The Value of Susceptibility Weighted Imaging in Determining Pathologic Grade of Hepatocellular Carcinoma in Rat Model_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIMou ¹ , ZHENGXing-ju ^1,2 , HUANGZi-xing ¹ ,  SONGBin ¹

1. Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China;
2. Department of Radiology, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China;

Corresponding?author：

SONGBin, Email: cjr.songbin@vip.163.com

Keywords：

Susceptibility weighted imaging; Hepatocellular carcinoma; Pathological grade; Rat

DOI：

10.7507/1007-9424.20160290

Video：

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Objective To evaluate the feasibility of susceptibility weighted imaging (SWI) in determining pathologic grade of hepatocellular carcinoma (HCC) in rat model. Methods Rat models were established first and SWI was performed before killing rats to be examined pathologically. The Edmondson-Steiner grading was used as gold reference for histological grade of HCC. The characters of intratumoral susceptibility signal intensity (ITSS) between lowand high-grade HCCs were compared. The diagnostic value of ITSS in differentiating lowfrom high-grade HCCs was evaluated. Results Forty eight rat models of HCC were successfully established. Thirty two HCCs (18 low-grade HCCs and 14 highgrade HCCs) were included finally. The incidence of ITSS between two groups was not significant (P=0.113). Characters including component of ITSS (P=0.002) and ratio of ITSS in HCC (P < 0.001) were compared between lowand high-grade HCCs, which were both statistically significant. When score of ratio of ITSS in HCC was assessed as 2 scores, the sensitivity and specificity of ITSS in differentiating lowfrom high-grade HCCs were 85.7% (95% CI:74.9%-96.5%) and 94.4% (95% CI:83.6%-100%) respectively, and the area under roc curve (AUC) was 0.917. Conclusion SWI can evaluate characters of ITSS in HCC and can be an alternative method in grading HCC.

Citation： LI Mou, ZHENG Xing-ju, HUANG Zi-xing, SONG Bin. The Value of Susceptibility Weighted Imaging in Determining Pathologic Grade of Hepatocellular Carcinoma in Rat Model. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(9): 1132-1135. doi: 10.7507/1007-9424.20160290 Copy

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9.	Jeng KS, Sheen IS, Jeng WJ. Azidothymidine treatment of hepatocellular carcinoma in rats:an in vivo study of telomerase inhibition. Hepatogastroenterology, 2011, 58(112):2091-2096.
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11.	許紹奇, 邢偉, 陳杰, 等.磁敏感成像與腎透明細胞癌病理分級的相關性研究.磁共振成像, 2015, 6(9):669-672.
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14.	Park MJ, Kim HS, Jahng GH, et al. Semiquantitative assessment of intratumoral susceptibility signals using non-contrast-enhanced high-field high-resolution susceptibility-weighted imaging in patients with gliomas:comparison with MR perfusion imaging. AJNR Am J Neuroradiol, 2009, 30(7):1402-1408.
15.	Hori M, Mori H, Aoki S, et al. Three-dimensional susceptibility-weighted imaging at 3 T using various image analysis methods in the estimation of grading intracranial gliomas. Magn Reson Imaging, 2010, 28(4):594-598.
16.	Pascual S, Herrera I, Irurzun J. New advances in hepatocellular carcinoma. World J Hepatol, 2016, 8(9):421-438.
17.	Bhardwaj N, Perera MT, Silva MA. Current treatment approaches to HCC with a special consideration to transplantation. J Transplant, 2016, 2016:7926264.
18.	Lee JM, Yoon JH, Joo I, et al. Recent advances in CT and MR imaging for evaluation of hepatocellular carcinoma. Liver Cancer, 2012, 1(1):22-40.
19.	Bolog N, Andreisek G, Oancea I, et al. CT and MR imaging of hepatocellular carcinoma. J Gastrointestin Liver Dis, 2011, 20(2):181-189.
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21.	Reichenbach JR, Venkatesan R, Schillinger DJ, et al. Small vessels in the human brain:MR venography with deoxyhemoglobin as an intrinsic contrast agent. Radiology, 1997, 204(1):272-277.
22.	Chen W, Delproposto Z, Liu W, et al. Susceptibility-weighted imaging for the noncontrast evaluation of hepatocellular carcinoma:a prospective study with histopathologic correlation. PLoS One, 2014, 9(5):e98303.
23.	Dai Y, Zeng M, Li R, et al. Improving detection of siderotic nodules in cirrhotic liver with a multi-breath-hold susceptibility-weighted imaging technique. J Magn Reson Imaging, 2011, 34(2):318-325.
24.	Li RK, Zeng MS, Rao SX, et al. Using a 2D multibreath-hold susceptibility-weighted imaging to visualize intratumoral hemorrhage of hepatocellular carcinoma at 3T MRI:correlation with pathology. J Magn Reson Imaging, 2012, 36(4):900-906.
25.	Qin LX, Tang ZY. Recent progress in predictive biomarkers for metastatic recurrence of human hepatocellular carcinoma:a review of the literature. J Cancer Res Clin Oncol, 2004, 130(9):497-513.
26.	Ribatti D, Vacca A, Nico B, et al. Angiogenesis and anti-angiogenesis in hepatocellular carcinoma. Cancer Treat Rev, 2006, 32(6):437-444.

