Clinicopathological significance of the peritumoral decreased uptake area of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid in hepatocellular carcinoma

Nishie, Akihiro; Asayama, Yoshiki; Ishigami, Kousei; Kakihara, Daisuke; Nakayama, Tomohiro; Ushijima, Yasuhiro; Takayama, Yoshiaki; Shirabe, Ken; Fujita, Nobuhiro; Kubo, Yuichiro; Hirakawa, Masakazu; Honda, Hiroshi

doi:10.1111/jgh.12423

Cited by 33 publications

(25 citation statements)

References 11 publications

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“…[ 10 , 11 ] A previous report confirmed whether the location of pathologic vascular invasion accorded with PDUA by means of joint evaluation by radiologist and pathologist. [ 10 ] Kim et al [ 11 ] reported that PDUA was observed in 26 (25.0%) of 104 HCCs, and 23 (88.5%) of these showed microvascular invasion. PDUA was a significant factor in predicting microvascular invasion of HCC in the study.…”

Section: Discussionmentioning

confidence: 80%

“…PDUA was classified into 3 types: wedge-shaped, irregular belt-shaped, and linear type, as previously reported. [ 10 ] The MR images were retrospectively analyzed by 2 radiologists who were unaware of the pathologic results. The κ value representing interobserver agreement in the presence of PDUA was 0.84.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, it has been suggested that the peritumoral decreased uptake area (PDUA) in the hepatobiliary phase of Gd-EOB-DTPA enhanced MRI could be observed in cases of impaired hepatocyte function induced by decreased portal flow. [ 10 ] PDUA was defined as the presence of a faint and hypointense area around the tumor in the hepatobiliary phase of Gd-EOB-DTPA enhanced MRI. The 3 suggested types of PDUA in the hepatobiliary phase of Gd-EOB-DTPA enhanced MRI are the following: wedge-shaped, irregular belt-shaped, and linear PDUA.…”

Section: Introductionmentioning

confidence: 99%

“…Previous reports have suggested that PDUA in the hepatobiliary phase of MRI may be associated with vascular invasion in HCC. [ 10 , 11 ] However, whether PDUA in the hepatobiliary phase of Gd-EOB-DTPA enhanced MRI has a clinically significant effect on the incidence of tumor recurrence following resection remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Peritumoral decreased uptake area of gadoxetic acid enhanced magnetic resonance imaging and tumor recurrence after surgical resection in hepatocellular carcinoma

Shin

Kim²,

Shim³

et al. 2017

Medicine

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Recently, it has been suggested that peritumoral decreased uptake area (PDUA) in the hepatobiliary phase (HBP) of gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) was associated with vascular invasion in hepatocellular carcinoma (HCC). We aimed to investigate correlations between microvascular invasion and PDUA, and elucidate the predictability of PDUA for tumor recurrence after resection.We retrospectively analyzed clinicopathological and radiological data from 126 consecutive patients with single HCC ≤5 cm without macrovascular invasion who underwent preoperative Gd-EOB-DTPA-enhanced MRI and surgical resection. The presence of a faint and hypointense area around the tumor in the HBP was defined as PDUA.Among 126 patients with HCCs, microvascular invasion was observed in 29 (23.0%) patients and PDUA was observed in 15 (11.9%) patients. PDUA [odds ratio (OR) 20.06, confidence interval (CI) 4.74–84.96, P < .001] was an independent risk factor for microvascular invasion. In multivariate survival analysis using Cox regression, PDUA [hazard ratio (HR) 4.51, CI 2.17–9.38, P < .001], pathologically confirmed satellite nodules (HR 5.18, CI 1.50–17.88, P = .009), and AFP (≥100 ng/mL, HR 2.28, CI 1.04–5.01, P = .040) were independent risk factors for recurrence after resection. Recurrence-free survival in the group with PDUA was significantly lower than that in the group without PDUA according to analysis using the Kaplan–Meier method with the log-rank test (P < .001).PDUA in the HBP of Gd-EOB-DTPA-enhanced MRI could be a useful preoperative predictor of microvascular invasion and independent prognostic factor after surgical resection in patients with single HCC ≤5 cm without macrovascular invasion.

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Section: Discussionmentioning

confidence: 80%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Peritumoral decreased uptake area of gadoxetic acid enhanced magnetic resonance imaging and tumor recurrence after surgical resection in hepatocellular carcinoma

Shin

Kim²,

Shim³

et al. 2017

Medicine

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“…It has actually become common to encounter cases where hypervascular HCC or nodule-in-nodule HCC that is undetectable by MDCT is detected in a routine screening by EOB-MRI because of early enhancement in the arterial phase or clear hypointensity in the hepatobiliary phase [11,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103]. Furthermore, studies comparing the diagnostic performance of EOB-MRI and MDCT for hypervascular HCC have shown that EOB-MRI is superior or, at the very l...…”

Section: Diagnostic Algorithmmentioning

confidence: 99%

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

et al. 2014

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Surveillance and diagnostic algorithms for hepatocellular carcinoma (HCC) have already been described in guidelines published by the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver and the European Organisation for Research and Treatment of Cancer (EASL-EORTC), and the Japan Society of Hepatology (JSH), but the content of these algorithms differs slightly. The JSH algorithm mainly differs from the other two algorithms in that it is highly sophisticated and considers the functional imaging techniques of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI (EOB-MRI) and Sonazoid contrast-enhanced ultrasound (CEUS) to be very important diagnostic modalities. In contrast, the AASLD and EASL-EORTC algorithms are less advanced and suggest that a diagnosis be made based solely on hemodynamic findings using dynamic CT/MRI and biopsy findings. A consensus meeting regarding the JSH surveillance and diagnostic algorithm was held at the 50th Liver Cancer Study Group of Japan Congress, and a 2014 update of the algorithm was completed. The new algorithm reaffirms the very important role of EOB-MRI and Sonazoid CEUS in the surveillance and diagnosis of liver cancer and is more sophisticated than those currently used in the United States and Europe. This is now an optimized algorithm that can be used to diagnose early-stage to classical HCC easily and highly accurately.

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Enhancements in hepatobiliary imaging: the spectrum of gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid usages in hepatobiliary magnetic resonance imaging

Channual¹,

Pahwa

Lu³

et al. 2016

Abdom Radiol

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Gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) is a unique hepatocyte-specific contrast agent approved for clinical use in the United States in 2008. Gd-EOB-DTPA-enhanced MR has shown to improve detection and characterization of hepatic lesions. Gd-EOB-DTPA is now being routinely used in daily clinical practice worldwide. Therefore, it is important for radiologists to be familiar with the potential uses and pitfalls of Gd-EOB-DTPA, which extends beyond the assessment of focal hepatic lesions. The purpose of this article is to review the various usages of Gd-EOB-DTPA in hepatobiliary MR imaging.

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Clinicopathological significance of the peritumoral decreased uptake area of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid in hepatocellular carcinoma

Abstract: By using this indicator, "microscopic" vascular invasion of HCC can be easily predicted with Gd-EOB-DTPA-enhanced MRI.

Cited by 33 publications

References 11 publications

Peritumoral decreased uptake area of gadoxetic acid enhanced magnetic resonance imaging and tumor recurrence after surgical resection in hepatocellular carcinoma

Peritumoral decreased uptake area of gadoxetic acid enhanced magnetic resonance imaging and tumor recurrence after surgical resection in hepatocellular carcinoma

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

Enhancements in hepatobiliary imaging: the spectrum of gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid usages in hepatobiliary magnetic resonance imaging

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