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The value of Gd-EOB-DTPA-enhanced MRI nomogram model in predicting microvascular invasion of small solitary hepatocellular carcinoma
TIAN Yaqi  HU Yabin  PENG Qiqi  SU Xiaohui  WANG Xiaolin  CHEN Jingjing 

Cite this article as: Tian YQ, Hu YB, Peng QQ, et al. The value of Gd-EOB-DTPA-enhanced MRI nomogram model in predicting microvascular invasion of small solitary hepatocellular carcinoma[J]. Chin J Magn Reson Imaging, 2021, 12(10): 57-60, 65. DOI:10.12015/issn.1674-8034.2021.10.013.


[Abstract] Objective To explore the value of the nomogram based on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI of the microvascular invasion (MVI) in small solitary hepatocellular carcinoma (≤3 cm). Materials andMethods In this study, we retrospectively analyzed 149 patients with small solitary hepatocellular carcinoma (≤3 cm) who underwent preoperative Gd-EOB-DTPA-enhanced MRI between January 2017 and June 2020. All patients were grouped into MVI-negative and MVI-positive cases according to the histopathological diagnosis. Then, preoperative clinical, Gd-EOB-DTPA-enhanced MRI and pathological data were collected. Univariate and multivariate Logistic regression analyses were used to analyze the relevant risk factors for MVI, and then a nomogram incorporated preoperative data was developed by multivariate Logistic regression. Finally, the prediction efficiency of the model is evaluated.Results Analysis of the MVI-positive group (45 cases) and the MVI-negative group (104 cases) showed peritumoral hypointensity on HBP (OR=5.951, 95% CI: 2.303—15.372, P<0.001), peritumor enhancement (OR=3.834, 95% CI: 1.301—11.299, P=0.015), peritumoral pseudocapsule incomplete (OR=9.721, 95% CI: 2.486—38.019, P=0.001), the lower ADC values (<0.990×10-3 mm2/s) were independent predictors of MVI of small solitary hepatocellular carcinoma. The area under the ROC curve was 0.844. A nomogram showed that peritumoral hypointensity on HBP was the largest contributing factor (100 points) in predicting MVI of small solitary hepatocellular carcinoma, and the others were peritumor enhancement, peritumoral pseudocapsule incomplete and lower ADC values. The C-index of the nomogram was 0.844, and the model was highly predictive of MVI.Conclusions A nomogram of Gd-EOB-DTPA-enhanced MRI can effectively predict microvascular invasion of solitary small hepatocellular carcinoma.
[Keywords] hepatocellular carcinoma;microvascular invasion;Gd-EOB-DTPA;magnetic resonance imaging;nomogram

TIAN Yaqi1, 2   HU Yabin2   PENG Qiqi1, 2   SU Xiaohui2   WANG Xiaolin1, 2   CHEN Jingjing2*  

1 School of Medicine, Qingdao University, Qingdao 266100, China

2 Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao 266016, China

Chen JJ, E-mail: chenjingjingsky@126.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Qingdao Science and Technology Project (17-3-3-22-nsh).
Received  2021-02-22
Accepted  2021-07-05
DOI: 10.12015/issn.1674-8034.2021.10.013
Cite this article as: Tian YQ, Hu YB, Peng QQ, et al. The value of Gd-EOB-DTPA-enhanced MRI nomogram model in predicting microvascular invasion of small solitary hepatocellular carcinoma[J]. Chin J Magn Reson Imaging, 2021, 12(10): 57-60, 65. DOI:10.12015/issn.1674-8034.2021.10.013.

