Extrahepatic Disease in Hepatocellular Carcinoma: Do We Always Need Whole-Body CT or Is Liver MRI Sufficient? A Subanalysis of the SORAMIC Trial
<b>Background:</b> To investigate whole-body contrast-enhanced CT and hepatobiliary contrast liver MRI for the detection of extrahepatic disease (EHD) in hepatocellular carcinoma (HCC) and to quantify the impact of EHD on therapy decision. <b>Methods:</b> In this post-hoc ana...
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2022-05-01
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| author | Thomas Geyer Philipp M. Kazmierczak Ingo G. Steffen Peter Malfertheiner Bora Peynircioglu Christian Loewe Otto van Delden Vincent Vandecaveye Bernhard Gebauer Maciej Pech Christian Sengel Irene Bargellini Roberto Iezzi Alberto Benito Christoph J. Zech Antonio Gasbarrini Kerstin Schütte Jens Ricke Max Seidensticker |
| author_facet | Thomas Geyer Philipp M. Kazmierczak Ingo G. Steffen Peter Malfertheiner Bora Peynircioglu Christian Loewe Otto van Delden Vincent Vandecaveye Bernhard Gebauer Maciej Pech Christian Sengel Irene Bargellini Roberto Iezzi Alberto Benito Christoph J. Zech Antonio Gasbarrini Kerstin Schütte Jens Ricke Max Seidensticker |
| author_sort | Thomas Geyer |
| collection | DOAJ |
| description | <b>Background:</b> To investigate whole-body contrast-enhanced CT and hepatobiliary contrast liver MRI for the detection of extrahepatic disease (EHD) in hepatocellular carcinoma (HCC) and to quantify the impact of EHD on therapy decision. <b>Methods:</b> In this post-hoc analysis of the prospective phase II open-label, multicenter, randomized controlled SORAMIC trial, two blinded readers independently analyzed the whole-body contrast-enhanced CT and gadoxetic acid-enhanced liver MRI data sets of 538 HCC patients. EHD (defined as tumor manifestation outside the liver) detection rates of the two imaging modalities were compared using multiparametric statistical tests. In addition, the most appropriate treatment recommendation was determined by a truth panel. <b>Results:</b> EHD was detected significantly more frequently in patients with portal vein infiltration (21% vs. 10%, <i>p</i> < 0.001), macrovascular infiltration (22% vs. 9%, <i>p</i> < 0.001), and bilobar liver involvement (18% vs. 9%, <i>p</i> = 0.006). Further on, the maximum lesion diameter in patients with EHD was significantly higher (8.2 cm vs. 5.8 cm, <i>p</i> = 0.002). CT detected EHD in significantly more patients compared to MRI in both reader groups (<i>p</i> < 0.001). Higher detection rates of EHD in CT led to a change in management only in one patient since EHD was predominantly present in patients with locally advanced HCC, in whom palliative treatment is the standard of care. <b>Conclusions:</b> Whole-body contrast-enhanced CT shows significantly higher EHD detection rates compared to hepatobiliary contrast liver MRI. However, the higher detection rate did not yield a significant impact on patient management in advanced HCC. |
| first_indexed | 2024-03-10T03:16:29Z |
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| last_indexed | 2024-03-10T03:16:29Z |
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| spelling | doaj.art-5ca9577705a94cd09617251ce3d62a592023-11-23T10:11:58ZengMDPI AGBiomedicines2227-90592022-05-01105115610.3390/biomedicines10051156Extrahepatic Disease in Hepatocellular Carcinoma: Do We Always Need Whole-Body CT or Is Liver MRI Sufficient? A Subanalysis of the SORAMIC TrialThomas Geyer0Philipp M. Kazmierczak1Ingo G. Steffen2Peter Malfertheiner3Bora Peynircioglu4Christian Loewe5Otto van Delden6Vincent Vandecaveye7Bernhard Gebauer8Maciej Pech9Christian Sengel10Irene Bargellini11Roberto Iezzi12Alberto Benito13Christoph J. Zech14Antonio Gasbarrini15Kerstin Schütte16Jens Ricke17Max Seidensticker18Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, School of Medicine, Hacettepe University, Sihhiye Campus, Ankara 06100, TurkeySection of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Radiology and Nuclear Medicine, Academic Medical Center, University of Amsterdam, 1105 Amsterdam, The NetherlandsDepartment of Radiology, University Hospitals Leuven, 3000 Leuven, BelgiumDepartment of Radiology, Charité-Universitätsmedizin Berlin, 10117 Berlin, GermanyDepartment of Radiology and Nuclear Medicine, University of Magdeburg, 39106 Magdeburg, GermanyRadiologie Interventionnelle