Fujita Nobuhiro, Nishie Akihiro, Asayama Yoshiki, Ishigami Kousei, Ushijima Yasuhiro, Takayama Yukihisa, Okamoto Daisuke, Morita Koichiro, Shirabe Ken, Koto Kazuhiro, Kubo Yuichiro, Oda Yoshinao, Honda Hiroshi
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University.
Magn Reson Med Sci. 2016;15(1):111-20. doi: 10.2463/mrms.2015-0012. Epub 2015 Sep 4.
We attempted to clarify the relationship between the signal intensity (SI) in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance (MR) imaging and the efficacy of hepatic arterial infusion chemotherapy (HAIC) in hepatocellular carcinomas (HCCs).
We enrolled 14 patients with HCCs who underwent gadoxetic acid-enhanced MR imaging prior to HAIC using cisplatin and 5-fluorouracil. In the hepatobiliary phase, we calculated the SI of the HCCs and the background liver. In cases with multiple HCCs, we calculated the SI of the largest lesion. Patients were classified into high (n = 7) and low intensity (n = 7) groups based on the median value of the SI ratio (SI of the tumor/SI of the background liver). We analyzed progression-free survival using the Kaplan-Meier method and the log-rank test. In the 5 patients with a history of HCC surgery, we compared the expression of immunohistochemical organic anion-transporting polypeptide (OATP) 8 between the high and low intensity groups by chi-square test.
The SI ratios were 0.568 ± 0.093 (mean ± standard deviation) in the high intensity group and 0.251 ± 0.086 in the low intensity group. Compared to the group with low signal intensity, the group with high signal intensity demonstrated significantly lower serum levels of alpha fetoprotein (AFP) (P = 0.0350), significantly higher progression-free survival (P = 0.0108), better differentiation of tumor grade at histologic examination (P = 0.0253), and significantly higher OATP8 expression (P = 0.0253).
Patients with HCCs of high SI ratio in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging can respond better to HAIC.
我们试图阐明钆塞酸增强磁共振（MR）成像肝胆期的信号强度（SI）与肝细胞癌（HCC）肝动脉灌注化疗（HAIC）疗效之间的关系。
我们纳入了14例接受HAIC（使用顺铂和5-氟尿嘧啶）治疗前进行钆塞酸增强MR成像的HCC患者。在肝胆期，我们计算了HCC和肝脏背景的SI。对于多发HCC病例，我们计算了最大病灶的SI。根据SI比值（肿瘤SI/肝脏背景SI）的中位数，将患者分为高强度组（n = 7）和低强度组（n = 7）。我们使用Kaplan-Meier法和对数秩检验分析无进展生存期。在5例有HCC手术史的患者中，我们通过卡方检验比较了高强度组和低强度组之间免疫组化有机阴离子转运多肽（OATP）8的表达情况。
高强度组的SI比值为0.568±0.093（平均值±标准差），低强度组为0.251±0.086。与低信号强度组相比，高信号强度组的甲胎蛋白（AFP）血清水平显著更低（P = 0.0350），无进展生存期显著更长（P = 0.0108），组织学检查时肿瘤分级的分化更好（P = 0.0253），且OATP8表达显著更高（P = 0.0253）。
钆塞酸增强MR成像肝胆期SI比值高的HCC患者对HAIC的反应可能更好。
