Evaluation and Prognostication of Gd‐EOB‐DTPA MRI and CT in Patients With Macrotrabecular‐Massive Hepatocellular Carcinoma

• Published in: Journal of magnetic resonance imaging 2024-06, Vol.59 (6), p.2071-2081
• Main Authors: Cheng, Jie, Li, Xiaofeng, Wang, Limei, Chen, Fengxi, Li, Yiman, Zuo, Guojiao, Pei, Mi, Zhang, Huarong, Yu, Linze, Liu, Chen, Wang, Jian, Han, Qi, Cai, Ping, Li, Xiaoming
• Format: Article
• Language: English
• Subjects: Adult; Aged; Carcinoma, Hepatocellular - diagnostic imaging; Computed tomography; Confidence intervals; Contrast Media; Diagnosis; Female; Field strength; Gadolinium; Gadolinium DTPA; Gd‐EOB‐DTPA; Hemorrhage; Hepatocellular carcinoma; Humans; Ischemia; Liver; Liver - diagnostic imaging; Liver - pathology; Liver cancer; Liver diseases; Liver Neoplasms - diagnostic imaging; macrotrabecular‐massive; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical imaging; Middle Aged; Necrosis; Nomograms; Patients; Prognosis; Prothrombin; Reproducibility of Results; Retrospective Studies; Statistical analysis; Statistical tests; Tomography, X-Ray Computed; Training
• ISSN: 1053-1807; 1522-2586; 1522-2586
• DOI: 10.1002/jmri.29052

Background Macrotrabecular‐massive hepatocellular carcinoma (MTM‐HCC) is highly aggressive. Comparing the diagnosis ability of CT and gadoxetate disodium (Gd‐EOB‐DTPA) MRI for MTM‐HCC are lacking. Purpose To compare the performance of Gd‐EOB‐DTPA MRI and CT for differentiating MTM‐HCC from non‐MTM‐HCC, and determine the prognostic indicator. Study Type Retrospective. Subjects Post‐surgery HCC patients, divided into the training (N = 272) and external validation (N = 44) cohorts. Field Strength/Sequence 3.0 T, T1‐weighted imaging, in‐opp phase, and T1‐weighted volumetric interpolated breath‐hold examination/liver acquisition with volume acceleration; enhanced CT. Assessment Three radiologists evaluated clinical characteristics (sex, age, liver disease, liver function, blood routine, alpha‐fetoprotein [AFP] and prothrombin time international normalization ratio [PT‐INR]) and imaging features (tumor length, intratumor fat, hemorrhage, arterial phase peritumoral enhancement, intratumor necrosis or ischemia, capsule, and peritumoral hepatobiliary phase [HBP] hypointensity). Compared the performance of CT and MRI for diagnosing MTM‐HCC. Follow‐up occurred every 3–6 months, and nomogram demonstrated the probability of MTM‐HCC. Statistical Tests Fisher test, t‐test or Wilcoxon rank‐sum test, area under the curve (AUC), 95% confidence interval (CI), multivariable logistic regression, Kaplan–Meier curve, and Cox proportional hazards. Significance level: P