Park Sae-Jin, Yoon Jeong Hee, Lee Dong Ho, Lim Woo Hyeon, Lee Jeong Min
Department of Radiology, Seoul National University Hospital, Seoul, Korea.
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
J Magn Reson Imaging. 2021 Feb;53(2):587-596. doi: 10.1002/jmri.27359. Epub 2020 Sep 11.
Tumor stiffness (TS), measured by magnetic resonance elastography (MRE), could be associated with tumor mechanical properties and tumor grade.
To determine whether TS obtained using MRE is associated with survival in patients with single nodular hepatocellular carcinoma (HCC) after hepatic resection (HR).
Retrospective.
In all, 95 patients with pathologically confirmed HCCs.
FIELD STRENGTH/SEQUENCE: 1.5T/3D spin-echo echo-planar imaging MRE.
TS values of the whole tumor (TS-WT) and of a solid portion of the tumor (TS-SP) after excluding the necrotic area were measured on stiffness maps. Known imaging prognostic factors of HCC were also analyzed. After surgery, pathologic findings were evaluated from resected pathology specimens.
Fisher's exact test and the Mann-Whitney U-test were performed to determine the significance of differences according to the tumor grade. Overall survival (OS) / recurrence-free survival (RFS) analyses were performed using Kaplan-Meier analyses and Cox multivariable models.
The average TS-WT was 2.14 ± 0.74 kPa, and the average TS-SP was 2.51 ± 1.07 kPa. The cumulative incidence of RFS was 73.1%, 63.1%, and 57.3% at 1, 3, and 5 years, respectively. The TS-WT, TS-SP, and tumor size (≥5 cm) were significant prognostic factors for RFS (P < 0.001; P < 0.001; P = 0.017, respectively). The estimated overall 1-, 3-, and 5-year survival rates were 95.7%, 86.9%, and 80.8%, respectively. The alpha-fetoprotein changes, platelets, tumor size (≥5 cm), and vascular invasion in pathology were significant predictive factors for overall survival (all P < 0.05). Tumor necrosis, TS-WT, TS-SP, and vascular invasion in pathology were significantly correlated with poorly differentiated HCC (all P < 0.05).
The TS-WT, TW-SP, and tumor size (≥5 cm) were significant predictive factors of RFS after HR in patients with HCC. Level of Evidence Technical Efficacy Stage 5 J. MAGN. RESON. IMAGING 2021;53:587-596.
通过磁共振弹性成像（MRE）测量的肿瘤硬度（TS）可能与肿瘤力学特性和肿瘤分级相关。
确定使用MRE获得的TS是否与肝切除（HR）后单结节肝细胞癌（HCC）患者的生存率相关。
回顾性研究。
总共95例经病理证实的HCC患者。
场强/序列：1.5T/3D自旋回波平面成像MRE。
在硬度图上测量排除坏死区域后整个肿瘤的TS值（TS-WT）和肿瘤实性部分的TS值（TS-SP）。还分析了已知的HCC影像学预后因素。手术后，从切除的病理标本评估病理结果。
采用Fisher精确检验和Mann-Whitney U检验根据肿瘤分级确定差异的显著性。使用Kaplan-Meier分析和Cox多变量模型进行总生存（OS）/无复发生存（RFS）分析。
TS-WT的平均值为2.14±0.74kPa，TS-SP的平均值为2.51±1.07kPa。1年、3年和5年时RFS的累积发生率分别为73.1%、63.1%和57.3%。TS-WT、TS-SP和肿瘤大小（≥5cm）是RFS的显著预后因素（分别为P<0.001；P<0.001；P=0.017）。估计的1年、3年和5年总生存率分别为95.7%、86.9%和80.8%。甲胎蛋白变化、血小板、肿瘤大小（≥5cm）和病理中的血管侵犯是总生存的显著预测因素（均P<0.05）。肿瘤坏死、TS-WT、TS-SP和病理中的血管侵犯与低分化HCC显著相关（均P<0.05）。
TS-WT、TS-SP和肿瘤大小（≥5cm）是HCC患者HR后RFS的显著预测因素。证据水平 技术效能 5级 J.MAGN.RESON.IMAGING 2021；53：587-596。
