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Quantitative free-breathing dynamic contrast-enhanced MRI in hepatocellular carcinoma using gadoxetic acid: correlations with Ki67 proliferation status, histological grades, and microvascular density

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Abstract

Purpose

To validate a free-breathing dynamic contrast-enhanced-MRI (DCE-MRI) in hepatocellular carcinoma (HCC) patients using gadoxetic acid, and to determine the relationship between DCE-MRI parameters and histological results.

Methods

Thirty-four HCC patients were included in this prospective study. Free-breathing DCE-MRI data was acquired preoperatively on a 3.0 Tesla scanner. Perfusion parameters (K trans, K ep, V e and the semi-quantitative parameter of initial area under the gadolinium concentration–time curve, iAUC) were calculated and compared with tumor enhancement at contrast-enhanced CT. The relationship between DCE-MRI parameters and Ki67 indices, histological grades and microvascular density (MVD) was determined by correlation analysis. Differences of perfusion parameters between different histopathological groups were compared. Receiver operation characteristic (ROC) analysis of discriminating high-grades (grade III and IV) from low-grades (grade I and II) HCC was performed for perfusion parameters.

Results

Significant relationship was found between DCE-MRI and CT results. The DCE-MRI derived K trans were significantly negatively correlated with Ki-67 indices (rho = − 0.408, P = 0.017) and the histological grades (rho = − 0.444, P = 0.009) of HCC, and K ep and V e were significantly related with tumor MVD (rho = − 0.405, P = 0.017 for K ep; and rho = 0.385, P = 0.024 for V e). K trans, K ep, and iAUC demonstrated moderate diagnostic performance (iAUC = 0.78, 0.77 and 0.80, respectively) for discriminating high-grades from low-grades HCC without significant differences.

Conclusions

The DCE-MRI derived parameters demonstrated weak but significant correlations with tumor proliferation status, histological grades or microvascular density, respectively. This free-breathing DCE-MRI is technically feasible and offers a potential avenue toward non-invasive evaluation of HCC malignancy.

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Acknowledgement

This study was funded by National Natural Science Foundation of China (Grant Number 81471658).

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Authors and Affiliations

  1. West China Medical School of Sichuan University, Chengdu, 610041, Sichuan, China

    Jie Chen

  2. Department of Radiology, West China Hospital of Sichuan University, Guoxuexiang No. 37, Chengdu, 610041, Sichuan province, China

    Chenyang Chen, Chunchao Xia, Zixing Huang & Bin Song

  3. MR Collaboration NE Asia, Siemens Healthcare, Beijing, 100000, China

    Panli Zuo

  4. Siemens Healthcare, 91052, Erlangen, Germany

    Alto Stemmer

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  1. Jie Chen
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  2. Chenyang Chen
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Correspondence to Bin Song.

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Conflict of interest

Author Jie Chen declares that she has no conflict of interest. Author Chenyang Chen declares that she has no conflict of interest. Author Chunchao Xia declares that he has no conflict of interest. Author Zixing Huang declares that he has no conflict of interest. Author Panli Zuo declares that she has no conflict of interest. Author Alto Stemmer declares that he has no conflict of interest. Author Bin Song declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Chen, J., Chen, C., Xia, C. et al. Quantitative free-breathing dynamic contrast-enhanced MRI in hepatocellular carcinoma using gadoxetic acid: correlations with Ki67 proliferation status, histological grades, and microvascular density. Abdom Radiol 43, 1393–1403 (2018). https://doi.org/10.1007/s00261-017-1320-3

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