nach oben

17.05.2024 | Hepatobiliary

Multiparametric MRI manifestations of the spontaneous intratumoral coagulative necrosis in HCC

verfasst von: Liping Zuo, Mingyuan Hou, Jinlei Fan, Fangxuan Li, Bowen Wang, Qian Zhao, Yanmin Yang, Deixin Yu

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To investigate the MRI manifestations of the spontaneous intratumoral coagulative necrosis (iCN) in patients with hepatocellular carcinoma (HCC) and its value in predicting the postoperative early recurrence (≤ 2 years).

Methods

Patients with HCC who underwent preoperative multiparametric MRI between January 2015 and February 2019 were enrolled in this retrospective study. The MRI manifestations of iCNs on TIWI, T2WI, and ADC were recorded. The sensitivity and specificity of MRI for the detection of iCNs were also evaluated. A multivariable Cox proportional hazards model and the Kaplan–Meier method were used to verify the value of histologically-confirmed and MRI-identified iCNs, respectively, in predicting early recurrence.

Results

A total of 163 patients (median age, 56 years; interquartile range, 49–64 years; 139 men) with HCCs were evaluated, of whom 27(16.6%) had histologically-confirmed iCNs. MRI identified 92.6% (25 of 27; 95% confidence interval [CI] 74.2%, 98.7%) of iCNs (sensitivity), with a specificity of 79.4% (78 of 136; 95% CI 71.4%, 85.7%), based on non-enhancement on post-contrast MRI. And the MRI-identified iCNs were characterized by a similar appearance to surrounding tumour tissue shown on pre-contrast MRI but not enhanced on post-contrast MRI. The multivariable Cox proportional hazards model revealed that only the presence of histologically-confirmed iCN was independently associated with early HCC recurrence (hazard ratio = 2.73; 95% CI 1.20, 6.21; P = 0.017). The Kaplan–Meier curve showed that the presence of MRI-identified iCN was also associated with early recurrence (P < 0.001).

Conclusion

Multiparametric MRI identified iCNs with high sensitivity and modest specificity. The presence of iCNs is associated with early HCC recurrence.

Graphical Abstract

Lee S, Kim SH, Hwang JA, Lee JE, Ha SY. Pre-operative ADC predicts early recurrence of HCC after curative resection. Eur Radiol. 2019;29(2):1003-12. https://doi.org/https://doi.org/10.1007/s00330-018-5642-5CrossRefPubMed

Marasco G, Colecchia A, Colli A, Ravaioli F, Casazza G, Bacchi Reggiani ML, et al. Role of liver and spleen stiffness in predicting the recurrence of hepatocellular carcinoma after resection. Journal of hepatology. 2019;70(3):440-8. https://doi.org/https://doi.org/10.1016/j.jhep.2018.10.022CrossRefPubMed

Wei T, Zhang XF, Bagante F, Ratti F, Marques HP, Silva S, et al. Early Versus Late Recurrence of Hepatocellular Carcinoma After Surgical Resection Based on Post-recurrence Survival: an International Multi-institutional Analysis. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 2021;25(1):125-33. https://doi.org/https://doi.org/10.1007/s11605-020-04553-2CrossRefPubMed

Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology (Baltimore, Md). 2018;67(1):358-80. https://doi.org/https://doi.org/10.1002/hep.29086CrossRefPubMed

Caruso R, Parisi A, Bonanno A, Paparo D, Quattrocchi E, Branca G, et al. Histologic coagulative tumour necrosis as a prognostic indicator of aggressiveness in renal, lung, thyroid and colorectal carcinomas: A brief review. Oncology letters. 2012;3(1):16-8. https://doi.org/https://doi.org/10.3892/ol.2011.420CrossRefPubMed

Atanasov G, Dietel C, Feldbrügge L, Benzing C, Krenzien F, Brandl A, et al. Tumor necrosis and infiltrating macrophages predict survival after curative resection for cholangiocarcinoma. Oncoimmunology. 2017;6(8):e1331806. https://doi.org/https://doi.org/10.1080/2162402X.2017.1331806CrossRefPubMedPubMedCentral

Richards CH, Mohammed Z, Qayyum T, Horgan PG, McMillan DC. The prognostic value of histological tumor necrosis in solid organ malignant disease: a systematic review. Future oncology (London, England). 2011;7(10):1223-35. https://doi.org/https://doi.org/10.2217/fon.11.99CrossRefPubMed

Wei T, Zhang XF, Bagante F, Ratti F, Marques HP, Silva S, et al. Tumor Necrosis Impacts Prognosis of Patients Undergoing Curative-Intent Hepatocellular Carcinoma. Annals of surgical oncology. 2021;28(2):797-805. https://doi.org/https://doi.org/10.1245/s10434-020-09390-wCrossRefPubMed

Chen J, Xia C, Duan T, Cao L, Jiang H, Liu X, et al. Macrotrabecular-massive hepatocellular carcinoma: imaging identification and prediction based on gadoxetic acid-enhanced magnetic resonance imaging. Eur Radiol. 2021;31(10):7696-704. https://doi.org/https://doi.org/10.1007/s00330-021-07898-7CrossRefPubMed

10.

Mulé S, Galletto Pregliasco A, Tenenhaus A, Kharrat R, Amaddeo G, Baranes L, et al. Multiphase Liver MRI for Identifying the Macrotrabecular-Massive Subtype of Hepatocellular Carcinoma. Radiology. 2020;295(3):562-71. https://doi.org/https://doi.org/10.1148/radiol.2020192230CrossRefPubMed

11.

Nguyen HS, Milbach N, Hurrell SL, Cochran E, Connelly J, Bovi JA, et al. Progressing Bevacizumab-Induced Diffusion Restriction Is Associated with Coagulative Necrosis Surrounded by Viable Tumor and Decreased Overall Survival in Patients with Recurrent Glioblastoma. AJNR American journal of neuroradiology. 2016;37(12):2201-8. https://doi.org/https://doi.org/10.3174/ajnr.A4898CrossRefPubMedPubMedCentral

12.

D'Onofrio M, Cardobi N, Ruzzenente A, Conci S, Ciaravino V, Guglielmi A, et al. Unenhanced magnetic resonance imaging immediately after radiofrequency ablation of liver malignancy: preliminary results. Abdominal radiology (New York). 2018;43(6):1379-85. https://doi.org/https://doi.org/10.1007/s00261-017-1299-9CrossRefPubMed

13.

Li S, Shi S, Li A, Liu H, Cai L. Diffusion-Weighted Magnetic Resonance Imaging in Assessment of Primary Liver Cancer after HIFU Treatment. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 2019;29(4):305–8. https://doi.org/10.29271/jcpsp.2019.04.305

14.

Wang Z, Gao L, Wang W, Guo X, Feng C, Lian W, et al. Coagulative necrotic pituitary adenoma apoplexy: A retrospective study of 21 cases from a large pituitary center in China. Pituitary. 2019;22(1):13-28. https://doi.org/https://doi.org/10.1007/s11102-018-0922-2CrossRefPubMed

15.

Nakai G, Yamada T, Hamada T, Atsukawa N, Tanaka Y, Yamamoto K, et al. Pathological findings of uterine tumors preoperatively diagnosed as red degeneration of leiomyoma by MRI. Abdominal radiology (New York). 2017;42(7):1825-31. https://doi.org/https://doi.org/10.1007/s00261-017-1126-3CrossRefPubMedPubMedCentral

16.

Sengupta S, Lohse CM, Leibovich BC, Frank I, