Diagnostic Value of Gd‐EOB‐DTPA‐Enhanced MRI for the Expression of Ki67 and Microvascular Density in Hepatocellular Carcinoma

Abstract

Contract grant sponsorNational Natural Science Foundation of China; Contract grant number: 81260214.BackgroundRecent studies have highlighted the diagnostic value of Gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid (Gd‐EOB‐DTPA)‐enhanced MRI in small hepatocellular carcinoma (HCC). Ki67 and CD34 are histologic markers that reflect the proliferation of tumor cells and the microvascular density (MVD).PurposeTo explore the diagnostic value of Gd‐EOB‐DTPA‐enhanced MRI for Ki67 expression and MVD in HCC.Study TypeRetrospective.SubjectsIn all, 180 patients with HCC.Field Strength/Sequence3.0T, Gd‐EOB‐DTPA‐enhanced T1WI volumetric interpolated breath‐hold examination (VIBE) axial fat suppression plain, and enhanced scanning.AssessmentThe T1 relaxation time (T1rt) and signal intensity (SI) of the lesion were measured. The Ki67 expressions and MVD were evaluated by immunohistochemistry.Statistical TestReceiver operating characteristic (ROC) curves were used to analyze the diagnostic efficacy of T1rt for high Ki67 expression (≥50%) and high MVD (≥100).ResultsThe T1rt‐20min, rrT1rt‐20min, and SI‐hepatobiliary phase (SI‐HBP) were strongly correlated with Ki67, the r values were 0.846, –0.765, and –0.760 (P < 0.05), respectively. There were moderate correlations with CD34, with r values –0.444, 0.336, and –0.463 (P < 0.05), respectively. The T1rt‐Pre, T1rt‐20min, SI‐Pre, and SI‐HBP were significantly different both between the high and low ki67 expression groups (P < 0.05) and between the high MVD and low MVD groups (P < 0.05). In the two groups the T1rt‐20min and SI‐HBP was 800.06 ± 128.91 vs. 530.06 ± 139.29 (P < 0.05) and 122.29 ± 39.39 vs. 173.49 ± 46.15 (P < 0.05); T1rt‐20min was found to have high diagnostic efficiency for high ki67 expression (area under the curve [AUC], 0.937; P < 0.05) T1rt‐20min had moderate diagnostic value for high MVD (AUC, 0.716; P < 0.05).Data ConclusionThe T1rt and SI of Gd‐EOB‐DTPA‐enhanced MRI were correlated with Ki67 expression and MVD. T1rt‐20min has a high diagnostic value for high ki67 expression and high MVD in HCC tissues.Level of Evidence: 3Technical Efficacy Stage: 2J. Magn. Reson. Imaging 2020;51:1755–1763.

Evaluation of the Therapeutic Effect of Adjuvant Transcatheter Arterial Chemoembolization Based on Ki67 After Hepatocellular Carcinoma Surgery

“…We divided the 180 patients with HCC into 97 patients with low expression of Ki67 and 83 patients with high expression of Ki67 [a Ki67 < 20% was considered low expression and a Ki67 ≥ 20% was considered high expression (12)]. The two groups of patients were further divided into surgery and surgery + TACE sub-groups.…”

Impact of gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid‐enhanced magnetic resonance imaging on the prognosis of hepatocellular carcinoma after surgery

“…Chen et al . reported that the SI value of tumors during the HBP in patients with HCC with a Ki67 index >50% was significantly lower than that in patients with a Ki67 index ≤50% 18 . In this study, the INI group showed significantly lower AFP levels and higher rates of patients with well‐differentiated HCC than the DI group.…”

Imaging biomarkers for predicting poor prognosis of hepatocellular carcinoma: a review

“…The parameter K trans of free-breathing DCE-MRI using gadoxetic acid is reported to be highly associated with Ki67 proliferation status, and the lower value of K trans indicate higher Ki-67 indices and histological grades of HCC [103] . In addition, the T1 rt-20 min, tumor-to-muscle signal intensity ratio, ADC value and the arterial inhomogeneous enhancement pattern on gadoxetic acid-enhanced-MRI are also correlated with high-Ki-67 expression [104][105][106] . Furthermore, texture analysis, on the basis of gadoxetic acid-enhanced-MRI, can be applied as a tentative approach to preoperatively predict the Ki-67 status of HCC after curative resection [107] .…”