Gadoxetic acid–enhanced MRI as a predictor of recurrence of HCC after liver transplantation View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-08-30

AUTHORS

Sunyoung Lee, Kyoung Won Kim, Woo Kyoung Jeong, Myeong-Jin Kim, Gi Hong Choi, Jin Sub Choi, Gi-Won Song, Sung-Gyu Lee

ABSTRACT

ObjectivesTo investigate the value of preoperative gadoxetic acid–enhanced MRI for tumor staging and recurrence prediction of hepatocellular carcinoma (HCC) after primary liver transplantation (LT).MethodsThis multicenter retrospective study included 122 recipients who underwent living donor LT (LDLT) for untreated HCC and pre-transplant gadoxetic acid–enhanced MRI from January 2009 to December 2013. Disease-free survival (DFS) was evaluated. Milan criteria, tumor grade, and microvascular invasion (MVI) were analyzed on the pathological examination of the explanted liver.ResultsThe 1-, 3-, 5-, and 7-year DFS rates were 93.3%, 90.7%, 88.9%, and 86.1%, respectively. In the multivariable analysis, independent predictors of HCC recurrence were “beyond the Milan criteria” (hazard ratio [HR], 3.54; 95% confidence interval [CI], 1.13–11.12; p = 0.030) and peritumoral hypointensity on hepatobiliary phase (HBP) (HR, 18.30; 95% CI, 4.33–77.34; p < 0.001). Pre-transplant MRI yielded a 90.2% accuracy to categorize the Milan criteria when compared with the explanted liver. Peritumoral hypointensity on HBP was significantly associated with a worse tumor grade (p = 0.010) and MVI (p < 0.001). The 5-year DFS rate in patients with “beyond the Milan criteria” but the absence of peritumoral hypointensity on HBP was not different from that in patients “within the Milan criteria” (92.2% vs. 92.9%, p = 0.438).ConclusionsPre-transplant gadoxetic acid–enhanced MRI may assist in the HCC recurrence risk prediction.Key Points• Lesions beyond the Milan criteria and peritumoral hypointensity on hepatobiliary phase (HBP) were independent predictors of HCC recurrence.• Peritumoral hypointensity on HBP significantly associated with a worse tumor grade and microvascular invasion. More... »

PAGES

987-995

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-019-06424-0

DOI

http://dx.doi.org/10.1007/s00330-019-06424-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1120718546

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31471754


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34 schema:description ObjectivesTo investigate the value of preoperative gadoxetic acid–enhanced MRI for tumor staging and recurrence prediction of hepatocellular carcinoma (HCC) after primary liver transplantation (LT).MethodsThis multicenter retrospective study included 122 recipients who underwent living donor LT (LDLT) for untreated HCC and pre-transplant gadoxetic acid–enhanced MRI from January 2009 to December 2013. Disease-free survival (DFS) was evaluated. Milan criteria, tumor grade, and microvascular invasion (MVI) were analyzed on the pathological examination of the explanted liver.ResultsThe 1-, 3-, 5-, and 7-year DFS rates were 93.3%, 90.7%, 88.9%, and 86.1%, respectively. In the multivariable analysis, independent predictors of HCC recurrence were “beyond the Milan criteria” (hazard ratio [HR], 3.54; 95% confidence interval [CI], 1.13–11.12; p = 0.030) and peritumoral hypointensity on hepatobiliary phase (HBP) (HR, 18.30; 95% CI, 4.33–77.34; p < 0.001). Pre-transplant MRI yielded a 90.2% accuracy to categorize the Milan criteria when compared with the explanted liver. Peritumoral hypointensity on HBP was significantly associated with a worse tumor grade (p = 0.010) and MVI (p < 0.001). The 5-year DFS rate in patients with “beyond the Milan criteria” but the absence of peritumoral hypointensity on HBP was not different from that in patients “within the Milan criteria” (92.2% vs. 92.9%, p = 0.438).ConclusionsPre-transplant gadoxetic acid–enhanced MRI may assist in the HCC recurrence risk prediction.Key Points• Lesions beyond the Milan criteria and peritumoral hypointensity on hepatobiliary phase (HBP) were independent predictors of HCC recurrence.• Peritumoral hypointensity on HBP significantly associated with a worse tumor grade and microvascular invasion.
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51 carcinoma
52 criteria
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55 examination
56 gadoxetic acid-enhanced MRI
57 grade
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60 hypointensity
61 independent predictors
62 invasion
63 lesions
64 liver
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66 microvascular invasion
67 multicenter retrospective study
68 multivariable analysis
69 pathological examination
70 patients
71 peritumoral hypointensity
72 phase
73 prediction
74 predictors
75 predictors of recurrence
76 preoperative gadoxetic acid-enhanced MRI
77 primary liver transplantation
78 rate
79 recipients
80 recurrence
81 recurrence risk prediction
82 retrospective study
83 risk prediction
84 staging
85 study
86 survival
87 transplantation
88 tumor grade
89 tumor staging
90 untreated hepatocellular carcinoma
91 values
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