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Prognostic role of magnetic resonance imaging vs. computed tomography for hepatocellular carcinoma undergoing chemoembolization

Authors
 Beom Kyung Kim  ;  Kyung Ah Kim  ;  Chansik An  ;  Eun Jin Yoo  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang-Hyub Han  ;  Seung Up Kim  ;  Myeong-Jin Kim 
Citation
 LIVER INTERNATIONAL, Vol.35(6) : 1722-1730, 2015 
Journal Title
LIVER INTERNATIONAL
ISSN
 1478-3223 
Issue Date
2015
MeSH
Aged ; Biomarkers* ; Carcinoma, Hepatocellular/diagnosis* ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/therapy ; Chemoembolization, Therapeutic ; Contrast Media ; Female ; Humans ; Liver Neoplasms/diagnosis* ; Liver Neoplasms/pathology ; Liver Neoplasms/therapy ; Magnetic Resonance Imaging* ; Male ; Middle Aged ; Prognosis ; Tomography, X-Ray Computed* ; Treatment Outcome
Keywords
chemoembolization ; computed tomography ; hepatocellular carcinoma ; magnetic resonance imaging ; prognosi
Abstract
BACKGROUND & AIMS: Computed tomography (CT) and magnetic resonance imaging (MRI) play important roles in diagnosis and staging of hepatocellular carcinoma (HCC). However, prognostic roles of radiological characteristics are not yet determined.

METHODS: Eighty-eight patients treated with chemoembolization were analysed. Radiological parameters at baseline were assessed in all patients using both dynamic CT and MRI. Treatment responses were assessed using modified RECIST 4 weeks after the first chemoembolization.

RESULTS: Gross vascular invasion (GVI), bile duct invasion, irregular tumour margin (ITM), peripheral ragged enhancement (PRE) and satellite nodules on CT or MRI were associated with non-response (stable disease or progression) after chemoembolization respectively (all P ≤ 0.05). GVI, ITM and PRE on CT or MRI were also independently associated with poor overall survival (OS) respectively (all P ≤ 0.05). Using these results, a prognostic scoring system for CT and MRI were developed; 0, absence of all three features (GVI, ITM and PRE); 1, presence of one feature; 2, presence of two features; and 3, presence of three features. After adjusting tumour size, tumour number and alpha-foetoprotein level, both CT and MRI scores were independently associated with OS (both P < 0.001). Patients with CT or MRI score ≥2 had a worse OS than those with score <2 (adjusted hazard ratios, 3.837 and 2.938 respectively). MRI-specific parameters such as signal intensity on T2- or T1-weighted images, fat signal or hyperintensity on diffusion-weighted images did not have prognostic value (all P > 0.05).

CONCLUSIONS: Radiological parameters by CT and MRI may be useful in biological characterization of tumours and prognostification for HCC treated with chemoembolization.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/liv.12751/abstract
DOI
10.1111/liv.12751
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
An, Chansik(안찬식) ORCID logo https://orcid.org/0000-0002-0484-6658
Yoo, Eun Jin(유은진)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140394
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