by Gd-EOB-MRI had well differentiated and minute (7 mm) HCC. However, the histological examination revealed newly 11 lesions and one false-positive lesion of HCC in the explanted livers. The median diameter of the preoperatively undetectable HCC by imaging was 8 mm (2–12). The histological characteristic of the preoperatively undetectable HCC was well differentiated HCC (10/11). The accuracy rate in MDCT and Gd-EOB-MRI was 53.6 % (15/28) and 57.1 % (16/28). The rate of positive predictive value in MDCT and Gd-EOB-MRI was 93.7 % (15/16) and 94.2 % (16/17), respectively. The expression of OATP2/OATP8 in the preoperatively undetectable HCC was negative in nine lesions, was weak positive in two lesions.

Conclusions

The detectability of Gd-EOB-MRI is almost equal to MDCT in a cirrhotic liver. Small HCCs were difficult to detect even with Gd-EOB-MRI. The transporter of OATP2/OATP8 was less expressed in the preoperatively undetectable HCCs.

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Abbreviations

HCC:

Hepatocellular carcinoma

Gd-EOB-MRI:

Gadoxetic acid-enhanced magnetic resonance imaging

MD-CT:

Multi-detector computed tomography

OATP:

Organic anion transporter

MELD:

Model for end-stage liver disease

AFP:

Alpha-fetoprotein

PIVKAII:

Protein induced by Vitamin K absence or antagonists-II

RFA:

Radio frequency ablation

TACE:

Trans-arterial chemoembolization

MRP:

Multidrug-resistant protein

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Authors and Affiliations

  1. Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Masaaki Hidaka, Mitsuhisa Takatsuki, Sadayuki Okudaira, Akihiko Soyama, Izumi Muraoka, Takayuki Tanaka, Izumi Yamaguchi, Takanobu Hara, Tamotsu Kuroki, Takashi Kanematsu & Susumu Eguchi

  2. Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Hisamitsu Miyaaki, Tatsuki Ichikawa & Kazuhiko Nakao

  3. Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan

    Tomayoshi Hayashi

  4. Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Ichiro Sakamoto

Authors
  1. Masaaki Hidaka
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  2. Mitsuhisa Takatsuki
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  3. Sadayuki Okudaira
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  4. Akihiko Soyama
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  5. Izumi Muraoka
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  6. Takayuki Tanaka
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  7. Izumi Yamaguchi
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  9. Hisamitsu Miyaaki
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  10. Tatsuki Ichikawa
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  11. Tomayoshi Hayashi
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  13. Kazuhiko Nakao
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  14. Tamotsu Kuroki
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  15. Takashi Kanematsu
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  16. Susumu Eguchi
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Corresponding author

Correspondence to Susumu Eguchi.

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Hidaka, M., Takatsuki, M., Okudaira, S. et al. The expression of transporter OATP2/OATP8 decreases in undetectable hepatocellular carcinoma by Gd-EOB-MRI in the explanted cirrhotic liver. Hepatol Int 7, 655–661 (2013). https://doi.org/10.1007/s12072-012-9379-y

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  • DOI: https://doi.org/10.1007/s12072-012-9379-y

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