Gd-EOB-DTPA dynamic contrast-enhanced magnetic resonance imaging and 64-row contrast-enhanced computed tomography for evaluating small hepatocellular carcinoma on the background of hepatitis B-related cirrhosis

Abstract

Abstract: Objective To comparatively analyze the difference of Gd-EOB-DTPA enhanced Magnetic Resonance Imaging (MRI) (Gd-EOB-DTPA-MRI) and 64-row spiral Computed Tomography (64-MDCT) in evaluating small hepatocellular carcinoma (SHCC).Methods Sixty patients including 43 males and 17 females with SHCC were examined by Gd-EOB-DTPA-MRI and 64-MDCT. The inclusive criteria are: preoperative diagnosis of HCC by surgical resection or ultrasound-guided biopsy; lesion diameter ≤2 cm; Gd-EOB-DTPA-MRI and 64-MDCT examination within 4 weeks; without metastatic liver cancer or other malignant tumors. MDCT or Gd-EOB-DTPA-MRI of typical SHCC lesions showed high enhancement of blood vessels at arterial phase and a rapid decrease in density at portal vein and delayed phases. Chi-square test was used for statistical analysis. Receiver operating characteristic curve(ROC)and the area under the curve (AUC) were drawn and the sensitivity and specificity under the curve were calculated.Results Seventy-four lesions were found in 60 SHCC patients (26 lesions were excised surgically and 48 lesions were biopsied under ultrasound guidance). In 64-MDCT arterial phase, there were 68 SHCC lesions with high enhancement (91.9%), 6 with equal enhancement (8.1%), 0 with low enhancement (0). In Gd-EOB-DTPA-MRI hepatobiliary phase, there were 1 lesion with high enhancement (1.4%), 4 with equal enhancement (5.4%) and 69 with low enhancement (93.2%). The sensitivity and specificity of 64-MDCT for diagnosing SHCC,were 79.5% and 91.4%, respectively. The sensitivity and specificity of Gd-EOB-DTPA-MRI were 81.6% and 82.0%. The sensitivity and specificity of 64-MDCT combined with Gd-EOB-DTPA-MRI were 67.8% and 100%. The sensitivity and specificity of 64-MDCT in arterial phase combined with Gd-EOB-DTPA-MRI in hepatobiliary phase were 94.2% and 93.0%, respectively. The AUC values of 64-MDCT in arterial phase combined with Gd-EOB-DTPA-MRI in hepatobiliary phase (0.92) were significantly higher than those of 64-MDCT (0.84, P<0.05), Gd-EOB-DTPA-MRI (0.81, P<0.05), and 64-MDCT combined with Gd-EOB-DTPA-MRI (0.85, P<0.05).Conclusion 64-MDCT in arterial phase combined with Gd-EOB-DTPA-MRI in hepatobiliary phase has higher sensitivity and specificity in identifying SHCC lesions, which is helpful for the diagnosis of SHCC.

Key words: Small hepatocellular carcinoma, Gd-EOB-DTPA enhanced Magnetic Resonance Imaging, 64-row spiral Computed Tomography, diagnosis

LIU Min, ZHANG Jin, LU Yu. Gd-EOB-DTPA dynamic contrast-enhanced magnetic resonance imaging and 64-row contrast-enhanced computed tomography for evaluating small hepatocellular carcinoma on the background of hepatitis B-related cirrhosis[J]. Chinese Hepatolgy, 2020, 25(12): 1278-1281.

References

[1] Tian N, Wu D, Tang M, et al. RAF1 expression is correlated with HAF, a parameter of liver computed tomographic perfusion, and may predict the early therapeutic response to sorafenib in advanced hepatocellular carcinoma patients. Open Med (Wars), 2020, 15:167-174.
[2] Huang L, Mo Z, Hu Z, et al. Diagnostic value of fibrinogen to prealbumin ratio and gamma-glutamyl transpeptidase to platelet ratio in the progression of AFP-negative hepatocellular carcinoma. Cancer Cell Int, 2020, 20:77.
[3] Qin S, Finn R, Kudo M, et al. Efficacy and safety of tislelizumab, an anti-PD-1 antibody, versus sorafenib as first-line treatment in patients with advanced hepatocellular carcinoma in a phase 3, randomized, open-label, multicenter study - Trial in progress. Ann Oncol, 2018, Suppl 5:v51.
[4] Wang G, Zhang W, Tan Y, et al. The risk factors for long-term survival outcome in solitary hepatocellular carcinoma up to 2 cm: Propensity score matching analysis in a population cohort with a high rate of HBV infection. Int J Surg, 2019, 72:1-6.
[5] Doyle A, Gorgen A, Muaddi H, et al. Outcomes of radiofrequency ablation as first-line therapy for hepatocellular carcinoma less than 3 cm in potentially transplantable patients. J Hepatol, 2019, 70:866-873.
[6] Yin Z, Jin H, Ma T, et al. A meta-analysis of long-term survival outcomes between surgical resection and radiofrequency ablation in patients with single hepatocellular carcinoma ≤2 cm (BCLC very early stage). Int J Surg, 2018, 56:61-67.
[7] Wang M, Wei C, Shi Z, et al. Study on the diagnosis of small hepatocellular carcinoma caused by hepatitis B cirrhosis via multi-slicespiral CT and MRI. Oncol Lett, 2018, 15:503-508.
[8] Maiwald B, Lobsien D, Kahn T, et al. Is 3-Tesla Gd-EOB-DTPA-enhanced MRI with diffusion-weighted imaging superior to 64-slice contrast-enhanced CT for the diagnosis of hepatocellular carcinoma? PLoS One, 2014, 9:e111935.
[9] Reizine E, Amaddeo G, Pigneur F, et al. Quantitative correlation between uptake of Gd-EOB-DTPA on hepatobiliary phase and tumor molecular features in patients with benign hepatocellular lesions. Eur Radiol, 2018, 28:4243-4253.
[10] Cortis K, Liotta R, Miraglia R, et al. Incorporating the hepatobiliary phase of gadobenate dimeglumine-enhanced MRI in the diagnosis of hepatocellular carcinoma: increasing the sensitivity without compromising specificity. Acta Radiol, 2016, 57:923-931.
[11] Kumar A, Acharya SK, Singh SP, et al. 2019 Update of Indian National Association for Study of the Liver Consensus on prevention, diagnosis, and management of hepatocellular carcinoma in India: the Puri II Recommendations. J Clin Exp Hepatol, 2020, 10:43-80.
[12] Quaia E, Pizzolato R, De Paoli L, et al. Arterial enhancing-only nodules less than 2 cm in diameter in patients with liver cirrhosis: predictors of hepatocellular carcinoma diagnosis on gadobenate dimeglumine-enhanced MR imaging. J Magn Reson Imaging, 2013, 37:892-902.
[13] 罗宴吉, 蔡华崧, 汤地, 等. 肝细胞特异性MR 对比剂在肝脏功能评价中的初步研究.中华消化病与影像杂志(电子版), 2013, 3: 242-246.
[14] 董春娇, 叶玉芳, 邢卫红, 等. 钆钡葡胺增强磁共振与多排螺旋CT诊断小肝癌的比较研究. 河北医药, 2019, 41:2790-2794.
[15] 张学琴, 陆健, 王霄英, 等. 多排螺旋CT与MRI对乙肝肝硬化背景小肝癌检出的比较研究. 临床放射学杂志, 2013, 32:831-836.