Value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging in gross morphological classification of hepatocellular carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SHENG Siman ¹ ,  CHEN Chuang ¹ , CHEN Xiaoyu ² , LIU Hongyang ² , ZHU Lun ³ , LI Hong ³ , DING Zhilong ¹ , XU Zhen ¹ , WANG Zheng ¹ , PAN Zhi ¹

1. Department of Hepatobiliary Surgery, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu 223002, P. R. China;
2. Department of Radiology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu 223002, P. R. China;
3. Department of Pathology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu 223002, P. R. China;

Corresponding?author：

CHEN Chuang, Email: chuang1030@126.com

Keywords：

hepatocellular carcinoma; gross morphological classification; gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid; magnetic resonance imaging

DOI：

10.7507/1007-9424.202303064

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Objective To investigate the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging (Gd-EOB-DTPA-MRI) in gross morphological classification of hepatocellular carcinoma (HCC). Methods The clinicopathologic data of patients with HCC who received surgical treatment in the Affiliated Huai’an Hospital of Xuzhou Medical University from January 2017 to December 2022 were retrospectively gathered. The Gd-EOB-DTPA-MRI was performed before operation. Two radiologists independently assessed the gross morphological classification of HCC according to the imaging performance. The tumors were cut into sections in a coronal plane and were taken pictures for recording pathological features after operation. The tumors were assigned into 4 types according to the references and clinical experiences: single nodular type (SN), single nodular with extranodular growth type (SN-EG), confluent multi-nodular type (CMN), and infiltration type (IF). Matching degree of morphological classification was analyzed between by the Gd-EOB-DTPA-MRI and resected specimen. The pathological features of 4 types of HCC were also analyzed. Results A total of 87 patients with HCC were included. The gross morphological classification by the Gd-EOB-DTPA-MRI was 28 (32.2%) patients with SN, 28 (32.2%) patients with SN-EG, 21 (24.1%) patients with CMN, 10 (11.5%) patients with IF, which by the resected specimen was 33 (37.9%) patients with SN, 24 (27.6%) patients with SN-EG, 21 (24.1%) patients with CMN, and 9 (10.4%) patients with IF in the 87 patients with HCC. The Kappa’s coefficient of agreement between the results of Gd-EOB-DTPA-MRI and postoperative resection specimens was 0.776 (P=0.199). There were statistical differences in the tumor diameter and microvascular invasion (MVI) among the 4 types of gross morphology classification (F=2.937, P=0.038; χ²=16.852, P=0.001), the MVI rate was highest and tumor diameter was biggest in the patients with IF among the 4 types of gross morphology classification (P<0.05). Conclusions From the results of this study, the gross morphological classification of HCC is closely related to the tumor diameter and MVI. Results of Gd-EOB-DTPA-MRI and postoperative resection specimens in assessing the gross morphological classification are good agreement. Therefore, an accurate preoperative planning and better therapy strategy for the patients with HCC can be provided according to gross morphological classification by preoperative Gd-EOB-DTPA-MRI.

Citation： SHENG Siman, CHEN Chuang, CHEN Xiaoyu, LIU Hongyang, ZHU Lun, LI Hong, DING Zhilong, XU Zhen, WANG Zheng, PAN Zhi. Value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging in gross morphological classification of hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(7): 814-819. doi: 10.7507/1007-9424.202303064 Copy

