{"title":"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","authors":"Emi Meren, Yoshiyuki Sawai, Kazuto Fukuda, Takumi Igura, Sachiyo Kogita, Yoshihiro Yukimura, Yasushi Seki, Norihiko Fujita, Masahide Oshita, Yasuharu Imai","doi":"10.1002/ygh2.495","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 (<i>P</i> < 0.01).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 7","pages":"435-442"},"PeriodicalIF":0.0000,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"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\",\"authors\":\"Emi Meren, Yoshiyuki Sawai, Kazuto Fukuda, Takumi Igura, Sachiyo Kogita, Yoshihiro Yukimura, Yasushi Seki, Norihiko Fujita, Masahide Oshita, Yasuharu Imai\",\"doi\":\"10.1002/ygh2.495\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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 (<i>P</i> < 0.01).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":12480,\"journal\":{\"name\":\"GastroHep\",\"volume\":\"3 7\",\"pages\":\"435-442\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-09-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"GastroHep\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ygh2.495\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"GastroHep","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ygh2.495","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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
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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