Accuracy of preoperative prediction of microinvasion of portal vein in hepatocellular carcinoma using superparamagnetic iron oxide-enhanced magnetic resonance imaging and computed tomography during hepatic angiography

Miyata, Ryohei; Tanimoto, Akihiro; Wakabayashi, Go; Shimazu, Motohide; Nakatsuka, Seishi; Mukai, Makio; Kitajima, Masaki

doi:10.1007/s00535-006-1890-2

Cited by 68 publications

(49 citation statements)

References 26 publications

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“…Recently, several reports have described peritumoral enhancement as a parameter that is suggestive of an increased risk of microvascular tumour invasion [10][11][12]. Kim et al [12] stated that irregular circumferential peritumoral enhancement is a risk factor for microvascular AFP, a-fetoprotein; HBV, hepatitis B virus; HCV, hepatitis C virus; SD, standard deviation.…”

Section: Discussionmentioning

confidence: 99%

“…Miyata et al [11] reported that distortion of corona enhancement and a tumorous arterioportal shunt on CT hepatic arteriography could be significant predictors of portal vein tumour invasion. Nishie et al [10] reported that the size of the peritumoral enhancement was a significant risk factor for microvascular invasion.…”

Section: Discussionmentioning

confidence: 99%

“…Many researchers have tried to elucidate microvascular invasion based on pre-operative imaging studies, including CT during hepatic angiography, dynamic MRI and superparamagnetic iron oxideenhanced MRI [10][11][12][13]. However, radiological findings suggestive of microvascular invasion in pre-operative CT have not yet been well established.…”

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confidence: 99%

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Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Rc²,

Cw³

et al. 2012

BJR

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Objective: The aim of this study was to diagnose microvascular invasion in patients with solitary hepatocellular carcinoma (HCC) from pre-operative CT imaging. Methods: 102 patients with solitary HCC who underwent curative hepatectomy were retrospectively included in our study. The pre-operative 3-phase CT imaging and laboratory data for the 102 patients were reviewed. Tumour size, tumour margin, peritumoral enhancement and a-fetoprotein level were assessed. Surgical pathology was reviewed; tumour differentiation, liver fibrosis score and microvascular invasion were recorded. Results: The histopathological results revealed that 50 HCCs were positive and the other 52 were negative for microvascular invasion. Univariate analysis revealed that tumour size (p50.036), higher Edmondson-Steiner grade (p50.047) and non-smooth tumour margin (p,0.001) showed statistically significant associations with microvascular invasion. Multivariate logistic regression analysis showed that non-smooth tumour margin had a statistically significant association with microvascular invasion only (p,0.001). The sensitivity, specificity, positive predictive value and negative predictive value of the non-smooth tumour margin in the prediction of microvascular invasion were 66%, 86.5%, 82.5% and 72.6%, respectively. Conclusion: Non-smooth tumour margin in pre-operative CT had a statistically significant association with microvascular invasion. More aggressive treatment should be considered in HCC patients with suspected positive microvascular invasion. Hepatic resection is a potentially curative treatment modality for patients with hepatocellular carcinoma (HCC) [1][2][3][4]. Histopathological vascular tumour invasion is a well-known major prognostic factor for patients with HCC who have undergone hepatic resection or liver transplantation [5][6][7][8]. Iwatsuki et al [9] reported that microvascular and macrovascular invasions were associated with a 4.4-and 15-fold increased risk of recurrence, respectively, for patients who had undergone liver transplantation. Because microvascular tumour invasion has a significant impact on recurrence and prognosis, preoperative diagnosis of microvascular invasion is needed.Radiological detection of microvascular tumour invasion may facilitate the pre-operative prediction of a patient's prognosis. Many researchers have tried to elucidate microvascular invasion based on pre-operative imaging studies, including CT during hepatic angiography, dynamic MRI and superparamagnetic iron oxideenhanced MRI [10][11][12][13]. However, radiological findings suggestive of microvascular invasion in pre-operative CT have not yet been well established. The purpose of our study was to diagnose microvascular invasion in patients with solitary HCC from pre-operative triphasic CT findings. Methods and materials PatientsApproval for retrospective study was obtained from our institutional review board. Between January 2007 and December 2009, 153 patients with HCC who underwent elective curative hepatectomy in our institution were...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Rc²,

Cw³

et al. 2012

BJR

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“…Vascular invasion can be classified as macrovascular invasion, which involves major (first or second branches) portal or hepatic veins, and microvascular invasion, which involves third branches or microscopic vessels (9). Myata et al (10) reported that microvascular and major vascular invasions of HCC were related with a 4.4-and 15-fold increased risk of tumor recurrence, respectively. Malignant portal vein thrombus in major portal branches can be identified on Doppler ultrasound (US) or contrast-enhanced US (11,12).…”

