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Magnetic resonance imaging with gadoxetic acid for local tumour progression after radiofrequency ablation in patients with hepatocellular carcinoma

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To develop and validate a prediction model using magnetic resonance imaging (MRI) for local tumour progression (LTP) after radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients.

Methods

Two hundred and eleven patients who had received RFA as first-line treatment for HCC were retrospectively analyzed. They had undergone gadoxetic acid-enhanced MRI before treatment, and parameters including tumour size; margins; signal intensities on T1-, T2-, and diffusion-weighted images, and hepatobiliary phase images (HBPI); intratumoral fat or tumoral capsules; and peritumoural hypointensity in the HBPI were used to develop a prediction model for LTP after treatment. This model to discriminate low-risk from high-risk LTP groups was constructed based on Cox regression analysis.

Results

Our analyses produced the following model: ‘risk score = 0.617 × tumour size + 0.965 × tumour margin + 0.867 × peritumoural hypointensity on HBPI’. This was able to predict which patients were at high risk for LTP after RFA (p < 0.001). Patients in the low-risk group had a significantly better 5-year LTP-free survival rate compared to the high-risk group (89.6 % vs. 65.1 %; hazard ratio, 3.60; p < 0.001).

Conclusion

A predictive model based on MRI before RFA could robustly identify HCC patients at high risk for LTP after treatment.

Key points

• Tumour size, margin, and peritumoural hypointensity on HBPI were risk factors for LTP.

• The risk score model can predict which patients are at high risk for LTP.

• This prediction model could be helpful for risk stratification of HCC patients.

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Abbreviations

RFA:

radiofrequency ablation

HCC:

hepatocellular carcinoma

LTP:

local tumour progression

MRI:

magnetic resonance imaging

US:

ultrasound

CT:

computed tomography

DWI:

diffusion-weighted image

HBPI:

hepatobiliary phase images

HR:

hazard ratio

CI:

confidence interval

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Acknowledgments

The scientific guarantor of this publication is Won Jae Lee. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors (Sin-Ho Jung) has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. This is the first study using this kind of cohort. Methodology: retrospective, prognostic study / observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Dong, Gangnam-gu, Seoul, 135-710, Korea

    Tae Wook Kang, Hyunchul Rhim, Jisun Lee, Kyoung Doo Song, Min Woo Lee, Young-sun Kim, Hyo Keun Lim, Kyung Mi Jang & Seong Hyun Kim

  2. Division of Hepatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 135-710, Republic of Korea

    Geum-Youn Gwak

  3. Biostatics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 135-710, Republic of Korea

    Sin-Ho Jung

Authors
  1. Tae Wook Kang
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Correspondence to Hyunchul Rhim.

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Kang, T.W., Rhim, H., Lee, J. et al. Magnetic resonance imaging with gadoxetic acid for local tumour progression after radiofrequency ablation in patients with hepatocellular carcinoma. Eur Radiol 26, 3437–3446 (2016). https://doi.org/10.1007/s00330-015-4190-5

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  • DOI: https://doi.org/10.1007/s00330-015-4190-5

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