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Does the change in volumetric functional MR metrics post-TACE predict histopathologic grading of hepatocellular carcinoma?

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Objectives

To evaluate whether the change in volumetric ADC (vADC) and volumetric venous enhancement (vVE) after transarterial chemoembolization (TACE) can predict the histologic grading of hepatocellular carcinoma (HCC).

Materials and methods

This HIPPA-compliant retrospective study was approved by our institutional review board. The study population included 106 HCC patients (147 index lesions) who had MR imaging within 3 months before and after TACE and pathologic report of the HCC either by biopsy or liver transplantation/resection between 2001 and 2017. Volumetric measurements of venous enhancement (VE) and apparent diffusion coefficient (ADC) were performed on baseline and post-TACE MRI. The tumors were histologically classified into two low-grade and high-grade groups. The parameters between two groups were compared using bivariate and multivariate analyses.

Results

Median change in vADC, vVE, and absolute vADC skewness after TACE was higher in low-grade HCCs as compared with high-grade HCCs (p < 0.001, p = 0.005, p = 0.04, respectively). Combining ΔvADC, ΔvVE, and the etiology for background liver disease in multivariate analysis had the highest accuracy in distinguishing high-grade tumors (AUC = 91%).

Conclusion

ΔvADC and ΔvVE after TACE are potential predictors of HCC histopathological grading. Combining functional MRI biomarkers with the etiology of liver disease can enhance the accuracy in assessing degree of differentiation.

Key Points

• Change in volumetric functional MRI biomarkers after TACE can be a non-invasive method to evaluate tumor histopathology in HCC.

• The etiology of background liver disease might be a predictor of tumor degree of differentiation.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the curve

DWI:

Diffusion-weighted MRI

HCC:

Hepatocellular carcinoma

IQR:

Interquartile range

MRI:

Magnetic resonance imaging

PVP:

Portal venous phase

ROC:

Receiver operating characteristics

vADC:

Volumetric ADC

vVE:

Volumetric venous enhancement

ΔvADC:

Change in volumetric ADC after TACE

ΔvVE:

Change in volumetric VE after TACE

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

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Authors and Affiliations

  1. Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Room 143, MRI 143, Baltimore, MD, 21287, USA

    Sanaz Ameli, Mohammadreza Shaghaghi, Mounes Aliyari Ghasabeh, Pallavi Pandey, Bita Hazhirkarzar, Roya Rezvani Habibabadi, Maryam Ghadimi, Pegah Khoshpouri, Ankur Pandey & Ihab R. Kamel

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  1. Sanaz Ameli
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  2. Mohammadreza Shaghaghi
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  3. Mounes Aliyari Ghasabeh
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  4. Pallavi Pandey
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  5. Bita Hazhirkarzar
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  6. Roya Rezvani Habibabadi
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  10. Ihab R. Kamel
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Correspondence to Ihab R. Kamel.

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The scientific guarantor of this publication is Dr. Ihab R. Kamel.

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Statistics and biometry

No complex statistical methods were necessary for this paper.

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Only if the study is on human subjects. Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

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• retrospective

• cross-sectional study

• performed at one institution

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Ameli, S., Shaghaghi, M., Ghasabeh, M.A. et al. Does the change in volumetric functional MR metrics post-TACE predict histopathologic grading of hepatocellular carcinoma?. Eur Radiol 30, 6709–6720 (2020). https://doi.org/10.1007/s00330-020-07052-9

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  • DOI: https://doi.org/10.1007/s00330-020-07052-9

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