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

Abstract

Background and Aim: Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (EOB-MRI) has been recognized as a useful imaging technique to distinguish the biological behavior of hepatocellular carcinoma (HCC). Methods: We analyzed 217 hepatectomy recipients with HCCs measuring 10 cm or less. We divided the patients into a decreased intensity (DI) group (n = 189, 87%) and an increased or neutral intensity (INI) group (n = 28, 13%) according to the ratio of tumor intensity to liver intensity during the hepatobiliary phase (HBP). According to the ratio of the maximum tumor diameter (including peritumoral hypointensity) between HBP images and precontrast T1-weighted images (RHBPP), we divided the patients as follows: The group whose RHBPP was ≥1.036 was the high RHBPP group (n = 60, 28%), and the group whose RHBPP was <1.036 was the low RHBPP group (n = 157, 72%). We investigated the prognoses and clinicopathological characteristics of these patients. Results: DI versus INI was not a prognostic factor for either survival or recurrence; however, a high RHBPP was an independent predictor of unfavorable survival and recurrence in patients. In addition, the INI group showed significantly lower α-fetoprotein (AFP) levels and higher rates of well-differentiated HCC and ICGR15 ≥15% than the DI group. The high RHBPP group showed significantly higher rates of vascular invasion and poorly differentiated HCC than the low RHBPP group. Conclusions: A high RHBPP by EOB-MRI is a preoperative predictor of vascular invasion and an unfavorable prognostic factor for survival and recurrence. These patients might be considered for highly curative operations such as anatomical liver resection.

Monitoring the hepatobiliary function using image techniques and labeled cholephilic compounds

“…The compound is secreted into bile 10-20 min after injection. Several studies have demonstrated that MRI using Gd-EOB-DTPA provides diagnostic accuracy for liver lesions and HCC [50,51]. However, it is essential to take into account that genetic polymorphisms affecting liver transporters for organic anions [organic anion transporting polypeptides (OATPs)] (Figure 2), as well as some drug interactions, can decrease Gd-EOB-DTPA uptake by hepatocytes.…”

Deep learning model based on contrast-enhanced MRI for predicting post-surgical survival in patients with hepatocellular carcinoma

“…Some clinical factors, such as the Barcelona Clinic Liver Cancer (BCLC) stage, microvascular invasion (MVI), serum alpha-fetoprotein (AFP), number or size of the tumor(s), hypointensity in the hepatobiliary phase, and incomplete capsule, are associated with postoperative prognosis [ [6] , [7] , [8] , [9] ]. Additionally, various nomograms based on staging systems have been developed to predict HCC outcomes [ 10 ].…”