Presence of non‐hypervascular hypointense nodules on Gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid‐enhanced magnetic resonance imaging in patients with hepatocellular carcinoma

• Published in: Journal of gastroenterology and hepatology 2017-04, Vol.32 (4), p.908-915
• Main Authors: Inoue, Masanori, Ogasawara, Sadahisa, Chiba, Tetsuhiro, Ooka, Yoshihiko, Wakamatsu, Toru, Kobayashi, Kazufumi, Suzuki, Eiichiro, Tawada, Akinobu, Yokosuka, Osamu
• Format: Article
• Language: English
• Subjects: Aftercare; Aged; Aged, 80 and over; Carcinoma, Hepatocellular - blood supply; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Catheter Ablation; Female; Gadolinium; Gd‐EOB‐DTPA‐enhanced MRI; Hepatocellular carcinoma; Humans; hypervascularization; Liver cancer; Liver Neoplasms - blood supply; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Magnetic resonance imaging; Male; Middle Aged; Neoplasm Recurrence, Local; NMR; Nodules; non‐hypervascular hypointense nodule; Nuclear magnetic resonance; Pentetic Acid; Predictive Value of Tests; radiofrequency ablation; recurrence; Retrospective Studies; Risk Factors
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.13622

Background and Aims Gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid (Gd‐EOB‐DTPA)‐enhanced magnetic resonance imaging (MRI) performed before curative therapy for hepatocellular carcinoma (HCC) can distinguish between intrahepatic distant recurrence and hypervascularization. This study aimed to retrospectively evaluate the presence of non‐hypervascular hypointense nodules on hepatobiliary phase images from Gd‐EOB‐DTPA‐enhanced MRI as a risk factor of the intrahepatic distant recurrence of early stage HCC following radiofrequency ablation (RFA). Methods A total of 132 patients who underwent preprocedural Gd‐EOB‐DTPA‐enhanced MRI followed by initial RFA were retrospectively analyzed. Post‐RFA intrahepatic distant recurrence, which excluded the hypervascularization of non‐hypervascular hypointense nodules detected by preprocedural Gd‐EOB‐DTPA‐enhanced MRI, was evaluated according to the presence of non‐hypervascular hypointense nodules on preprocedural Gd‐EOB‐DTPA‐enhanced MRI. Results Intrahepatic distant recurrence rates following RFA were higher in patients with non‐hypervascular hypointense nodules (1‐year: 22.5%, 2‐year: 52.1%, 5‐year: 89.1%) compared with in patients without non‐hypervascular hypointense nodules (1‐year: 7.0%, 2‐year: 28.8%, 5‐year: 48.7%). The presence of non‐hypervascular hypointense nodules was associated with markedly increased cumulative recurrence rates of both identical and different subsegment intrahepatic distant recurrence, being an independent risk factor for post‐RFA identical and different subsegment intrahepatic distant recurrence (identical: HR = 2.365, P = 0.027; different: HR = 3.276, P