Yoon Ja Kyung, Han Dai Hoon, Lee Sunyoung, Choi Jin-Young, Choi Gi Hong, Kim Do Young, Kim Myeong-Jin
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Liver Int. 2024 Oct;44(10):2847-2857. doi: 10.1111/liv.16059. Epub 2024 Aug 6.
BACKGROUND & AIMS: Accumulating evidence suggests that certain imaging features of hepatocellular carcinoma (HCC) may have prognostic implications. This study aimed to intraindividually compare MRIs with extracellular contrast agent (ECA-MRI) and hepatobiliary agent (HBA-MRI) for prognostic imaging features of HCC and to compare the prediction of microvascular invasion (MVI) and early recurrence between the two MRIs.
The present study included 102 prospectively enrolled at-risk patients (median age, 61.0 years; 83 men) with surgically resected single HCC with both preoperative ECA-MRI and HBA-MRI between July 2019 and June 2023. The McNemar test was used to compare each prognostic imaging feature between the two MRIs. Significant imaging features associated with MVI were identified by multivariable logistic regression analysis, and early recurrence rates (<2 years) were compared between the two MRIs.
The frequencies of prognostic imaging features were not significantly different between the two MRIs (p = .07 to >.99). Non-smooth tumour margin (ECA-MRI, odds ratio [OR] = 5.30; HBA-MRI, OR = 7.07) and peritumoral arterial phase hyperenhancement (ECA-MRI, OR = 4.26; HBA-MRI, OR = 4.43) were independent factors significantly associated with MVI on both MRIs. Two-trait predictor of venous invasion (presence of internal arteries and absence of hypoattenuating halo) on ECA-MRI (OR = 11.24) and peritumoral HBP hypointensity on HBA-MRI (OR = 20.42) were other predictors of MVI. Early recurrence rates of any two or more significant imaging features (49.8% on ECA-MRI vs 51.3% on HBA-MRI, p = .75) were not significantly different between the two MRIs.
Prognostic imaging features of HCC may be comparable between ECA-MRI and HBA-MRI.
越来越多的证据表明，肝细胞癌（HCC）的某些影像学特征可能具有预后意义。本研究旨在对接受细胞外对比剂的磁共振成像（ECA-MRI）和肝胆对比剂的磁共振成像（HBA-MRI）进行个体内比较，以观察HCC的预后影像学特征，并比较两种磁共振成像对微血管侵犯（MVI）和早期复发的预测情况。
本研究纳入了102例前瞻性登记的高危患者（中位年龄61.0岁；83例男性），这些患者在2019年7月至2023年6月期间接受了手术切除的单发HCC，术前均进行了ECA-MRI和HBA-MRI检查。采用McNemar检验比较两种磁共振成像之间的每个预后影像学特征。通过多变量逻辑回归分析确定与MVI相关的显著影像学特征，并比较两种磁共振成像之间的早期复发率（<2年）。
两种磁共振成像之间的预后影像学特征频率无显著差异（p = 0.07至>0.99）。肿瘤边缘不光滑（ECA-MRI，比值比[OR]=5.30；HBA-MRI，OR = 7.07）和瘤周动脉期强化（ECA-MRI，OR = 4.26；HBA-MRI，OR = 4.43）是两种磁共振成像上与MVI显著相关的独立因素。ECA-MRI上静脉侵犯的双特征预测指标（存在内部动脉且无低衰减晕）（OR = 11.24）和HBA-MRI上瘤周肝胆期低信号（OR = 20.42）是MVI的其他预测指标。两种磁共振成像之间，任意两种或更多显著影像学特征的早期复发率无显著差异（ECA-MRI为49.8%，HBA-MRI为51.3%，p = 0.75）。
ECA-MRI和HBA-MRI对HCC的预后影像学特征评估可能具有可比性。
