Gd-EOB MRI for HCC subtype differentiation in a western population according to the 5
Gadoxetic acid
Hepatocellular carcinoma
Liver
Magnetic resonance imaging
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
27
02
2023
accepted:
10
04
2023
revised:
29
03
2023
medline:
21
9
2023
pubmed:
28
4
2023
entrez:
28
4
2023
Statut:
ppublish
Résumé
To investigate the value of gadoxetic acid (Gd-EOB)-enhanced magnetic resonance imaging (MRI) for noninvasive subtype differentiation of HCCs according to the 5 This retrospective study included 262 resected lesions in 240 patients with preoperative Gd-EOB-enhanced MRI. Subtypes were assigned by two pathologists. Gd-EOB-enhanced MRI datasets were assessed by two radiologists for qualitative and quantitative imaging features, including imaging features defined in LI-RADS v2018 and area of hepatobiliary phase (HBP) iso- to hyperintensity. The combination of non-rim arterial phase hyperenhancement with non-peripheral portal venous washout was more common in "not otherwise specified" (nos-ST) (88/168, 52%) than other subtypes, in particular macrotrabecular massive (mt-ST) (3/15, 20%), chromophobe (ch-ST) (1/8, 13%), and scirrhous subtypes (sc-ST) (2/9, 22%) (p = 0.035). Macrovascular invasion was associated with mt-ST (5/16, p = 0.033) and intralesional steatosis with steatohepatitic subtype (sh-ST) (28/32, p < 0.001). Predominant iso- to hyperintensity in the HBP was only present in nos-ST (16/174), sh-ST (3/33), and clear cell subtypes (cc-ST) (3/13) (p = 0.031). Associations were found for the following non-imaging parameters: age and sex, as patients with fibrolamellar subtype (fib-ST) were younger (median 44 years (19-66), p < 0.001) and female (4/5, p = 0.023); logarithm of alpha-fetoprotein (AFP) was elevated in the mt-ST (median 397 µg/l (74-5370), p < 0.001); type II diabetes mellitus was more frequent in the sh-ST (20/33, p = 0.027). Gd-EOB-MRI reproduces findings reported in the literature for extracellular contrast-enhanced MRI and CT and may be a valuable tool for noninvasive HCC subtype differentiation. Better characterization of the heterogeneous phenotypes of HCC according to the revised WHO classification potentially improves both diagnostic accuracy and the precision of therapeutic stratification for HCC. • Previously reported imaging features of common subtypes in CT and MRI enhanced with extracellular contrast agents are reproducible with Gd-EOB-enhanced MRI. • While uncommon, predominant iso- to hyperintensity in the HBP was observed only in NOS, clear cell, and steatohepatitic subtypes. • Gd-EOB-enhanced MRI offers imaging features that are of value for HCC subtype differentiation according to the 5
Identifiants
pubmed: 37115216
doi: 10.1007/s00330-023-09669-y
pii: 10.1007/s00330-023-09669-y
pmc: PMC10511376
doi:
Substances chimiques
Gadolinium DTPA
K2I13DR72L
Contrast Media
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
6902-6915Informations de copyright
© 2023. The Author(s).
Références
Llovet JM, Zucman-Rossi J, Pikarsky E et al (2016) Hepatocellular carcinoma. Nat Rev Dis Primers 2:16018
Kulik L, El-Serag HB (2019) Epidemiology and management of hepatocellular carcinoma. Gastroenterology 156(2):477–91 e1
European Association for the Study of the Liver (2018) Electronic address eee, European Association for the Study of the L. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol 69(1):182–236
Nagtegaal ID, Odze RD, Klimstra D et al (2020) The 2019 WHO classification of tumours of the digestive system. Histopathology 76(2):182-8
Torbenson MN, Ng IOL, Park YN, Roncalli M, Sakamato M (2019) WHO classification of digestive systems tumors. In: WHO Classification of Tumours, 5th ed, vol 1. International Agency for Research on Cancer, Lyon
Ziol M, Poté N, Amaddeo G et al (2018) Macrotrabecular-massive hepatocellular carcinoma: a distinctive histological subtype with clinical relevance. Hepatology 68(1):103-12
Cannella R, Dioguardi Burgio M, Beaufrère A et al (2021) Imaging features of histological subtypes of hepatocellular carcinoma: implication for LI-RADS. JHEP Rep 3(6):100380
Torbenson MS (2017) Morphologic subtypes of hepatocellular carcinoma. Gastroenterol Clin North Am 46(2):365–391
doi: 10.1016/j.gtc.2017.01.009
pubmed: 28506370
Erstad DJ, Tanabe KK (2019) Prognostic and therapeutic implications of microvascular invasion in hepatocellular carcinoma. Ann Surg Oncol 26(5):1474–1493
doi: 10.1245/s10434-019-07227-9
pubmed: 30788629
Mulé S, Galletto Pregliasco A, Tenenhaus A et al (2020) Multiphase liver MRI for identifying the macrotrabecular-massive subtype of hepatocellular carcinoma. Radiology 295(3):562-71
Mulé S, Serhal A, Pregliasco AG et al (2023) MRI features associated with HCC histologic subtypes: a western American and European bicenter study. Eur Radiol 33(2):1342–1352
Bioulac-Sage P, Rebouissou S, Thomas C et al (2007) Hepatocellular adenoma subtype classification using molecular markers and immunohistochemistry. Hepatology 46(3):740-8
Bioulac-Sage P, Balabaud C, Zucman-Rossi J (2010) Subtype classification of hepatocellular adenoma. Dig Surg 27(1):39–45
doi: 10.1159/000268406
pubmed: 20357450
Nault JC, Paradis V, Cherqui D, Vilgrain V, Zucman-Rossi J (2017) Molecular classification of hepatocellular adenoma in clinical practice. J Hepatol 67(5):1074–1083
doi: 10.1016/j.jhep.2017.07.009
pubmed: 28733222
Nault JC, Couchy G, Balabaud C et al (2017) Molecular classification of hepatocellular adenoma associates with risk factors, bleeding, and malignant transformation. Gastroenterology 152(4):880–94 e6
Auer TA, Fehrenbach U, Grieser C et al (2020) Hepatocellular adenomas: is there additional value in using Gd-EOB-enhanced MRI for subtype differentiation? Eur Radiol 30(6):3497-506
Tse JR, Naini BV, Lu DS, Raman SS (2016) Qualitative and quantitative gadoxetic acid-enhanced MR imaging helps subtype hepatocellular adenomas. Radiology 279(1):118–127
doi: 10.1148/radiol.2015142449
pubmed: 26505921
Auer TA, Walter-Rittel T, Geisel D et al (2021) HBP-enhancing hepatocellular adenomas and how to discriminate them from FNH in Gd-EOB MRI. BMC Med Imaging 21(1):28
Lee SA, Lee CH, Jung WY et al (2011) Paradoxical high signal intensity of hepatocellular carcinoma in the hepatobiliary phase of Gd-EOB-DTPA enhanced MRI: initial experience. Magn Reson Imaging 29(1):83-90
Kim JY, Kim MJ, Kim KA, Jeong HT, Park YN (2012) Hyperintense HCC on hepatobiliary phase images of gadoxetic acid-enhanced MRI: correlation with clinical and pathological features. Eur J Radiol 81(12):3877–3882
doi: 10.1016/j.ejrad.2012.07.021
pubmed: 22954410
Kitao A, Matsui O, Yoneda N et al (2011) The uptake transporter OATP8 expression decreases during multistep hepatocarcinogenesis: correlation with gadoxetic acid enhanced MR imaging. Eur Radiol 21(10):2056-66
