Efficacy and significance of DCE-MRI parameters in evaluating tumor pathological grading in patients with primary liver cancer

Abstract

Abstract: Objective To study the efficacy and significance of dynamic enhanced magnetic resonance imaging (DCE-MRI) parameters in evaluating the pathological grading of primary liver cancer (PLC) patients. Methods Eighty PLC patients admitted to our hospital from June 2020 to June 2023 were selected as the observation group and 50 patients with hepatic benign nodules were selected as the control group. Edmondson-Steiner's tumor pathological grading method was used to evaluate the patients in the observation group, and 24 cases of grade Ⅰ were included in the mild group, 30 cases of grade Ⅱ to Ⅲ were included in the moderate group, and 26 cases of grade Ⅳ were included in the severe group. All patients underwent DCE-MRI, and their extracellular volume (V_e), plasma volume fraction (V_p), transfer constant (K^trans), and outflow rate (K_ep) were recorded. Receiver operating characteristic (ROC) curves were used to analyze the value of DCE-MRI parameters in diagnosing severe PLC. Results The values of V_e, V_p, K^trans and K_ep in the observation group were (0.75±0.24), (0.41±0.09), (1.04±0.31) and (2.74±0.49), respectively. The values of V_e, V_p, K^trans and Kep in control group were (0.43±0.12), (0.24±0.07), (0.63±0.17) and (1.58±0.34), respectively. The values of V_e, V_p, K^trans and K_ep in observation group were higher than those in control group (P<0.05). The values of V_e, V_p, K^trans and K_ep in mild group were (0.53±0.17), (0.27±0.07), (0.84±0.19) and (1.93±0.45), respectively. The values of V_e, V_p, K^trans and K_ep in the moderate group were (0.68±0.22), (0.39±0.12), (0.97±0.23) and (2.51±0.72), respectively. The values of V_e, V_p, K^trans and K_ep in the severe group were (0.91±0.29), (0.51±0.16), (1.15±0.29) and (3.18±0.85), respectively. The values of V_e, V_p, K^trans and K_ep in the mild group were lower than those in the moderate and severe groups. The V_e, V_p, K^trans and K_ep values in moderate group were lower than those in severe group (P<0.05). ROC analysis showed that the area under the curve (AUC) value of the V_e, V_p, K^trans, and K_ep for diagnosing the moderate to severe PLC were 0.905 (95% CI: 0.846~0.964), 0.751 (95% CI: 0.639~0.830), 0.772 (95% CI: 0.674~0.870), and 0.916 (95% CI: 0.871~0.961), respectively. Conclusion The quantitative parameters in DCE-MRI of PLC patients with different pathological grades are different to some extent, and the higher the pathological grade is, the higher the V_e, V_p, K^trans, K_ep values are. Clinically, the pathological grading of patients can be evaluated based on indicators such as V_e, V_p, K^trans, K_ep, etc., with good efficacy.

Key words: Primary liver cancer, Dynamic enhanced magnetic resonance scanning, Quantitative parameters, Tumor pathological grade, Diagnostic efficiency

ZHAO Yan, LI Wen-hua, ZENG Xu, WANG Xu-sheng. Efficacy and significance of DCE-MRI parameters in evaluating tumor pathological grading in patients with primary liver cancer[J]. Chinese Hepatolgy, 2025, 30(11): 1503-1506.

