Rationale and Objectives
Magnetic resonance imaging (MRI) is the most useful imaging tool for small hepatocellular
carcinoma (HCC) evaluation. Patients undergoing transarterial chemoembolization (TACE)
might have predictive imaging prognostic factors. This study aimed to find predictive
gadoxetic acid (GA)-enhanced MRI features that affect tumor response and outcomes
in patients with early HCC who underwent conventional TACE.
Materials and Methods
Among patients who underwent conventional TACE as a first-line treatment for Barcelona
clinic liver cancer stage 0 or A (<3 cm), 135 patients who underwent GA-enhanced MRI
before treatment were included in this retrospective study. The patients’ pretreatment
clinical characteristics and MRI features were evaluated. Post-treatment tumor response,
progression-free survival (PFS), and overall survival (OS) were also investigated.
Results
The median follow-up period was 47 (range: 7-133) months, with 90 (67%) patients showing
complete remission (CR) at the 1-month follow-up after TACE. Tumor number (odds ratio
[OR] 0.602, 95% confidence interval [CI]: 0.375-0.967), central location (OR: 0.349,
95% CI: 0.145-0.837) were inversely associated with CR achievement. Median PFS and
OS time were 22 (range: 1-133) and 67 (range: 7-133) months, respectively. The MRI
features affecting poor survival outcomes were tumor number (PFS: hazard ratio [HR]=1.444,
95% CI=1.124-1.854; OS: HR=1.459, 95% CI=1.018-2.090), central location (PFS: HR=1.664,
95% CI=1.038-2.667; OS: HR=1.890, 95% CI=1.021-3.497), and marginal irregularity (PFS:
HR=3.099, 95% CI=1.953-4.979; OS: HR=1.985, 95% CI=1.084-3.634).
Conclusion
Multiplicity, central location, and marginal irregularity of HCC on GA-enhanced MRI
were significant factors associated with poor prognosis of patients with early HCC
after conventional TACE.
Key Words
Abbreviations:
BCLC (Barcelona clinic liver cancer), BMI (Body mass index), CI (Confidence interval), CR (Complete remission), CT (Computed tomography), Fr (French), GA (Gadoxetic acid), HASTE (Half-Fourier acquisition single-shot turbo-spin echo), HBP (Hepatobiliary phase), HCC (Hepatocellular carcinoma), HR (Hazard ratio), HU (Hounsfield unit), m-RECIST (modified Response Evaluation Criteria In Solid Tumors), MRI (Magnetic resonance imaging), OR (Odds ratio), OS (Overall survival), PD (Progressive disease), PR (Partial response), PFS (Progression-free survival), RFA (Radiofrequency ablation), SI (Signal intensity), T1WI (T1-weighted images), T2WI (T2-weighted images), TACE (Transarterial chemoembolization), VIBE (volumetric interpolated breath-hold examination))To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: February 09, 2022
Accepted:
October 18,
2021
Received in revised form:
October 7,
2021
Received:
July 26,
2021
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of The Association of University Radiologists.
