Hepatobiliary phase hypointensity on gadobenate dimeglumine- enhanced magnetic resonance imaging may improve the diagnosis of hepatocellular carcinoma

Li, Yueming; Chen, Jianwei; Weng, Shaohuang; Bai, Guangdong; Ye, Rongping; Zhu, Yuemin; Lv, Wen; Cao, Dairong; Hong, Jinsheng

doi:10.21037/atm.2020.02.38

Cited by 14 publications

(7 citation statements)

References 40 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among the AFs, some speci c AFs show good performance in the diagnosis of HCC [21,22].The nodule-in-nodule feature is a typical manifestation of tumour heterogeneity, and it is a variant of the "mosaic" architecture of HCC [23]. The development of most HCCs in patients with cirrhosis occur via a multistep process of carcinogenesis, from a regenerative nodule (RN) to a DN and nally to HCC [24].…”

Section: Discussionmentioning

confidence: 99%

Threshold growth has a limited role in differentiating HCC from other focal hepatic lesions

Lyu

Wang

et al. 2023

Preprint

View full text Add to dashboard Cite

Background The role of threshold growth, as one of the major features (MFs) of HCC in the Liver Imaging Reporting and Data System (LI-RADS) is inconsistent. This study evaluated the LI-RADS diagnostic performance for HCC when threshold growth was removed or replaced by highly frequent ancillary features (AFs). Methods This was a retrospective institutional review board-approved study including patients with a high HCC risk with gadoxetic acid-enhanced MRI findings consistent with pathologically proven focal hepatic observations. With pathological results used as the gold standard reference, the observations were divided into three groups: HCC, non-HCC malignancy and benign lesion. The sizes of the lesions with and without threshold growth were compared. The MFs and AFs of each observation were evaluated and compared among the three groups to select the most highly frequent AFs of HCC and was used to replace threshold growth. The LI-RADS categories of observations were categorized as follows: Scheme A, using all MFs and AFs according to LI-RADS v2018; scheme B, using all MFs except threshold growth, with threshold growth treated as an AF favouring malignancy; and scheme C, using the highly frequent AFs inplace of threshold growth as new MFs. The LR-5 (the category of definitely HCC) diagnostic performance for HCC among the 3 schemes was compared. Results A total of 379 patients and 426 observations were included. There was no statistically significant difference in the frequency of threshold growth between HCCs and non-HCC malignancies (p = 0.560). Whether HCCs, non-HCC malignancies, or benign lesions, the mean size with threshold growth was smaller than that without threshold growth (all p < 0.05). The nodule-in-nodule feature was a highly frequent AF (p < 0.05) and was used to replace threshold growth as a new MF in scheme C. The LR-5 diagnostic performance values for HCC with schemes A, B, and C were respectively as follows: a sensitivity of 74.4%, 74.0% and 75.6%; specificity of 88.6%, 88.6% and 88.6%; and accuracy of 80.3%, 80.0% and 81.0%. There was no statistically significant difference in diagnostic performance between schemes A and B or between schemes A and C (all p > 0.05). Conclusion The threshold growth is removed or replaced by the nodule-in-nodule feature

show abstract

Section: Discussionmentioning

confidence: 99%

Threshold growth has a limited role in differentiating HCC from other focal hepatic lesions

Lyu

Wang

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that some special AFs contribute to the diagnosis of HCC [ 21 , 22 ]. The nodule-in-nodule feature, a variant of the “mosaic” architecture of HCC, is a typical manifestation of tumour heterogeneity [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Threshold growth has a limited role in differentiating hepatocellular carcinoma from other focal hepatic lesions

