The value of hepatobiliary phase in EOB-MRI in predicting hypervascularization outcome of non-hypervascular hypointense lesions in high-risk patients for hepatocellular carcinoma.

Abstract

PURPOSE:

To estimate the role of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI (EOB-MRI) in predicting hypervascularization outcome of non-hypervascular hypointense hepatic lesions in high-risk patients for hepatocellular carcinoma (HCC).

METHODS:

Under the premise of non-hyperenhance in arterial phase (AP) and hypointensity in hepatobiliary phase (HBP) of EOB-MRI, 29 fresh lesions from 22 patients with chronic viral hepatitis (median (range) age: 69(57-82) years) were prospectively enrolled. During continuously followed-up by EOB-MRI, lesional vascularity in AP, the signal intensity (SI) ratios of lesions-to-parenchyma in HBP images (post-contrast ratio) and adjusted enhancement with reference of unenhanced images (EOB enhancement ratio) were examined.

RESULTS:

After 644 (220-2912) days of follow-up, 20 lesions changed into hyperenhancement in AP of EOB-MRI (hypervascularized group), while nine remained non-hyperenhanced (maintained non-hypervascular group). There is no statistical difference of post-contrast ratio at the initial detection. The post-contrast ratios in hypervascularized group were different between each follow-up time point when followed-up ≥ three (P < 0.01) and four (P < 0.05) times, and exposed a linear downward trend with time. Between the hypervascularized and maintained non-hypervascular groups, there were significant differences in the post-contrast ratio at endpoint for three-times' follow-up (P < 0.001); and at the second (P = 0.037), third follow-up time points (P = 0.005), endpoint (P = 0.005) for four-times' follow-up. EOB enhancement ratio showed inter-group difference only at endpoint for three-times' follow-up (P = 0.008).

CONCLUSION:

For non-hypervascular, HBP hypointense hepatic lesions, decreasing trend of SI in HBP may early predict unfavorable hypervascularized outcome.

• Authors: Feiqian Wang, Kazushi Numata, Makoto Chuma, Hiromi Nihonmatsu, Satoshi Moriya, Akito Nozaki, Katsuaki Ogushi, Hiroyuki Fukuda, Masahiro Okada, Litao Ruan, Wen Luo, Norihiro Koizumi, Masayuki Nakano, Masako Otani, Yoshiaki Inayama, Shin Maeda
• Journal: Abdominal radiology (New York) (Abdom Radiol (NY)) Vol. 46 Issue 6 Pg. 2527-2539 (06 2021) ISSN: 2366-0058 [Electronic] United States
• PMID: 33388895 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Gadolinium DTPA

Topics

• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (diagnostic imaging)
• Contrast Media
• Gadolinium DTPA
• Humans
• Liver Neoplasms (diagnostic imaging)
• Magnetic Resonance Imaging
• Retrospective Studies