Gd-EOB-DTPA-enhanced MRI proves advantageous in selecting surgical candidates for patients with early-stage hepatocellular carcinoma: An analysis in terms of oncological outcomes

iLIVER Pub Date : 2024-09-18 DOI:10.1016/j.iliver.2024.100117

Zhiwei Ye , Jing Zhao , Dandan Hu , Zhoutian Yang , Jinbin Chen , Li Xu , Zhongguo Zhou , Minshan Chen , Yaojun Zhang

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Abstract

Background and aims

To determine the value of preoperative Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in comparison with extracellular contrast agent MRI and CT in the selection of surgical candidates among patients with hepatocellular carcinoma (HCC), particularly in terms of oncological outcomes after hepatectomy.

Methods

This retrospective study included 542 consecutive patients who underwent radical hepatectomy for HCC. One group underwent preoperative Gd-EOB-DTPA-enhanced MRI, one group underwent contrast-enhanced CT, and one group underwent extracellular contrast agent MRI. We compared oncologic outcomes including recurrence free survival and overall survival between the three groups. Subgroup analyses were also performed to provide more specific candidates or beneficiaries for preoperative EOB-MRI.

Results

A total of 244 patients had tumor recurrence, with 55 in the EOB-MRI group, 106 in the Routine-MRI group, and 83 in the CT group (p = 0.010). The numbers with early recurrence (<2 years) in each group were 40 (27.03%), 78 (35.78%), and 62 (35.22%), respectively (p = 0.018). The 1, 2, and 3-year recurrence-free survival (RFS) percentages were 82.4%, 73.0%, and 68.2% in the EOB-MRI group, 70.2%, 64.3%, and 56.9% in the Routine-MRI group, and 76.8%, 64.83%, and 58.9% in the CT group (p = 0.010). The 1, 2, and 3-year overall survival percentages were 89.19%, 83.11%, and 80.41% in the EOB-MRI group, 79.82%, 73.86%, and 67.44% in the Routine-MRI group, and 86.55%, 76.14%, and 69.32% in the CT group (p = 0.016). Subgroup analysis showed significant differences in RFS in patients with solitary tumor <3 cm.

Conclusion

Preoperative EOB-MRI is superior to contrast-enhanced CT or extracellular contrast agent MRI for selecting surgical candidates at low risk of recurrence following hepatic resection for HCC.

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钆-EOB-DTPA增强核磁共振成像在为早期肝细胞癌患者选择手术候选者方面证明具有优势：肿瘤结果分析

背景和目的确定术前 Gd-EOB-DTPA 增强磁共振成像（MRI）与细胞外造影剂 MRI 和 CT 相比，在选择肝细胞癌（HCC）患者手术候选者方面的价值，尤其是在肝切除术后的肿瘤预后方面。一组接受术前 Gd-EOB-DTPA 增强核磁共振成像，一组接受造影剂增强 CT，一组接受细胞外造影剂核磁共振成像。我们比较了三组之间的肿瘤学结果，包括无复发生存率和总生存率。结果共有 244 名患者出现肿瘤复发，其中 EOB-MRI 组 55 人，常规 MRI 组 106 人，CT 组 83 人（P = 0.010）。各组早期复发（2 年）人数分别为 40 人（27.03%）、78 人（35.78%）和 62 人（35.22%）（P = 0.018）。EOB-MRI组的1年、2年和3年无复发生存率（RFS）分别为82.4%、73.0%和68.2%，Routine-MRI组分别为70.2%、64.3%和56.9%，CT组分别为76.8%、64.83%和58.9%（P = 0.010）。EOB-MRI组的1年、2年和3年总生存率分别为89.19%、83.11%和80.41%，Routine-MRI组分别为79.82%、73.86%和67.44%，CT组分别为86.55%、76.14%和69.32%（P = 0.016）。亚组分析显示，单发肿瘤为 3 厘米的患者的 RFS 有明显差异。结论在选择 HCC 肝切除术后复发风险低的手术候选者方面，术前 EOB-MRI 优于对比增强 CT 或细胞外造影剂 MRI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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iLIVER

CiteScore

0.60

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0.00%

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