1.	Gilles H, Garbutt T, Landrum J. Hepatocellular carcinoma. Crit Care Nurs Clin North Am, 2022, 34(3): 289-301.
2.	McGlynn KA, Petrick JL, El-Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology, 2021, 73 Suppl 1(Suppl 1): 4-13.
3.	Venook AP, Papandreou C, Furuse J, et al. The incidence and epidemiology of hepatocellular carcinoma: a global and regional perspective. Oncologist, 2010, 15 Suppl 4: 5-13.
4.	Kwon SK, Yun SS, Kim HJ, et al. The risk factors of early recurrence after hepatectomy in hepatocellular carcinoma. Ann Surg Treat Res, 2014, 86(6): 283-288.
5.	Shirabe K, Aishima S, Taketomi A, et al. Prognostic importance of the gross classification of hepatocellular carcinoma in living donor-related liver transplantation. Br J Surg, 2011, 98(2): 261-267.
6.	Lee Y, Park H, Lee H, et al. The clinicopathological and prognostic significance of the gross classification of hepatocellular carcinoma. J Pathol Transl Med, 2018, 52(2): 85-92.
7.	Liao H, Xiong T, Peng J, et al. Classification and prognosis prediction from histopathological images of hepatocellular carcinoma by a fully automated pipeline based on machine learning. Ann Surg Oncol, 2020, 27(7): 2359-2369.
8.	周斌, 徐光, 戴社教, 等. 原發性肝癌介入治療后療效影響因素的分析. 實用放射學雜志, 2007, 23(2): 220-222.
9.	陳柯, 田云鴻, 劉小紅. 預測肝癌術后早期與晚期的復發因素研究. 西部醫學, 2015, 27(7): 1008-1010.
10.	江柳, 唐光健. 肝膽特異性磁共振對比劑Gd-EOB-DTPA的臨床研究進展. 國際醫學放射學雜志, 2011, 34(6): 564-568.
11.	He J, Shi J, Fu X, et al. The clinicopathologic and prognostic significance of gross classification on solitary hepatocellular carcinoma after hepatectomy. Medicine (Baltimore), 2015, 94(32): e1331. doi: 10.1097/MD.0000000000001331.
12.	Kanai T, Hirohashi S, Upton MP, et al. Pathology of small hepatocellular carcinoma. A proposal for a new gross classification. Cancer, 1987, 60(4): 810-819.
13.	Kudo M, Kitano M, Sakurai T, et al. General rules for the clinical and pathological study of primary liver cancer, nationwide follow-up survey and clinical practice guidelines: the outstanding achievements of the Liver Cancer Study Group of Japan. Dig Dis, 2015, 33(6): 765-770.
14.	Ichikawa T, Saito K, Yoshioka N, et al. Detection and characterization of focal liver lesions: a Japanese phase Ⅲ, multicenter comparison between gadoxetic acid disodium-enhanced magnetic resonance imaging and contrast-enhanced computed tomography predominantly in patients with hepatocellular carcinoma and chronic liver disease. Invest Radiol, 2010, 45(3): 133-141.
15.	于長江, 朱紹成. 磁共振影像生物標志物預測肝細胞癌術后復發風險的研究進展. 磁共振成像, 2022, 13(5): 154-157.
16.	李小慶, 周智鵬, 何松青, 等. 磁共振成像對比劑Gd-EOB-DTPA動態增強對肝臟局灶性病變的臨床價值. 中華肝膽外科雜志, 2013, 19(11): 815-820.
17.	羅琳, 單鴻, 王勁. 釓塞酸二鈉在肝硬化性結節及小肝癌評估中的應用進展. 中華肝膽外科雜志, 2013, 19(12): 955-960.
18.	Murakami T, Sofue K, Hori M. Diagnosis of hepatocellular carcinoma using Gd-EOB-DTPA MR imaging. Magn Reson Med Sci, 2022, 21(1): 168-181.
19.	Wang WT, Zhu S, Ding Y, et al. T1 mapping on gadoxetic acid-enhanced MR imaging predicts recurrence of hepatocellular carcinoma after hepatectomy. Eur J Radiol, 2018, 103: 25-31.
20.	Kudo M. Early hepatocellular carcinoma: definition and diagnosis. Liver Cancer, 2013, 2(2): 69-72.
21.	Kitao A, Zen Y, Matsui O, et al. Hepatocellular carcinoma: signal intensity at gadoxetic acid-enhanced MR imaging—correlation with molecular transporters and histopathologic features. Radiology, 2010, 256(3): 817-826.
22.	Chong YS, Kim YK, Lee MW, et al. Differentiating mass-forming intrahepatic cholangiocarcinoma from atypical hepatocellular carcinoma using gadoxetic acid-enhanced MRI. Clin Radiol, 2012, 67(8): 766-773.
23.	李晨霞, 劉海甜, 李香, 等. 釓塞酸二鈉增強MRI在評估肝功能中的參數選擇研究. 中華實用診斷與治療雜志, 2019, 33(12): 1212-1216.
24.	劉桂勤, 沈加林. 肝硬化影像學診斷新進展. 中華實用診斷與治療雜志, 2014, 28(2): 112-114.
25.	饒圣祥, 曾蒙蘇. 肝特異性對比劑Gd-EOB-DTPA增強磁共振成像評價肝功能的研究進展. 世界華人消化雜志, 2016, 24(28): 3940-3945.
26.	Ueno S, Kubo F, Sakoda M, et al. Efficacy of anatomic resection vs nonanatomic resection for small nodular hepatocellular carcinoma based on gross classification. J Hepatobiliary Pancreat Surg, 2008, 15(5): 493-500.
27.	鄭麗榮, 沈俊頤, 陳衛霞, 等. CT增強掃描預測肝細胞癌微血管侵犯、根治性切除術后早期復發. 中國普外基礎與臨床雜志, 2016, 23(11): 1400-1406.
28.	伏旭, 何健, 史炯, 等. 肝細胞癌大體形態分型的臨床意義. 中華消化外科雜志, 2015, 14(2): 120-126.

