Hepatobiliary MR contrast agent uptake as a predictive biomarker of aggressive features on pathology and reduced recurrence-free survival in resectable hepatocellular carcinoma: comparison with dual-tracer 18F-FDG and 18F-FCH PET/CT

Autor: Julia Chalaye, Alain Luciani, Arthur Tenenhaus, Rym Kharrat, Alexis Laurent, Vania Tacher, Julien Calderaro, Giuliana Amaddeo, F. Legou, Hicham Kobeiter, Emmanuel Itti, Hélène Regnault, Sébastien Mulé, Athena Galletto Pregliasco
Přispěvatelé: Service de radiothérapie [Reims], Institut du cancer Courlancy-Reims, CHU Henri Mondor, Laboratoire des signaux et systèmes (L2S), CentraleSupélec-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Ospedali Galliera, Danmarks Tekniske Universitet = Technical University of Denmark (DTU), Service d'hépato-gastro-entérologie [APHP Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Technical University of Denmark [Lyngby] (DTU)
Rok vydání: 2020
Předmět:
Adult
Male
Pathology
medicine.medical_specialty
Fluorine Radioisotopes
Carcinoma
Hepatocellular
Contrast Media
Disease-Free Survival
030218 nuclear medicine & medical imaging
Choline
03 medical and health sciences
0302 clinical medicine
Meglumine
Resectable Hepatocellular Carcinoma
[STAT.ML]Statistics [stat]/Machine Learning [stat.ML]
[MATH.MATH-ST]Mathematics [math]/Statistics [math.ST]
Fluorodeoxyglucose F18
Recurrence
Positron Emission Tomography Computed Tomography
medicine
Organometallic Compounds
Humans
Radiology
Nuclear Medicine and imaging
ComputingMilieux_MISCELLANEOUS
Neuroradiology
Aged
Neoplasm Staging
Retrospective Studies
Aged
80 and over
PET-CT
[STAT.AP]Statistics [stat]/Applications [stat.AP]
medicine.diagnostic_test
Receiver operating characteristic
Proportional hazards model
business.industry
Liver Neoplasms
Magnetic resonance imaging
Interventional radiology
General Medicine
Middle Aged
medicine.disease
Magnetic Resonance Imaging
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Female
Radiology
Radiopharmaceuticals
business
[STAT.ME]Statistics [stat]/Methodology [stat.ME]
Zdroj: European Radiology
European Radiology, Springer Verlag, 2020, 30 (10), pp.5348-5357. ⟨10.1007/s00330-020-06923-5⟩
ISSN: 1432-1084
0938-7994
DOI: 10.1007/s00330-020-06923-5⟩
Popis: To compare the performance of the quantitative analysis of the hepatobiliary phase (HBP) tumor enhancement in gadobenate dimeglumine (Gd-BOPTA)–enhanced MRI and of dual-tracer 18F-FDG and 18F-fluorocholine (FCH) PET/CT for the prediction of tumor aggressiveness and recurrence-free survival (RFS) in resectable hepatocellular carcinoma (HCC). This retrospective, IRB approved study included 32 patients with 35 surgically proven HCCs. All patients underwent Gd-BOPTA-enhanced MRI including delayed HBP images, 18F-FDG PET/CT, and (for 29/32 patients) 18F-FCH PET/CT during the 2 months prior to surgery. For each lesion, the lesion-to-liver contrast enhancement ratio (LLCER) on MRI HBP images and the SUVmax tumor-to-liver ratio (SUVT/L) for both tracers were calculated. Their predictive value for aggressive pathological features—including the histological grade and microvascular invasion (MVI)—and RFS were analyzed and compared using area under receiver operating characteristic (AUROC) curves and Cox regression models, respectively. The AUROCs for the identification of aggressive HCCs on pathology with LLCER, 18F-FDG SUVT/L, and 18F-FCH SUVT/L were 0.92 (95% CI 0.78, 0.98), 0.89 (95% CI 0.74, 0.97; p = 0.70), and 0.64 (95% CI 0.45, 0.80; p = 0.035). At multivariate Cox regression analysis, LLCER was identified as an independent predictor of RFS (HR (95% CI) = 0.91 (0.84, 0.99), p = 0.022). LLCER − 4.72% or less also accurately predicted moderate-poor differentiation grade (Se = 100%, Sp = 92.9%) and MVI (Se = 93.3%, Sp = 60%) and identified patients with poor RFS after surgical resection (p = 0.030). HBP tumor enhancement after Gd-BOPTA injection may help identify aggressive HCC pathological features, and patients with reduced recurrence-free survival after surgical resection. • In patients with resectable HCC, the quantitative analysis of the HBP tumor enhancement in Gd-BOPTA-enhanced MRI (LLCER) accurately identifies moderately-poorly differentiated and/or MVI-positive HCCs. • After surgical resection for HCC, patients with LLCER − 4.72% or less had significantly poorer recurrence-free survival than patients with LLCER superior to − 4.72%. • Gd-BOPTA-enhanced MRI with delayed HBP images may be suggested as part of pre-surgery workup in patients with resectable HCC.
Databáze: OpenAIRE
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