Circulating Cell-Free DNA Combined to Magnetic Resonance Imaging for Early Detection of HCC in Patients with Liver Cirrhosis

Liquid biopsy based on circulating cell-free DNA (cfDNA) is a promising non-invasive tool for the prognosis of hepatocellular cancer (HCC). In this exploratory study we investigated whether cfDNA and gene variants associated with HCC may be found in patients with liver cirrhosis (LC) and thus identi...

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Main Authors: Marianna Alunni-Fabbroni, Sabine Weber, Osman Öcal, Max Seidensticker, Julia Mayerle, Peter Malfertheiner, Jens Ricke
Format: Article
Language:English
Published: MDPI AG 2021-01-01
Series:Cancers
Subjects:
Online Access:https://www.mdpi.com/2072-6694/13/3/521
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author Marianna Alunni-Fabbroni
Sabine Weber
Osman Öcal
Max Seidensticker
Julia Mayerle
Peter Malfertheiner
Jens Ricke
author_facet Marianna Alunni-Fabbroni
Sabine Weber
Osman Öcal
Max Seidensticker
Julia Mayerle
Peter Malfertheiner
Jens Ricke
author_sort Marianna Alunni-Fabbroni
collection DOAJ
description Liquid biopsy based on circulating cell-free DNA (cfDNA) is a promising non-invasive tool for the prognosis of hepatocellular cancer (HCC). In this exploratory study we investigated whether cfDNA and gene variants associated with HCC may be found in patients with liver cirrhosis (LC) and thus identify those at an increased risk for HCC. A cohort of 40 LC patients with no suspect neoplastic lesions was included in this study. Next generation sequencing (NGS) of cfDNA isolated from plasma was performed on a panel of 597 selected genes. Images of the patients who underwent MRI with hepatospecific contrast media during the study period were retrospectively re-evaluated (imaging was not part of the prospective study). cfDNA was detected in the plasma of 36 patients with LC. NGS-based analyses identified 20 variants in different combinations. Re-evaluation of the MRI images that were available for a proportion of the patients (<i>n</i> = 27) confirmed the absence of lesions in 8 cases carrying cfDNA without variants. In 6 of 19 patients with identified variants and MRI images available, MRI revealed a precursor lesion compatible with HCC and new lesions were discovered at follow-up in two patients. These precursor lesions were amenable for curative treatments. Mutation analysis revealed selective HCC related gene mutations in a subset of patients with LC, raising the suspect that these patients were at an increased risk for HCC development. MRI findings confirmed suspect nodular lesions of early stage HCC not detected with current standard screening procedures, which were only seen in patients carrying cfDNA variants. This opens a perspective for an HCC screening strategy combining both liquid biopsy and MRI in patients with LC.
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spelling doaj.art-a825a26cc0424a37b9a95804c0e3c2792023-12-03T15:13:46ZengMDPI AGCancers2072-66942021-01-0113352110.3390/cancers13030521Circulating Cell-Free DNA Combined to Magnetic Resonance Imaging for Early Detection of HCC in Patients with Liver CirrhosisMarianna Alunni-Fabbroni0Sabine Weber1Osman Öcal2Max Seidensticker3Julia Mayerle4Peter Malfertheiner5Jens Ricke6Department of Radiology, University Hospital, LMU Munich, 81377 Munich, GermanyDepartment of Medicine II, University Hospital, LMU Munich, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, 81377 Munich, GermanyDepartment of Medicine II, University Hospital, LMU Munich, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, 81377 Munich, GermanyLiquid biopsy based on circulating cell-free DNA (cfDNA) is a promising non-invasive tool for the prognosis of hepatocellular cancer (HCC). In this exploratory study we investigated whether cfDNA and gene variants associated with HCC may be found in patients with liver cirrhosis (LC) and thus identify those at an increased risk for HCC. A cohort of 40 LC patients with no suspect neoplastic lesions was included in this study. Next generation sequencing (NGS) of cfDNA isolated from plasma was performed on a panel of 597 selected genes. Images of the patients who underwent MRI with hepatospecific contrast media during the study period were retrospectively re-evaluated (imaging was not part of the prospective study). cfDNA was detected in the plasma of 36 patients with LC. NGS-based analyses identified 20 variants in different combinations. Re-evaluation of the MRI images that were available for a proportion of the patients (<i>n</i> = 27) confirmed the absence of lesions in 8 cases carrying cfDNA without variants. In 6 of 19 patients with identified variants and MRI images available, MRI revealed a precursor lesion compatible with HCC and new lesions were discovered at follow-up in two patients. These precursor lesions were amenable for curative treatments. Mutation analysis revealed selective HCC related gene mutations in a subset of patients with LC, raising the suspect that these patients were at an increased risk for HCC development. MRI findings confirmed suspect nodular lesions of early stage HCC not detected with current standard screening procedures, which were only seen in patients carrying cfDNA variants. This opens a perspective for an HCC screening strategy combining both liquid biopsy and MRI in patients with LC.https://www.mdpi.com/2072-6694/13/3/521liver cirrhosisMRIHCCliquid biopsycirculating cell-free DNA
spellingShingle Marianna Alunni-Fabbroni
Sabine Weber
Osman Öcal
Max Seidensticker
Julia Mayerle
Peter Malfertheiner
Jens Ricke
Circulating Cell-Free DNA Combined to Magnetic Resonance Imaging for Early Detection of HCC in Patients with Liver Cirrhosis
Cancers
liver cirrhosis
MRI
HCC
liquid biopsy
circulating cell-free DNA
title Circulating Cell-Free DNA Combined to Magnetic Resonance Imaging for Early Detection of HCC in Patients with Liver Cirrhosis
title_full Circulating Cell-Free DNA Combined to Magnetic Resonance Imaging for Early Detection of HCC in Patients with Liver Cirrhosis
title_fullStr Circulating Cell-Free DNA Combined to Magnetic Resonance Imaging for Early Detection of HCC in Patients with Liver Cirrhosis
title_full_unstemmed Circulating Cell-Free DNA Combined to Magnetic Resonance Imaging for Early Detection of HCC in Patients with Liver Cirrhosis
title_short Circulating Cell-Free DNA Combined to Magnetic Resonance Imaging for Early Detection of HCC in Patients with Liver Cirrhosis
title_sort circulating cell free dna combined to magnetic resonance imaging for early detection of hcc in patients with liver cirrhosis
topic liver cirrhosis
MRI
HCC
liquid biopsy
circulating cell-free DNA
url https://www.mdpi.com/2072-6694/13/3/521
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