1. Gilles H, Garbutt T, Landrum J. Hepatocellular carcinoma. Crit Care Nurs Clin North Am, 2022, 34(3): 289-301.
2. McGlynn KA, Petrick JL, El-Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology, 2021, 73 Suppl 1(Suppl 1): 4-13.
3. Venook AP, Papandreou C, Furuse J, et al. The incidence and epidemiology of hepatocellular carcinoma: a global and regional perspective. Oncologist, 2010, 15 Suppl 4: 5-13.
4. Kwon SK, Yun SS, Kim HJ, et al. The risk factors of early recurrence after hepatectomy in hepatocellular carcinoma. Ann Surg Treat Res, 2014, 86(6): 283-288.
5. Shirabe K, Aishima S, Taketomi A, et al. Prognostic importance of the gross classification of hepatocellular carcinoma in living donor-related liver transplantation. Br J Surg, 2011, 98(2): 261-267.
6. Lee Y, Park H, Lee H, et al. The clinicopathological and prognostic significance of the gross classification of hepatocellular carcinoma. J Pathol Transl Med, 2018, 52(2): 85-92.
7. Liao H, Xiong T, Peng J, et al. Classification and prognosis prediction from histopathological images of hepatocellular carcinoma by a fully automated pipeline based on machine learning. Ann Surg Oncol, 2020, 27(7): 2359-2369.
8. 周斌, 徐光, 戴社教, 等. 原發性肝癌介入治療后療效影響因素的分析. 實用放射學雜志, 2007, 23(2): 220-222.
9. 陳柯, 田云鴻, 劉小紅. 預測肝癌術后早期與晚期的復發因素研究. 西部醫學, 2015, 27(7): 1008-1010.
10. 江柳, 唐光健. 肝膽特異性磁共振對比劑Gd-EOB-DTPA的臨床研究進展. 國際醫學放射學雜志, 2011, 34(6): 564-568.
11. He J, Shi J, Fu X, et al. The clinicopathologic and prognostic significance of gross classification on solitary hepatocellular carcinoma after hepatectomy. Medicine (Baltimore), 2015, 94(32): e1331. doi: 10.1097/MD.0000000000001331.
12. Kanai T, Hirohashi S, Upton MP, et al. Pathology of small hepatocellular carcinoma. A proposal for a new gross classification. Cancer, 1987, 60(4): 810-819.
13. Kudo M, Kitano M, Sakurai T, et al. General rules for the clinical and pathological study of primary liver cancer, nationwide follow-up survey and clinical practice guidelines: the outstanding achievements of the Liver Cancer Study Group of Japan. Dig Dis, 2015, 33(6): 765-770.
