Cervelli Rosa, Cencini Matteo, Aringhieri Giacomo, Silvestrini Beatrice, Cacciato Insilla Andrea, Campani Daniela, Ghinolfi Davide, De Simone Paolo, Tosetti Michela, Crocetti Laura
Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy.
Pisa Division, National Institute for Nuclear Physics (INFN), Pisa, Italy.
Radiol Med. 2025 Apr;130(4):567-576. doi: 10.1007/s11547-025-01962-8. Epub 2025 Feb 12.
Hepatocellular carcinoma's (HCC) pathological grading is a recognized factor influencing intrahepatic recurrence after treatment. Thus, understanding the HCC heterogeneity is crucial to select the best treatment option aiming at personalized medicine. 7T MRI can provide qualitative and quantitative data, potentially identifying imaging biomarkers for lesions characterization.
From May 2019 to December 2019, all explanted livers of patients undergoing liver transplant were enrolled. All patients underwent whole body CT before liver transplant and all the explanted livers were evaluated (ex-vivo) by 7T MRI within 12 h from liver removal with qualitative and quantitative acquisitions, including 2D/3D magnetic resonance fingerprinting (MRF). First, two expert radiologists qualitatively and quantitatively evaluated the imaging data focusing on both lesions and surrounding tissue, comparing conventional and MRF sequences. Then, specimens were evaluated by an expert pathologist regarding both liver tissues and lesions, particularly focusing on HCC grading.
This work may represent the first step supporting the introduction of quantitative MR imaging (including MRF) in the clinical practice. Along with conventional protocol and dynamic contrast enhancement, the integration of quantitative MR imaging can provide imaging biomarkers useful to identify HCC lesions more prone to recurrence, leading to a better patient selection, according to a personalized medicine approach.
肝细胞癌（HCC）的病理分级是影响治疗后肝内复发的一个公认因素。因此，了解HCC的异质性对于选择旨在实现个性化医疗的最佳治疗方案至关重要。7T磁共振成像（MRI）能够提供定性和定量数据，有可能识别用于病变特征描述的影像生物标志物。
纳入2019年5月至2019年12月期间接受肝移植患者的所有离体肝脏。所有患者在肝移植前均接受了全身CT检查，并且所有离体肝脏在肝切除后12小时内通过7T MRI进行了评估（体外），采用定性和定量采集，包括二维/三维磁共振指纹成像（MRF）。首先，两名放射科专家对影像数据进行定性和定量评估，重点关注病变及周围组织，比较传统序列和MRF序列。然后，由一名病理专家对肝脏组织和病变进行评估，尤其侧重于HCC分级。
这项工作可能代表了支持在临床实践中引入定量磁共振成像（包括MRF）的第一步。除了传统方案和动态对比增强外，定量磁共振成像的整合能够提供有助于识别更易复发的HCC病变的影像生物标志物，从而根据个性化医疗方法实现更好的患者选择。