Torbenson MZ, Zen Y, Yeh M (2018) Tumors of the Liver in AFIP Atlas of Tumor Pathology; 4th series, fascicle 27. American Registry of Pathology, Washington, DC, pp 265–278
Salomao M, Yu WM, Brown RS Jr, Emond JC, Lefkowitch JH (2010) Steatohepatitic hepatocellular carcinoma (SH-HCC): a distinctive histological variant of HCC in hepatitis C virus-related cirrhosis with associated NAFLD/NASH. Am J Surg Pathol 34(11):1630–1636
doi: 10.1097/PAS.0b013e3181f31caa
pubmed: 20975341
Salomao M, Remotti H, Vaughan R, Siegel AB, Lefkowitch JH, Moreira RK (2012) The steatohepatitic variant of hepatocellular carcinoma and its association with underlying steatohepatitis. Hum Pathol 43(5):737–746
doi: 10.1016/j.humpath.2011.07.005
pubmed: 22018903
Edmondson HA, Steiner PE (1954) Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies. Cancer 7(3):462–503
doi: 10.1002/1097-0142(195405)7:3<462::AID-CNCR2820070308>3.0.CO;2-E
pubmed: 13160935
Kleiner DE, Brunt EM, Van Natta M et al (2005) Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 41(6):1313-21
Desmet VJ, Gerber M, Hoofnagle JH, Manns M, Scheuer PJ (1994) Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology 19(6):1513–1520
doi: 10.1002/hep.1840190629
pubmed: 8188183
Chernyak V, Fowler KJ, Kamaya A et al (2018) Liver Imaging Reporting and Data System (LI-RADS) Version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology 289(3):816-30
Wood LD, Heaphy CM, Daniel HD et al (2013) Chromophobe hepatocellular carcinoma with abrupt anaplasia: a proposal for a new subtype of hepatocellular carcinoma with unique morphological and molecular features. Mod Pathol 26(12):1586-93
Calderaro J, Couchy G, Imbeaud S et al (2017) Histological subtypes of hepatocellular carcinoma are related to gene mutations and molecular tumour classification. J Hepatol 67(4):727-38
Feng Z, Li H, Zhao H et al (2021) Preoperative CT for Characterization of aggressive macrotrabecular-massive subtype and vessels that encapsulate tumor clusters pattern in hepatocellular carcinoma. Radiology 300(1):219-29
Zhu Y, Weng S, Li Y et al (2021) A radiomics nomogram based on contrast-enhanced MRI for preoperative prediction of macrotrabecular-massive hepatocellular carcinoma. Abdom Radiol (NY) 46(7):3139–3148
doi: 10.1007/s00261-021-02989-x
pubmed: 33641018
Inui S, Kondo H, Tanahashi Y et al (2021) Steatohepatitic hepatocellular carcinoma: imaging findings with clinicopathological correlation. Clin Radiol 76(2):160.e15-160.e25. https://doi.org/10.1016/j.crad.2020.09.011
Bannasch P, Ribback S, Su Q, Mayer D (2017) Clear cell hepatocellular carcinoma: origin, metabolic traits and fate of glycogenotic clear and ground glass cells. Hepatobiliary Pancreat Dis Int 16(6):570–594
doi: 10.1016/S1499-3872(17)60071-7
pubmed: 29291777
Eggert T, McGlynn KA, Duffy A, Manns MP, Greten TF, Altekruse SF (2013) Fibrolamellar hepatocellular carcinoma in the USA, 2000–2010: a detailed report on frequency, treatment and outcome based on the Surveillance, Epidemiology, and End Results database. United European Gastroenterol J 1(5):351–357
doi: 10.1177/2050640613501507
pubmed: 24917983
pmcid: 4040774
Haimerl M, Utpatel K, Gotz A et al (2021) Quantification of contrast agent uptake in the hepatobiliary phase helps to differentiate hepatocellular carcinoma grade. Sci Rep 11(1):22991
doi: 10.1038/s41598-021-02499-2
pubmed: 34837039
pmcid: 8626433
Aoki T, Nishida N, Ueshima K et al (2021) Higher enhancement intrahepatic nodules on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI as a poor responsive marker of anti-PD-1/PD-L1 monotherapy for unresectable hepatocellular carcinoma. Liver Cancer 10(6):615–628
doi: 10.1159/000518048
pubmed: 34950184
pmcid: 8647075
Nakachi K, Tamai H, Mori Y et al (2014) Prediction of poorly differentiated hepatocellular carcinoma using contrast computed tomography. Cancer Imaging 14(1):7
doi: 10.1186/1470-7330-14-7
pubmed: 25608454
pmcid: 4331839