Risk stratification of hepatocellular carcinoma in patients with chronic liver disease by combining gadolinium-ethoxybenzyl diethylenetriamine-pentaacetic acid–enhanced magnetic resonance imaging and magnetic resonance elastography

GastroHep Pub Date : 2021-09-28 DOI:10.1002/ygh2.495

Emi Meren, Yoshiyuki Sawai, Kazuto Fukuda, Takumi Igura, Sachiyo Kogita, Yoshihiro Yukimura, Yasushi Seki, Norihiko Fujita, Masahide Oshita, Yasuharu Imai

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引用次数: 1

Abstract

Background

Liver stiffness (LS) as measured by magnetic resonance elastography (MRE) and the presence of intrahepatic nonhypervascular hypointense nodules (NHHNs) during the hepatobiliary phase of gadolinium-ethoxybenzyl diethylenetriamine-pentaacetic acid–enhanced magnetic resonance imaging are non-invasive MR-based biomarkers of hepatocarcinogenesis.

Methods

We retrospectively evaluated the ability of these two MR-based biomarkers to stratify the risk of hepatocellular carcinoma (HCC) development in patients with chronic liver disease. Between September 2013 and April 2020, 868 consecutive patients underwent MRE and gadolinium-ethoxybenzyl diethylenetriamine-pentaacetic acid–enhanced magnetic resonance imaging, among whom 487 were enrolled in this study. Factors associated with hepatocarcinogenesis were analysed by a Cox proportional hazard model.

Results

Thirty-two patients developed hypervascular HCC. According to the time-dependent receiver operating characteristic analysis, an LS value of 3.94 kPa was selected as the optimal cut-off value for predicting HCC development. Multivariate analyses identified high LS (≥3.94 kPa) and the presence of NHHN as independent predictive factors for HCC development. Patients were classified as follows: high LS/NHHN+ (Group 1), high LS/NHHN− (Group 2), low LS/NHHN+ (Group 3) and low LS/NHHN− (Group 4). The 5-year incidence rates of HCC in Groups 1, 2, 3 and 4 were 49.0%, 16.3%, 10.0% and 2.5% respectively. The HCC development rate was highest in Group 1 and lowest in Group 4 (P < 0.01).

Conclusion

MRE-based LS measurements and the presence of NHHN are useful biomarkers to stratify the risk of HCC development among chronic liver disease patients. Combining these biomarkers can provide a detailed classification of the risk of HCC development.

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钆-乙氧基苄基二亚乙基三胺-五乙酸联合增强磁共振成像和磁共振弹性成像对慢性肝病患者肝细胞癌的风险分层

背景磁共振弹性成像（MRE）测量的肝硬度（LS）和钆乙氧基苄基二亚乙基三胺五乙酸肝胆期肝内非血管性低强度结节（NHHNs）的存在-增强磁共振成像是基于磁共振的非侵入性生物标志物肝癌发生。方法我们回顾性评估了这两种基于MR的生物标志物对慢性肝病患者肝细胞癌（HCC）发展风险的分层能力。2013年9月至2020年4月，868名连续患者接受了MRE和钆乙氧基苄基二亚乙基三胺五乙酸增强磁共振成像，其中487人参与了本研究。通过Cox比例风险模型分析与肝癌发生相关的因素。结果32例患者出现血管性肝癌。根据与时间相关的受试者工作特性分析，选择3.94kPa的LS值作为预测HCC发展的最佳截止值。多因素分析确定高LS（≥3.94kPa）和NHHN的存在是HCC发展的独立预测因素。患者分为：高LS/NHN+（第1组）、高LS/NHHN−（第2组）、低LS/NHHN+（第3组）和低LS/NHHN−（第4组）。1、2、3和4组HCC的5年发病率分别为49.0%、16.3%、10.0%和2.5%。HCC发生率在第1组最高，在第4组最低（P<；0.01）。结论基于MRE的LS测量和NHHN的存在是对慢性肝病患者HCC发生风险进行分层的有用生物标志物。结合这些生物标志物可以提供HCC发展风险的详细分类。

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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GastroHep

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