References

[1] 赖奉庭. 卡瑞利珠单抗治疗晚期原发性肝癌临床效果及安全性研究[J]. 山西医药杂志,2021,50(15):2269-2272.
[2] Schaffler-Schaden D, Birsak T, Zintl R, et al. Risk of needle tract seeding after coaxial ultrasound-guided percutaneous biopsy for primary and metastatic tumors of the liver: report of a single institution.[J]. Abdom Radiol (NY),2020,45(10):3301-3306.
[3] 张荣,尚晓娜. 超声剪切波弹性成像技术联合穿刺活检对小肝癌的诊断价值[J]. 中国肿瘤临床与康复,2022,29(3):274-277.
[4] 邬政宏,吴冬秋,刘四斌. DCE-MRI诊断原发性肝癌效能和TACE术后评估肿瘤活性应用价值研究[J]. 实用肝脏病杂志,2022,25(6):881-884.
[5] Song Q, Guo Y, Yao X, et al. Comparative study of evaluating the microcirculatory function status of primary small HCC between the CE (DCE-MRI) and Non-CE (IVIM-DWI) MR Perfusion Imaging.[J]. Abdom Radiol (NY),2021,46(6):2575-2583.
[6] 江慧珍,陈俊,陈春美,等. 动态增强磁共振定量参数诊断肝脏占位性病变良恶性效能分析[J]. 实用肝脏病杂志,2023,26(1):100-103.
[7] 敬文斌. DWI联合DCE-MRI对肝脏局灶性结节性病变的诊断价值[J]. 中国CT和MRI杂志,2018,16(11):90-93.
[8] Zhou L, Rui J A, Zhou W X, et al. Edmondson-Steiner grade: a crucial predictor of recurrence and survival in hepatocellular carcinoma without microvascular invasio.[J]. Pathol Res Pract,2017,213(7):824-830.
[9] 中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗规范(2019年版)[J]. 中华消化病与影像杂志(电子版),2020,10(1):22-48.
[10] 贾乃龙,王松海,李传资. MSCT和Gd-EOB-DTPA DCE-MRI诊断肝脏局灶性病变的价值对比[J]. 中国CT和MRI杂志,2020,18(5):5-7,17.
[11] Sun Y, Zhu Q, Huang M, et al. Liver DCE-MRI registration based on sparse recovery of contrast agent curves[J]. Med Phys,2021,48(11):6916-6929.
[12] Phonlakrai M, Ramadan S, Simpson J, et al. Determination of hepatic extraction fraction with gadoxetate low-temporal resolution DCE-MRI-based deconvolution analysis: validation with AlbI score and Child-Pugh class.[J]. J Med Radiat Sci,2023,70(Suppl 2):48-58.
[13] 朱志敏,李华,陈轶,等. 动态增强磁共振成像定量参数鉴别诊断肝脏小占位性病变良恶性价值研究[J]. 实用肝脏病杂志,2023,26(5):726-729.
[14] Berks M, Little R A, Watson Y, et al. A model selection framework to quantify microvascular liver function in gadoxetate-enhanced MRI: application to healthy liver, diseased tissue, and hepatocellular carcinoma.[J]. Magn Reson Med,2021,86(4):1829-1844.
[15] 莫焕涛,郭秀云. 弥散加权成像联合动态对比增强磁共振成像诊断肝脏恶性肿瘤的效果研究[J]. 中西医结合肝病杂志,2020,30(5):438-440.
[16] 张文涛,王力,王俊. DCE-MRI定量灌注参数与原发性肝癌病理分级及预后的关系[J]. 实用癌症杂志,2023,38(6):976-980,989.
[17] 邢腾龙,成戈,周智鹏,等. MRI动态增强定量参数对肝细胞癌和肝良性肿瘤鉴别诊断的价值[J]. 实用放射学杂志,2016,32(3):366-369,379.
[18] 于巍伟,于卫永,刘坤,等. MRI多期动态对比增强灌注参数与原发性肝癌患者微血管密度、病理分级的关联[J]. 中西医结合肝病杂志,2021,31(2):161-164.
[19] 陈天佑,袁敏,周粟,等. 3.0T动态增强磁共振灌注成像对小肝癌射频消融疗效评估的价值研究[J]. 介入放射学杂志,2022,31(2):154-159.
[20] 刘东,钱海峰. 动态对比增强磁共振渗透性参数早期监测肝转移瘤贝伐单抗联合常规化疗治疗敏感性的价值[J]. 中国医学科学院学报,2018,40(2):256-263.