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- Title
Hepatocellular carcinoma: clinical significance of signal heterogeneity in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging.
- Authors
Fujita, Nobuhiro; Nishie, Akihiro; Kubo, Yuichiro; Asayama, Yoshiki; Ushijima, Yasuhiro; Takayama, Yukihisa; Moirta, Koichiro; Shirabe, Ken; Aishima, Shinichi; Honda, Hiroshi
- Abstract
Objectives: To clarify the relationship between the biological behaviour of hepatocellular carcinomas (HCCs) and their signal intensity in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging with a special focus on the signal heterogeneity. Methods: A total of 68 patients with 70 pathologically proven HCCs were enrolled. On the basis of the signal intensity in the hepatobiliary phase, the lesions were classified into three groups: group 1, homogeneous hypointensity ( n = 44); group 2, heterogeneous hyperintensity ( n = 20); and group 3, homogeneous hyperintensity ( n = 6). The clinicopathological findings were compared among the three groups. Results: The tumour size and the serum level of protein induced by vitamin K absence or antagonist-II (PIVKA-II) were significantly higher in group 2 compared to group 1 ( p = 0.0155, p = 0.0215, respectively) and compared to group 3 ( p = 0.0330, p = 0.0220, respectively). The organic anion transporting polypeptide 8 (OATP8) expression in group 2 and group 3 was significantly higher than in group 1 ( p < 0.0001, p < 0.0001, respectively). Group 2 showed a significantly lower disease-free survival rate compared to group 1 ( p = 0.0125), and group 2 was an independent prognostic factor for disease-free survival ( p = 0.0308). Conclusions: HCCs in the hepatobiliary phase that are heterogeneously hyperintense on gadoxetic acid-enhanced MR imaging have more malignant potential than other types of HCCs. Key Points: • Heterogeneous uptake of gadoxetic acid suggests more malignant potential in HCC • Uptake of gadoxetic acid does not suggest less malignancy in HCC • Evaluation of signal heterogeneity on gadoxetic acid-enhanced MR imaging is useful
- Subjects
LIVER cancer; MAGNETIC resonance imaging; VITAMIN K; LIVER diseases; POLYPEPTIDES
- Publication
European Radiology, 2015, Vol 25, Issue 1, p211
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-014-3349-9