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confidence: 99%

Prediction of microvascular invasion of hepatocellular carcinoma: Usefulness of peritumoral hypointensity seen on gadoxetate disodium‐enhanced hepatobiliary phase images

Kim

Jeon

et al. 2011

Magnetic Resonance Imaging

165

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Purpose: To determine whether peritumoral hypointensity seen on hepatobiliary phase images of preoperative gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) is useful for predicting microvascular invasion of hepatocellular carcinoma (HCC). Materials and Methods:This study was approved by the Institutional Review Board. In all, 104 HCC masses in 104 patients who had undergone EOB-MRI and liver surgery within 1 month after EOB-MRI were evaluated. Two radiologists independently recorded the presence of a peritumoral hypointensity on hepatobiliary phase. Interobserver agreement was assessed and consensus records were used. Tumor size was measured. A chi-square test and independent t-test were used for univariate analysis. Multiple logistic regression was performed to determine factors for predicting microvascular invasion. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of peritumoral hypointensity were calculated.Results: Sixty HCCs had microvascular invasion and 44 did not. Interobserver agreement in determining peritumoral hypointensity was excellent (k ¼ 0.83). By univariate analysis, peritumoral hypointensity and tumor size were significant for predicting microvascular invasion of HCC. On multiple logistic regression analysis, only peritumoral hypointensity was significant in predicting microvascular invasion of HCC (P ¼ 0.013). The sensitivity, specificity, PPV, and NPV of peritumoral hypointensity were 38.3%, 93.2%, 88.5%, and 52.6%, respectively. Conclusion:Peritumoral hypointensity on the hepatobiliary phase of EOB-MRI is not sensitive but has high specificity for predicting microvascular invasion of HCC.

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“…Intrahepatic recurrence is due to two mechanisms; intrahepatic metastasis (IM) originating from the primary cancer, and a second primary cancer arising from multicentric carcinogenesis (MC). IM may correlate with early recurrence and poor prognosis, whereas MC is associated with relatively good prognosis [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Prevention of intrahepatic metastasis of liver cancer by suicide gene therapy and chemokine ligand 2/monocyte chemoattractant protein‐1 delivery in mice

Kakinoki¹,

Nakamoto²,

Kagaya³

et al. 2010

The Journal of Gene Medicine

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Background The prognosis of patients with hepatocellular carcinoma (HCC) remains poor, largely as a result of intrahepatic metastasis. Using a mouse model of intrahepatic metastasis, we investigated whether chemokine ligand 2/monocyte chemoattractant protein‐1 (CCL2/MCP‐1) could potentiate the antitumor effects of the herpes simplex virus thymidine kinase/ganciclovir (HSV‐tk/GCV) system. Methods Mouse hepatoma cells infected with recombinant adenovirus vectors expressing HSV‐tk, CCL2/MCP‐1 and LacZ at multiplicities of infection of Ad‐tk/Ad‐MCP1 = 3/0.03 (T/MLow), 3/3 (T/MHigh) and Ad‐tk/Ad‐LacZ = 3/3 (T/L) were injected into BALB/c mice. Results Intrahepatic tumor growth was significantly lower in T/MLow mice. By contrast, no tumor suppression was observed in T/MHigh mice. The tumor‐specific cytolytic activities of splenocytes from T/MLow and T/MHigh mice were comparable. Immunohistochemical analysis of liver tissues showed similar infiltration by Mac‐1+ and T cells in these animals, whereas the proportions of classical activated (M1) monocytes/macrophages were significantly higher in T/MLow mice. In addition, interleukin‐12 production was elevated in these tissues. Vascular endothelial growth factor‐A expression and CD31+ microvessels were increased in T/MHigh mice. Conclusions Collectively, these results demonstrate that an adequate amount of CCL2/MCP‐1, together with the HSV‐tk/GCV system, may induce T helper 1‐polarized antitumor effects without inducing tumor angiogenesis in the microenvironment of intrahepatic HCC progression. Copyright © 2010 John Wiley & Sons, Ltd.

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Accuracy of preoperative prediction of microinvasion of portal vein in hepatocellular carcinoma using superparamagnetic iron oxide-enhanced magnetic resonance imaging and computed tomography during hepatic angiography

Abstract: Distortion of corona, tumorous AP shunt, and tumor size are good predictors of the risk of PVI. This scoring system is simple and worth using clinically.

Cited by 68 publications

References 26 publications

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Prediction of microvascular invasion of hepatocellular carcinoma: Usefulness of peritumoral hypointensity seen on gadoxetate disodium‐enhanced hepatobiliary phase images

Prevention of intrahepatic metastasis of liver cancer by suicide gene therapy and chemokine ligand 2/monocyte chemoattractant protein‐1 delivery in mice

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