[1]
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424. DOI: 10.3322/caac.21492.
[2]
Bureau of Medical Administration, Nationsl Health Commiaaion of the People's Republic of China. Standardization for diagnosis and treatment of primary hepatic carcinom (2019 edition)[J]. Chin J Pract Surg, 2020, 40(2): 121-138. DOI: 10.19538/j.cjps.issn1005-2208.2020.02.01.
[3]
Ichikawa T, Sano K, Morisaka H. Diagnosis of Pathologically Early HCC with EOB-MRI: Experiences and Current Consensus[J]. Liver cancer, 2014, 3(2): 97-107. DOI: 10.1159/000343865.
[4]
Du M, Chen LL, Zhao J, et al. Microvascular invasion (MVI) is a poorer prognostic predictor for small hepatocellular carcinoma[J]. BMC Cancer, 2014, 14(1): 38. DOI: 10.1186/1471-2407-14-38.
[5]
Rao SX, Zeng MS. Development in clinical application of hepatocyte-specific contrast agent of gadoxetic acid[J]. Chin J Radiol, 2019, 53(12): 1031-1036. DOI: 10.3760/cma.j.issn.1005-1201.2019.12.003.
[6]
Cucchetti A, Qiao GL, Cescon M, et al. Anatomic versus nonanatomic resection in cirrhotic patients with early hepatocellular carcinoma[J]. Surgery, 2014, 155(3): 512-521. DOI: 10.1016/j.surg.2013.10.009.
[7]
Liu C, Yang Q, Qin CL. The effect of microvascular invasion on the choice of resection margin of hepatectomy for early stage cancer and the prognosis of patients[J]. J Hepatobiliary Surg, 2017, 25(5): 353-357. DOI: 10.3969/j.issn.1006-4761.2017.05.012.
[8]
Xu PJ, Zeng MS, Liu K, et al. Microvascular invasion in small hepatocellular carcinoma: is it predictable with preoperative diffusion-weighted imaging?[J]. J Gastroenterol Hepatol, 2014, 29(2): 330-336. DOI: 10.1111/jgh.12358.
[9]
Zhang L, Yu X, Wei WX, et al. Prediction of HCC microvascular invasion with gadobenate-enhanced MRI: correlation with pathology[J]. Eur Radiol, 2020, 30(10): 5327-5336. DOI: 10.1007/s00330-020-06895-6.
[10]
American College of Radiology. Liver Imaging Reporting and Data System version 2018[EB /OL]. [2020-03-18]. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS.
[11]
Kitao A, Matsui O, Yoneda N, et al. Gadoxetic acid-enhanced MR imaging for hepatocellular carcinoma: molecular and genetic background[J]. Eur Radiol, 2020, 30(6): 3438-3447. DOI: 10.1007/s00330-020-06687-y.
[12]
Yang CW, Jiang HY, Song B, et al. The diagnostic performance of version 2018 LI-RADS for hepatocellular carcinoma on Gd-EOB-DTPA enhanced MRI[J]. Chin J Radiol, 2019, 53(12): 1060-1064. DOI: 10.3760/cma.j.issn.1005-1201.2019.12.007.
[13]
Zhu ZH, Xing W, Liu HF, et al. Study of Gd-EOB-DTPA T1 mapping in quantitatively staging hepatic fibrosis in a rabbit model[J]. Chin J Magn Reson Imaging, 2020, 11(10): 890-895. DOI: 10.12015/issn.1674-8034.2020.10.011.
[14]
Ahn SY, Lee JM, Joo I, et al. Prediction of microvascular invasion of hepatocellular carcinoma using gadoxetic acid-enhanced MR and (18)F-FDG PET/CT[J]. Abdominal imaging, 2015, 40(4): 843-851. DOI: 10.1007/s00261-014-0256-0.
[15]
Yang L, Gu DS, Wei JW, et al. A Radiomics Nomogram for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma[J]. Liver cancer, 2019, 8(5): 373-386. DOI: 10.1159/000494099.
[16]
Chen PP, Lu J, Zhang T, et al. The value of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced MRI in the prediction of microvascular invasion of hepatocellular carcinoma[J]. Chin J Radiol, 2019, 53(2): 103-108. DOI: 10.3760/cma.j.issn.1005-1201.2019.02.005.
[17]
Tsuboyama T, Onishi H, Kim T, et al. Hepatocellular carcinoma: hepatocyte-selective enhancement at gadoxetic acid-enhanced MR imaging--correlation with expression of sinusoidal and canalicular transporters and bile accumulation[J]. Radiology, 2010, 255(3): 824-833. DOI: 10.1148/radiol.10091557.
[18]
Huang MQ, Liao B, Xu P, et al. Prediction of Microvascular Invasion in Hepatocellular Carcinoma: Preoperative Gd-EOB-DTPA-Dynamic Enhanced MRI and Histopathological Correlation[J]. Contrast media & molecular imaging, 2018, 2018: 9674565. DOI: 10.1155/2018/9674565.
[19]
Kim KA, Kim MJ, Jeon HM, et al. Prediction of microvascular invasion of hepatocellular carcinoma: usefulness of peritumoral hypointensity seen on gadoxetate disodium-enhanced hepatobiliary phase images[J]. Journal of magnetic resonance imaging: JMRI, 2012, 35(3): 629-634. DOI: 10.1002/jmri.22876.
[20]
Hu HT, Shen SL, Wang Z, et al. Peritumoral tissue on preoperative imaging reveals microvascular invasion in hepatocellular carcinoma: a systematic review and meta-analysis[J]. Abdominal radiology (New York), 2018, 43(12): 3324-3330. DOI: 10.1007/s00261-018-1646-5.
[21]
Ariizumi S-i, Kitagawa K, Kotera Y, et al. A non-smooth tumor margin in the hepatobiliary phase of gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging predicts microscopic portal vein invasion, intrahepatic metastasis, and early recurrence after hepatectomy in patients with hepatocellular carcinoma[J]. J Hepatobiliary Pancreat Sci, 2011, 18(4): 575-585. DOI: 10.1007/s00534-010-0369-y.
[22]
Lee S, Kim SH, Lee JE, et al. Preoperative gadoxetic acid-enhanced MRI for predicting microvascular invasion in patients with single hepatocellular carcinoma[J]. J Hepatol, 2017, 67(3): 526-534. DOI: 10.1016/j.jhep.2017.04.024.
[23]
Chen JB, Zhou J, Kuang SC, et al. Liver Imaging Reporting and Data System Category 5: MRI Predictors of Microvascular Invasion and Recurrence After Hepatectomy for Hepatocellular Carcinoma[J]. AJR Am J Roentgenol, 2019, 213(4): 821-830. DOI: 10.2214/AJR.19.21168.

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