Lyu,

Wang,

et al. 2023

BMC Med Imaging

View full text Add to dashboard Cite

Background and Objective The role of threshold growth, as one of the major features (MFs) of hepatocellular carcinoma (HCC) in the Liver Imaging Reporting and Data System (LI-RADS) is inconsistent. This study evaluated the LI-RADS diagnostic performance for HCC when threshold growth was removed or replaced by independently significant ancillary features (AFs). Materials and Methods This retrospective institutional review board-approved study included patients with a high HCC risk who underwent gadoxetic acid-enhanced MRIs. The MRI findings were consistent with pathologically proven focal hepatic observations. The pathological results were used as the gold standard reference. The sizes of the lesions with and without threshold growth were compared. Univariate and multivariate logistic regression analyses were used to confirm the independently significant AFs of HCC. In addition to the classification criteria of LI-RADS version 2018 (LI-RADS v2018), the lesions were also reclassified according to the following two schemes: scheme A, using all MFs except threshold growth, with threshold growth feature treated as an AF favouring malignancy; and scheme B, replacing the threshold growth feature with independently significant AFs and treated them as new MFs. The diagnostic performance of the above two LI-RADS schemes for HCC was calculated and compared with that of LI-RADS v2018. Results A total of 379 patients and 426 observations were included. Threshold growth was not an independent significant MF for HCC diagnosis [odds ratio (OR), 1.0; 95% confidence interval (CI), 0.6–1.8; p = 0.927]. For all three groups of observations (HCCs, non-HCC malignancies, and benign lesions), the mean size with threshold growth was smaller than that without threshold growth (all p < 0.05). The nodule-in-nodule feature was an independent significant AF (OR, 9.8; 95% CI, 1.2–79.3; p = 0.032) and was used to replace threshold growth as a new MF in scheme B. The sensitivities of schemes A and B were 74.0% and 75.6%, respectively. The specificities of schemes A and B were the same (88.6%). None of the diagnostic performance metrics for HCC (sensitivity, specificity, accuracy) of either scheme A or B was significantly different from those of LI-RADS v2018 (all p > 0.05). Conclusion Threshold growth is not an independently significant MF for HCC diagnosis. The diagnostic performance of LI-RADS for HCC is not affected regardless of whether threshold growth is removed from the list of MFs or replaced with an independently significant and more HCC-specific AF, which is the nodule-in-nodule feature.

show abstract

“…Gadobenate dimeglumine (Gd-BOPTA) is a hepatobiliary-specific agent, it can be selectively taken up into function hepatocytes by the specific organic anion transporting polypeptides (OATP1B1, OATP1B3) located on the surface of hepatocytes ( 12 – 14 ). In addition to dynamic contrast-enhanced MRI of the liver, this agent may also assist with specific imaging in the hepatobiliary phase (HBP) within 40–120 min after injection ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

A preoperative model based on gadobenate-enhanced MRI for predicting microvascular invasion in hepatocellular carcinomas (≤ 5 cm)

Zhang

Huo²,

Zhang³

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

PurposeThe present study aimed to develop and validate a preoperative model based on gadobenate-enhanced magnetic resonance imaging (MRI) for predicting microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC) size of ≤5 cm. In order to provide preoperative guidance for clinicians to optimize treatment options.Methods164 patients with pathologically confirmed HCC and preoperative gadobenate-enhanced MRI from July 2016 to December 2020 were retrospectively included. Univariate and multivariate logistic regression (forward LR) analyses were used to determine the predictors of MVI and the model was established. Four-fold cross validation was used to verify the model, which was visualized by nomograms. The predictive performance of the model was evaluated based on discrimination, calibration, and clinical utility.ResultsElevated alpha-fetoprotein (HR 1.849, 95% CI: 1.193, 2.867, P=0.006), atypical enhancement pattern (HR 3.441, 95% CI: 1.523, 7.772, P=0.003), peritumoral hypointensity on HBP (HR 7.822, 95% CI: 3.317, 18.445, P<0.001), and HBP hypointensity (HR 3.258, 95% CI: 1.381, 7.687, P=0.007) were independent risk factors to MVI and constituted the HBP model. The mean area under the curve (AUC), sensitivity, specificity, and accuracy values for the HBP model were as follows: 0.830 (95% CI: 0.784, 0.876), 0.71, 0.78, 0.81 in training set; 0.826 (95% CI:0.765, 0.887), 0.8, 0.7, 0.79 in test set. The decision curve analysis (DCA) curve showed that the HBP model achieved great clinical benefits.ConclusionIn conclusion, the HBP imaging features of Gd-BOPTA-enhanced MRI play an important role in predicting MVI for HCC. A preoperative model, mainly based on HBP imaging features of gadobenate-enhanced MRI, was able to excellently predict the MVI for HCC size of ≤5cm. The model may help clinicians preoperatively assess the risk of MVI in HCC patients so as to guide clinicians to optimize treatment options.

show abstract

Hepatobiliary phase hypointensity on gadobenate dimeglumine- enhanced magnetic resonance imaging may improve the diagnosis of hepatocellular carcinoma

Cited by 14 publications

References 40 publications

Threshold growth has a limited role in differentiating HCC from other focal hepatic lesions

Threshold growth has a limited role in differentiating HCC from other focal hepatic lesions

Threshold growth has a limited role in differentiating hepatocellular carcinoma from other focal hepatic lesions

A preoperative model based on gadobenate-enhanced MRI for predicting microvascular invasion in hepatocellular carcinomas (≤ 5 cm)

Contact Info

Product

Resources

About