Hepatobiliary MR contrast agent uptake as a predictive biomarker of aggressive features on pathology and reduced recurre
- PDF / 1,256,745 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 41 Downloads / 144 Views
HEPATOBILIARY-PANCREAS
Hepatobiliary MR contrast agent uptake as a predictive biomarker of aggressive features on pathology and reduced recurrence-free survival in resectable hepatocellular carcinoma: comparison with dual-tracer 18F-FDG and 18F-FCH PET/CT Sébastien Mulé 1,2,3 & Julia Chalaye 4 & François Legou 1 & Arthur Tenenhaus 5 & Julien Calderaro 2,3,6 & Athena Galletto Pregliasco 1 & Alexis Laurent 2,7 & Rym Kharrat 1 & Giuliana Amaddeo 2,3,8 & Hélène Regnault 8 & Vania Tacher 1,2,3 & Hicham Kobeiter 1,2 & Emmanuel Itti 2,4 & Alain Luciani 1,2,3 Received: 28 January 2020 / Revised: 26 March 2020 / Accepted: 28 April 2020 # European Society of Radiology 2020
Abstract Objectives To compare the performance of the quantitative analysis of the hepatobiliary phase (HBP) tumor enhancement in gadobenate dimeglumine (Gd-BOPTA)–enhanced MRI and of dual-tracer 18F-FDG and 18F-fluorocholine (FCH) PET/CT for the prediction of tumor aggressiveness and recurrence-free survival (RFS) in resectable hepatocellular carcinoma (HCC). Methods This retrospective, IRB approved study included 32 patients with 35 surgically proven HCCs. All patients underwent Gd-BOPTA-enhanced MRI including delayed HBP images, 18F-FDG PET/CT, and (for 29/32 patients) 18F-FCH PET/CT during the 2 months prior to surgery. For each lesion, the lesion-to-liver contrast enhancement ratio (LLCER) on MRI HBP images and the SUVmax tumor-to-liver ratio (SUVT/L) for both tracers were calculated. Their predictive value for aggressive pathological features—including the histological grade and microvascular invasion (MVI)—and RFS were analyzed and compared using area under receiver operating characteristic (AUROC) curves and Cox regression models, respectively. Results The AUROCs for the identification of aggressive HCCs on pathology with LLCER, 18F-FDG SUVT/L, and 18F-FCH SUVT/L were 0.92 (95% CI 0.78, 0.98), 0.89 (95% CI 0.74, 0.97; p = 0.70), and 0.64 (95% CI 0.45, 0.80; p = 0.035). At multivariate Cox regression analysis, LLCER was identified as an independent predictor of RFS (HR (95% CI) = 0.91 (0.84, 0.99), p = 0.022). LLCER − 4.72% or less also accurately predicted moderate-poor differentiation grade (Se = 100%, Sp = 92.9%) and MVI (Se = 93.3%, Sp = 60%) and identified patients with poor RFS after surgical resection (p = 0.030). Conclusions HBP tumor enhancement after Gd-BOPTA injection may help identify aggressive HCC pathological features, and patients with reduced recurrence-free survival after surgical resection.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-06923-5) contains supplementary material, which is available to authorized users. * Sébastien Mulé [email protected] 1
Service d’Imagerie Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, France
2
Faculté de Médecine, Université Paris Est Créteil, Créteil, France
3
INSERM IMRB, U 955, Equipe 18, Créteil, France
4
Service de Médecine Nucléaire, AP-HP, Hôpita
Data Loading...