1. Bosch FX, Ribes J, Díaz M, et al. Primary liver cancer:worldwide incidence and trends. Gastroenterology, 2004, 127(5 Suppl 1):S5-S16.
2. Bosetti C, Turati F, La Vecchia C. Hepatocellular carcinoma epidemiology. Best Pract Res Clin Gastroenterol, 2014, 28(5):753-770.
3. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin, 2005, 55(2):74-108.
4. Trojan J, Zangos S, Schnitzbauer AA. Diagnostics and treatment of hepatocellular carcinoma in 2016. Standards and developments. Visc Med, 2016, 32(2):116-120.
5. Lauwers GY, Terris B, Balis UJ, et al. Prognostic histologic indicators of curatively resected hepatocellular carcinomas:a multi-institutional analysis of 425 patients with definition of a histologic prognostic index. Am J Surg Pathol, 2002, 26(1):25-34.
6. Radbruch A, Bendszus M. Advanced MR imaging in neuro-oncology. Clin Neuroradiol, 2015, 25 Suppl 2:143-149.
7. Haacke EM, Ye Y. The role of susceptibility weighted imaging in functional MRI. Neuroimage, 2012, 62(2):923-929.
8. Lee JH, Park MJ, Kim JK, et al. Assessment of angiogenesis of hepatocellular carcinoma using dynamic contrast enhanced MR and histopathologic correlation in an experimental rat model. Hepatogastroenterology, 2014, 61(130):447-452.
9. Jeng KS, Sheen IS, Jeng WJ. Azidothymidine treatment of hepatocellular carcinoma in rats:an in vivo study of telomerase inhibition. Hepatogastroenterology, 2011, 58(112):2091-2096.
10. Jo W, Yu ES, Chang M, et al. Metformin inhibits early stage diethylnitrosamine-induced hepatocarcinogenesis in rats. Mol Med Rep, 2016, 13(1):146-152.
11. 許紹奇, 邢偉, 陳杰, 等.磁敏感成像與腎透明細胞癌病理分級的相關性研究.磁共振成像, 2015, 6(9):669-672.
12. Zhou L, Rui JA, Ye DX, et al. Edmondson-steiner grading increases the predictive efficiency of TNM staging for long-term survival of patients with hepatocellular carcinoma after curative resection. World J Surg, 2008, 32(8):1748-1756.
13. Zhou L, Rui JA, Wang SB, et al. Factors predictive for long-term survival of male patients with hepatocellular carcinoma after curative resection. J Surg Oncol, 2007, 95(4):298-303.
14. Park MJ, Kim HS, Jahng GH, et al. Semiquantitative assessment of intratumoral susceptibility signals using non-contrast-enhanced high-field high-resolution susceptibility-weighted imaging in patients with gliomas:comparison with MR perfusion imaging. AJNR Am J Neuroradiol, 2009, 30(7):1402-1408.
15. Hori M, Mori H, Aoki S, et al. Three-dimensional susceptibility-weighted imaging at 3 T using various image analysis methods in the estimation of grading intracranial gliomas. Magn Reson Imaging, 2010, 28(4):594-598.
16. Pascual S, Herrera I, Irurzun J. New advances in hepatocellular carcinoma. World J Hepatol, 2016, 8(9):421-438.
17. Bhardwaj N, Perera MT, Silva MA. Current treatment approaches to HCC with a special consideration to transplantation. J Transplant, 2016, 2016:7926264.
18. Lee JM, Yoon JH, Joo I, et al. Recent advances in CT and MR imaging for evaluation of hepatocellular carcinoma. Liver Cancer, 2012, 1(1):22-40.
19. Bolog N, Andreisek G, Oancea I, et al. CT and MR imaging of hepatocellular carcinoma. J Gastrointestin Liver Dis, 2011, 20(2):181-189.
20. Chapel F, Guettier C, Chastang C, et al. Needle biopsy of hepatocellular carcinoma:assessment of prognostic contribution of histologic parameters including proliferating cell nuclear antigen labeling and correlations with clinical outcomes. Group d'Etude et de Traitement du Carcinoma Hépatocellulaire. Cancer, 1996, 77(5):864-871.
21. Reichenbach JR, Venkatesan R, Schillinger DJ, et al. Small vessels in the human brain:MR venography with deoxyhemoglobin as an intrinsic contrast agent. Radiology, 1997, 204(1):272-277.
22. Chen W, Delproposto Z, Liu W, et al. Susceptibility-weighted imaging for the noncontrast evaluation of hepatocellular carcinoma:a prospective study with histopathologic correlation. PLoS One, 2014, 9(5):e98303.
23. Dai Y, Zeng M, Li R, et al. Improving detection of siderotic nodules in cirrhotic liver with a multi-breath-hold susceptibility-weighted imaging technique. J Magn Reson Imaging, 2011, 34(2):318-325.
24. Li RK, Zeng MS, Rao SX, et al. Using a 2D multibreath-hold susceptibility-weighted imaging to visualize intratumoral hemorrhage of hepatocellular carcinoma at 3T MRI:correlation with pathology. J Magn Reson Imaging, 2012, 36(4):900-906.
25. Qin LX, Tang ZY. Recent progress in predictive biomarkers for metastatic recurrence of human hepatocellular carcinoma:a review of the literature. J Cancer Res Clin Oncol, 2004, 130(9):497-513.
26. Ribatti D, Vacca A, Nico B, et al. Angiogenesis and anti-angiogenesis in hepatocellular carcinoma. Cancer Treat Rev, 2006, 32(6):437-444.

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The Value of Susceptibility Weighted Imaging in Determining Pathologic Grade of Hepatocellular Carcinoma in Rat Model

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