Vasculaire et Percutanée, CHU de Grenoble, 38043 Grenoble, FranceDivision of Interventional Radiology, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, ItalyDipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radiologia, 00168 Rome, ItalyAbdominal Radiology Unit, Department of Radiology, Clínica Universidad de Navarra, Universidad de Navarra, 31008 Pamplona, SpainRadiology and Nuclear Medicine, University Hospital Basel, University of Basel, 4001 Basel, SwitzerlandFondazione Policlinico Gemelli IRCCS, Università’ Cattolica del Sacro Cuore, 00168 Rome, ItalyDepartment of Gastroenterology, Hepatology and Infectious Diseases, Otto-Von-Guericke University, 39106 Magdeburg, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany<b>Background:</b> To investigate whole-body contrast-enhanced CT and hepatobiliary contrast liver MRI for the detection of extrahepatic disease (EHD) in hepatocellular carcinoma (HCC) and to quantify the impact of EHD on therapy decision. <b>Methods:</b> In this post-hoc analysis of the prospective phase II open-label, multicenter, randomized controlled SORAMIC trial, two blinded readers independently analyzed the whole-body contrast-enhanced CT and gadoxetic acid-enhanced liver MRI data sets of 538 HCC patients. EHD (defined as tumor manifestation outside the liver) detection rates of the two imaging modalities were compared using multiparametric statistical tests. In addition, the most appropriate treatment recommendation was determined by a truth panel. <b>Results:</b> EHD was detected significantly more frequently in patients with portal vein infiltration (21% vs. 10%, <i>p</i> < 0.001), macrovascular infiltration (22% vs. 9%, <i>p</i> < 0.001), and bilobar liver involvement (18% vs. 9%, <i>p</i> = 0.006). Further on, the maximum lesion diameter in patients with EHD was significantly higher (8.2 cm vs. 5.8 cm, <i>p</i> = 0.002). CT detected EHD in significantly more patients compared to MRI in both reader groups (<i>p</i> < 0.001). Higher detection rates of EHD in CT led to a change in management only in one patient since EHD was predominantly present in patients with locally advanced HCC, in whom palliative treatment is the standard of care. <b>Conclusions:</b> Whole-body contrast-enhanced CT shows significantly higher EHD detection rates compared to hepatobiliary contrast liver MRI. However, the higher detection rate did not yield a significant impact on patient management in advanced HCC.https://www.mdpi.com/2227-9059/10/5/1156hepatocellular carcinomaextrahepatic diseaseliver MRIpatient managementtherapeutic decision-making |
| spellingShingle | Thomas Geyer Philipp M. Kazmierczak Ingo G. Steffen Peter Malfertheiner Bora Peynircioglu Christian Loewe Otto van Delden Vincent Vandecaveye Bernhard Gebauer Maciej Pech Christian Sengel Irene Bargellini Roberto Iezzi Alberto Benito Christoph J. Zech Antonio Gasbarrini Kerstin Schütte Jens Ricke Max Seidensticker Extrahepatic Disease in Hepatocellular Carcinoma: Do We Always Need Whole-Body CT or Is Liver MRI Sufficient? A Subanalysis of the SORAMIC Trial Biomedicines hepatocellular carcinoma extrahepatic disease liver MRI patient management therapeutic decision-making |
| title | Extrahepatic Disease in Hepatocellular Carcinoma: Do We Always Need Whole-Body CT or Is Liver MRI Sufficient? A Subanalysis of the SORAMIC Trial |
| title_full | Extrahepatic Disease in Hepatocellular Carcinoma: Do We Always Need Whole-Body CT or Is Liver MRI Sufficient? A Subanalysis of the SORAMIC Trial |
| title_fullStr | Extrahepatic Disease in Hepatocellular Carcinoma: Do We Always Need Whole-Body CT or Is Liver MRI Sufficient? A Subanalysis of the SORAMIC Trial |
| title_full_unstemmed | Extrahepatic Disease in Hepatocellular Carcinoma: Do We Always Need Whole-Body CT or Is Liver MRI Sufficient? A Subanalysis of the SORAMIC Trial |
| title_short | Extrahepatic Disease in Hepatocellular Carcinoma: Do We Always Need Whole-Body CT or Is Liver MRI Sufficient? A Subanalysis of the SORAMIC Trial |
| title_sort | extrahepatic disease in hepatocellular carcinoma do we always need whole body ct or is liver mri sufficient a subanalysis of the soramic trial |
| topic | hepatocellular carcinoma extrahepatic disease liver MRI patient management therapeutic decision-making |
| url | https://www.mdpi.com/2227-9059/10/5/1156 |
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