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A non-smooth tumor margin in the hepatobiliary phase of gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging predicts microscopic portal vein invasion, intrahepatic metastasis, and early recurrence after hepatectomy in patients with hepatocellular carcinoma

  • Original article
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Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Background

The value of the hepatobiliary phase of gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) in patients with hepatocellular carcinoma (HCC) has not been evaluated in detail.

Methods

Between 2008 and 2009, 61 patients with HCC within the Milan criteria underwent Gd-EOB-DTPA-enhanced MRI and hepatectomy. The tumor margin was determined preoperatively based on hepatobiliary phase images. Microscopic portal vein invasion (MPVI), intrahepatic metastasis (IM), and recurrence of HCC within 1 year after hepatectomy were evaluated in 24 patients with non-smooth margins at the periphery of the tumor and 37 patients with smooth margins.

Results

The number of patients with MPVI and IM of HCC was significantly higher among those with non-smooth margins (42 and 38%, respectively) than among those with smooth margins (3%; p = 0.0002 and 5%; p = 0.0042, respectively). A non-smooth margin was identified as a significant predictor of MPVI (odds ratio 18.814, p = 0.024) and IM (odds ratio 6.498, p = 0.036) of HCC on multivariate analysis. Furthermore, a non-smooth margin was identified as a significant predictor of recurrence within 1 year after hepatectomy (odds ratio 4.306, p = 0.04) on multivariate analysis.

Conclusions

A non-smooth tumor margin in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI is useful to predict MPVI, IM, and early recurrence of HCC after hepatectomy.

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Acknowledgments

The authors are indebted to Associate Professor Raoul Breugelmans of the Department of International Medical Communications of Tokyo Medical University for his review of this manuscript.

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Authors and Affiliations

  1. Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, 8-1 Kawada, Shinjuku-ku, Tokyo, 162-8666, Japan

    Shun-ichi Ariizumi, Koichi Kitagawa, Yoshihito Kotera, Yutaka Takahashi, Satoshi Katagiri & Masakazu Yamamoto

  2. Department of Radiology, Juntendo University, Faculty of Medicine, Tokyo, Japan

    Ryohei Kuwatsuru

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  1. Shun-ichi Ariizumi
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  2. Koichi Kitagawa
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  3. Yoshihito Kotera
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  4. Yutaka Takahashi
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  7. Masakazu Yamamoto
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Correspondence to Shun-ichi Ariizumi.

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Ariizumi, Si., Kitagawa, K., Kotera, Y. et al. A non-smooth tumor margin in the hepatobiliary phase of gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging predicts microscopic portal vein invasion, intrahepatic metastasis, and early recurrence after hepatectomy in patients with hepatocellular carcinoma. J Hepatobiliary Pancreat Sci 18, 575–585 (2011). https://doi.org/10.1007/s00534-010-0369-y

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