Predictors of changes in preoperative tumor stage between dynamic computed tomography and gadoxetate disodium-enhanced magnetic resonance imaging for hepatocellular carcinoma
Background/Purpose: Gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) has a higher diagnostic accuracy for hepatocellular carcinoma (HCC) than computed tomography (CT). However, indications for performing EOB-MRI after dynamic CT are not well defined. Therefore, we investigated the c...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664621005933 |
| _version_ | 1811218790501842944 |
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| author | Chih-Horng Wu Yu-Hsin Lee Po-Chin Liang Rey-Heng Hu Tiffany Ting-Fang Shih Ming-Chih Ho |
| author_facet | Chih-Horng Wu Yu-Hsin Lee Po-Chin Liang Rey-Heng Hu Tiffany Ting-Fang Shih Ming-Chih Ho |
| author_sort | Chih-Horng Wu |
| collection | DOAJ |
| description | Background/Purpose: Gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) has a higher diagnostic accuracy for hepatocellular carcinoma (HCC) than computed tomography (CT). However, indications for performing EOB-MRI after dynamic CT are not well defined. Therefore, we investigated the clinical factors associated with changes in the preoperative tumor stage between dynamic CT and EOB-MRI. Methods: A prospective cohort was conducted from January 2014 to December 2017. 156 adult patients with clinical suspicion of HCC before liver resection were enrolled and we retrospectively reviewed the images. The tumor staging was evaluated by dynamic CT and then EOB-MRI subsequently according to the TNM staging system. The changes in tumor stage between two modalities were identified, and the associated clinical factors were analyzed. Results: A total of 99 patients were analyzed after excluding 57 patients. 20 patients (20.2%) had changes in tumor stage between dynamic CT and EOB-MRI. The change occurred only in early stage (T1 and T2 lesions) based on dynamic CT initially. Furthermore, in univariate and multivariate analyses, albumin–bilirubin (ALBI) grade 2 and log alpha-fetoprotein (AFP) levels were associated with changes in tumor staging by EOB-MRI than those without (50% vs. 9.9%, p < 0.001 and 2.04 ± 1.35 vs. 1.40 ± 1.16, p = 0.038, respectively). Patients with changes in tumor stage also exhibited higher 1-year recurrence rate and shorter recurrence-free survival. Conclusion: Changes in preoperative tumor stage between dynamic CT and EOB-MRI were associated with CT-defined early stage, ALBI grades, higher log AFP levels, and early recurrence. |
| first_indexed | 2024-04-12T07:15:17Z |
| format | Article |
| id | doaj.art-bfa7b3bbab95430c8b3cde5f327ed519 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-04-12T07:15:17Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-bfa7b3bbab95430c8b3cde5f327ed5192022-12-22T03:42:30ZengElsevierJournal of the Formosan Medical Association0929-66462022-08-01121815501559Predictors of changes in preoperative tumor stage between dynamic computed tomography and gadoxetate disodium-enhanced magnetic resonance imaging for hepatocellular carcinomaChih-Horng Wu0Yu-Hsin Lee1Po-Chin Liang2Rey-Heng Hu3Tiffany Ting-Fang Shih4Ming-Chih Ho5Department of Medical Imaging, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Radiology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Radiology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Radiology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Center for Functional Image and Interventional Image, National Taiwan University, Taipei, Taiwan; Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan; Corresponding author. Department of Surgery, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 10002, Taiwan.Background/Purpose: Gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) has a higher diagnostic accuracy for hepatocellular carcinoma (HCC) than computed tomography (CT). However, indications for performing EOB-MRI after dynamic CT are not well defined. Therefore, we investigated the clinical factors associated with changes in the preoperative tumor stage between dynamic CT and EOB-MRI. Methods: A prospective cohort was conducted from January 2014 to December 2017. 156 adult patients with clinical suspicion of HCC before liver resection were enrolled and we retrospectively reviewed the images. The tumor staging was evaluated by dynamic CT and then EOB-MRI subsequently according to the TNM staging system. The changes in tumor stage between two modalities were identified, and the associated clinical factors were analyzed. Results: A total of 99 patients were analyzed after excluding 57 patients. 20 patients (20.2%) had changes in tumor stage between dynamic CT and EOB-MRI. The change occurred only in early stage (T1 and T2 lesions) based on dynamic CT initially. Furthermore, in univariate and multivariate analyses, albumin–bilirubin (ALBI) grade 2 and log alpha-fetoprotein (AFP) levels were associated with changes in tumor staging by EOB-MRI than those without (50% vs. 9.9%, p < 0.001 and 2.04 ± 1.35 vs. 1.40 ± 1.16, p = 0.038, respectively). Patients with changes in tumor stage also exhibited higher 1-year recurrence rate and shorter recurrence-free survival. Conclusion: Changes in preoperative tumor stage between dynamic CT and EOB-MRI were associated with CT-defined early stage, ALBI grades, higher log AFP levels, and early recurrence.http://www.sciencedirect.com/science/article/pii/S0929664621005933Neoplasm stagingHepatocellular carcinomaComputed tomographyGadoxetic acidMagnetic resonance imaging |
| spellingShingle | Chih-Horng Wu Yu-Hsin Lee Po-Chin Liang Rey-Heng Hu Tiffany Ting-Fang Shih Ming-Chih Ho Predictors of changes in preoperative tumor stage between dynamic computed tomography and gadoxetate disodium-enhanced magnetic resonance imaging for hepatocellular carcinoma Journal of the Formosan Medical Association Neoplasm staging Hepatocellular carcinoma Computed tomography Gadoxetic acid Magnetic resonance imaging |
| title | Predictors of changes in preoperative tumor stage between dynamic computed tomography and gadoxetate disodium-enhanced magnetic resonance imaging for hepatocellular carcinoma |
| title_full | Predictors of changes in preoperative tumor stage between dynamic computed tomography and gadoxetate disodium-enhanced magnetic resonance imaging for hepatocellular carcinoma |
| title_fullStr | Predictors of changes in preoperative tumor stage between dynamic computed tomography and gadoxetate disodium-enhanced magnetic resonance imaging for hepatocellular carcinoma |
| title_full_unstemmed | Predictors of changes in preoperative tumor stage between dynamic computed tomography and gadoxetate disodium-enhanced magnetic resonance imaging for hepatocellular carcinoma |
| title_short | Predictors of changes in preoperative tumor stage between dynamic computed tomography and gadoxetate disodium-enhanced magnetic resonance imaging for hepatocellular carcinoma |
| title_sort | predictors of changes in preoperative tumor stage between dynamic computed tomography and gadoxetate disodium enhanced magnetic resonance imaging for hepatocellular carcinoma |
| topic | Neoplasm staging Hepatocellular carcinoma Computed tomography Gadoxetic acid Magnetic resonance imaging |
| url | http://www.sciencedirect.com/science/article/pii/S0929664621005933 |
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