Evaluation and Prognostication of Gd-EOB-DTPA MRI and CT in Patients With Macrotrabecular-Massive Hepatocellular Carcinoma

作者全名："Cheng, Jie; Li, Xiaofeng; Wang, Limei; Chen, Fengxi; Li, Yiman; Zuo, Guojiao; Pei, Mi; Zhang, Huarong; Yu, Linze; Liu, Chen; Wang, Jian; Han, Qi; Cai, Ping; Li, Xiaoming"

作者地址："[Cheng, Jie; Wang, Limei; Chen, Fengxi; Li, Yiman; Zuo, Guojiao; Pei, Mi; Liu, Chen; Wang, Jian; Han, Qi; Cai, Ping; Li, Xiaoming] Army Med Univ, Mil Med Univ 3, Southwest Hosp, Dept Radiol, Chongqing, Peoples R China; [Cheng, Jie; Wang, Limei; Chen, Fengxi; Li, Yiman; Zuo, Guojiao; Pei, Mi; Liu, Chen; Wang, Jian; Han, Qi; Cai, Ping; Li, Xiaoming] Army Med Univ, Mil Med Univ 3, Southwest Hosp, Magnet Resonance Imaging Translat Med Ctr 7T, Chongqing, Peoples R China; [Li, Xiaofeng] Chongqing Med Univ, Affiliated Hosp 3, Dept Radiol, Chongqing, Peoples R China; [Zhang, Huarong] Army Med Univ, Mil Med Univ 3, Inst Pathol, Chongqing, Peoples R China; [Zhang, Huarong] Army Med Univ, Mil Med Univ 3, Southwest Hosp, Southwest Canc Ctr, Chongqing, Peoples R China; [Yu, Linze] North Sichuan Med Coll, Sch Med Imaging, Nanchong, Peoples R China"

通信作者："Cai, P; Li, XM (通讯作者)，Army Med Univ, Mil Med Univ 3, Southwest Hosp, Dept Radiol, Chongqing, Peoples R China.; Cai, P; Li, XM (通讯作者)，Army Med Univ, Mil Med Univ 3, Southwest Hosp, Magnet Resonance Imaging Translat Med Ctr 7T, Chongqing, Peoples R China."

来源：JOURNAL OF MAGNETIC RESONANCE IMAGING

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001084479800001

JCR分区：Q1

影响因子：3.3

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：macrotrabecular-massive; hepatocellular carcinoma; Gd-EOB-DTPA; magnetic resonance imaging; computed tomography

摘要："Background: Macrotrabecular-massive hepatocellular carcinoma (MTM-HCC) is highly aggressive. Comparing the diagnosis ability of CT and gadoxetate disodium (Gd-EOB-DTPA) MRI for MTM-HCC are lacking.Purpose: To compare the performance of Gd-EOB-DTPA MRI and CT for differentiating MTM-HCC from non-MTM-HCC, and determine the prognostic indicator.Study Type: Retrospective.Subjects: Post-surgery HCC patients, divided into the training (N = 272) and external validation (N = 44) cohorts.Field Strength/Sequence: 3.0 T, T1-weighted imaging, in-opp phase, and T1-weighted volumetric interpolated breath-hold examination/liver acquisition with volume acceleration; enhanced CT.Assessment: Three radiologists evaluated clinical characteristics (sex, age, liver disease, liver function, blood routine, alpha-fetoprotein [AFP] and prothrombin time international normalization ratio [PT-INR]) and imaging features (tumor length, intratumor fat, hemorrhage, arterial phase peritumoral enhancement, intratumor necrosis or ischemia, capsule, and peritumoral hepatobiliary phase [HBP] hypointensity). Compared the performance of CT and MRI for diagnosing MTM-HCC. Follow-up occurred every 3-6 months, and nomogram demonstrated the probability of MTM-HCC.Statistical Tests: Fisher test, t-test or Wilcoxon rank-sum test, area under the curve (AUC), 95% confidence interval (CI), multivariable logistic regression, Kaplan-Meier curve, and Cox proportional hazards. Significance level: P < 0.05.Results: Gd-EOB-DTPA MRI (AUC: 0.793; 95% CI, 0.740-0.839) outperformed CT (AUC: 0.747; 95% CI, 0.691-0.797) in the training cohort. The nomogram, incorporating AFP, PT-INR, and MRI features (non-intratumor fat, incomplete capsule, intratumor necrosis or ischemia, and peritumoral HBP hypointensity) demonstrated powerful performance for diagnosing MTM-HCC with an AUC of 0.826 (95% CI, 0.631-1.000) in the external validation cohort. Median follow-up was 347 days (interquartile range [IQR], 606 days) for the training cohort and 222 days (IQR, 441 days) for external validation cohort. Intratumor necrosis or ischemia was an independent indicator for poor prognosis.Data Conclusion: Gd-EOB-DTPA MRI might assist in preoperative diagnosis of MTM-HCC, and intratumor necrosis or ischemia was associated with poor prognosis."

基金机构：This work was supported by the Program of the National Natural Science Foundation of Chongqing (CSTB2022NSCQMSX1371). [CSTB2022NSCQMSX1371]; Program of the National Natural Science Foundation of Chongqing

基金资助正文：This work was supported by the Program of the National Natural Science Foundation of Chongqing (CSTB2022NSCQMSX1371).