Shusuke Okamura1, Shuji Sumie2, Tatsuyuki Tonan3, Masahito Nakano2, Manabu Satani2, Shigeo Shimose2, Tomotake Shirono2, Hideki Iwamoto2, Hajime Aino2, Takashi Niizeki2, Nobuyoshi Tajiri2, Ryoko Kuromatsu2, Koji Okuda4, Osamu Nakashima5, Takuji Torimura2. 1. Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan. Electronic address: okamura_shyuusuke@kurume-u.ac.jp. 2. Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan. 3. Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan. 4. Division of Hepato-Biliary-Pancreatic Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan. 5. Department of Clinical Laboratory Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Abstract
BACKGROUND: Poor differentiation and microvascular invasion are indicators of poor outcome after hepatectomy for patients with small hepatocellular carcinoma (HCC). AIMS: We investigated whether gadoxetic acid-enhanced and diffusion-weighted magnetic resonance imaging (MRI) could predict these factors before hepatectomy. METHODS: Between July 2008 and April 2012, 75 patients who underwent hepatectomy for small HCCs (diameter: ≤3cm, tumor number: ≤3) were consecutively enrolled. In gadoxetic acid-enhanced MRI, the signal intensity in the tumor was corrected to that in the paraspinous muscles, and the relative enhancement was calculated. In diffusion-weighted imaging, we measured the apparent diffusion coefficient (ADC). We then investigated the correlations between relative enhancement or ADC and histological grade, microvascular invasion and recurrence-free survival. RESULTS: Poorly differentiated HCCs showed significantly lower ADC than well-differentiated and moderately differentiated HCCs. There was no significant difference in the hepatobiliary phase. Only ADC was an independent predictor of microvascular invasion, and the best cut-off point of its prediction was 1.175×10(-3)mm(2)/s. Additionally, the recurrence-free survival was significantly shorter in low-ADC group than in high-ADC group. CONCLUSION: ADC is useful for predicting poorly differentiated HCCs and microvascular invasion, and low ADC is associated with increased recurrence risk for small HCCs after hepatectomy.
BACKGROUND: Poor differentiation and microvascular invasion are indicators of poor outcome after hepatectomy for patients with small hepatocellular carcinoma (HCC). AIMS: We investigated whether gadoxetic acid-enhanced and diffusion-weighted magnetic resonance imaging (MRI) could predict these factors before hepatectomy. METHODS: Between July 2008 and April 2012, 75 patients who underwent hepatectomy for small HCCs (diameter: ≤3cm, tumor number: ≤3) were consecutively enrolled. In gadoxetic acid-enhanced MRI, the signal intensity in the tumor was corrected to that in the paraspinous muscles, and the relative enhancement was calculated. In diffusion-weighted imaging, we measured the apparent diffusion coefficient (ADC). We then investigated the correlations between relative enhancement or ADC and histological grade, microvascular invasion and recurrence-free survival. RESULTS: Poorly differentiated HCCs showed significantly lower ADC than well-differentiated and moderately differentiated HCCs. There was no significant difference in the hepatobiliary phase. Only ADC was an independent predictor of microvascular invasion, and the best cut-off point of its prediction was 1.175×10(-3)mm(2)/s. Additionally, the recurrence-free survival was significantly shorter in low-ADC group than in high-ADC group. CONCLUSION: ADC is useful for predicting poorly differentiated HCCs and microvascular invasion, and low ADC is associated with increased recurrence risk for small HCCs after hepatectomy.
Authors: Likun Cao; Jie Chen; Ting Duan; Min Wang; Hanyu Jiang; Yi Wei; Chunchao Xia; Xiaoyue Zhou; Xu Yan; Bin Song Journal: Quant Imaging Med Surg Date: 2019-04
Authors: Alexey Surov; Maciej Pech; Jazan Omari; Frank Fischbach; Robert Damm; Katharina Fischbach; Maciej Powerski; Borna Relja; Andreas Wienke Journal: Liver Cancer Date: 2021-01-27 Impact factor: 11.740
Authors: Christian Eberhardt; Moritz C Wurnig; Andrea Wirsching; Cristina Rossi; Idana Feldmane; Mickael Lesurtel; Andreas Boss Journal: PLoS One Date: 2018-02-14 Impact factor: 3.240