14. Ichikawa T, Saito K, Yoshioka N, et al. Detection and characterization of focal liver lesions: a Japanese phase Ⅲ, multicenter comparison between gadoxetic acid disodium-enhanced magnetic resonance imaging and contrast-enhanced computed tomography predominantly in patients with hepatocellular carcinoma and chronic liver disease. Invest Radiol, 2010, 45(3): 133-141.
15. 于長江, 朱紹成. 磁共振影像生物標志物預測肝細胞癌術后復發風險的研究進展. 磁共振成像, 2022, 13(5): 154-157.
16. 李小慶, 周智鵬, 何松青, 等. 磁共振成像對比劑Gd-EOB-DTPA動態增強對肝臟局灶性病變的臨床價值. 中華肝膽外科雜志, 2013, 19(11): 815-820.
17. 羅琳, 單鴻, 王勁. 釓塞酸二鈉在肝硬化性結節及小肝癌評估中的應用進展. 中華肝膽外科雜志, 2013, 19(12): 955-960.
18. Murakami T, Sofue K, Hori M. Diagnosis of hepatocellular carcinoma using Gd-EOB-DTPA MR imaging. Magn Reson Med Sci, 2022, 21(1): 168-181.
19. Wang WT, Zhu S, Ding Y, et al. T1 mapping on gadoxetic acid-enhanced MR imaging predicts recurrence of hepatocellular carcinoma after hepatectomy. Eur J Radiol, 2018, 103: 25-31.
20. Kudo M. Early hepatocellular carcinoma: definition and diagnosis. Liver Cancer, 2013, 2(2): 69-72.
21. Kitao A, Zen Y, Matsui O, et al. Hepatocellular carcinoma: signal intensity at gadoxetic acid-enhanced MR imaging—correlation with molecular transporters and histopathologic features. Radiology, 2010, 256(3): 817-826.
22. Chong YS, Kim YK, Lee MW, et al. Differentiating mass-forming intrahepatic cholangiocarcinoma from atypical hepatocellular carcinoma using gadoxetic acid-enhanced MRI. Clin Radiol, 2012, 67(8): 766-773.
23. 李晨霞, 劉海甜, 李香, 等. 釓塞酸二鈉增強MRI在評估肝功能中的參數選擇研究. 中華實用診斷與治療雜志, 2019, 33(12): 1212-1216.
24. 劉桂勤, 沈加林. 肝硬化影像學診斷新進展. 中華實用診斷與治療雜志, 2014, 28(2): 112-114.
25. 饒圣祥, 曾蒙蘇. 肝特異性對比劑Gd-EOB-DTPA增強磁共振成像評價肝功能的研究進展. 世界華人消化雜志, 2016, 24(28): 3940-3945.
26. Ueno S, Kubo F, Sakoda M, et al. Efficacy of anatomic resection vs nonanatomic resection for small nodular hepatocellular carcinoma based on gross classification. J Hepatobiliary Pancreat Surg, 2008, 15(5): 493-500.
27. 鄭麗榮, 沈俊頤, 陳衛霞, 等. CT增強掃描預測肝細胞癌微血管侵犯、根治性切除術后早期復發. 中國普外基礎與臨床雜志, 2016, 23(11): 1400-1406.
28. 伏旭, 何健, 史炯, 等. 肝細胞癌大體形態分型的臨床意義. 中華消化外科雜志, 2015, 14(2): 120-126.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging in gross morphological classification of hepatocellular carcinoma

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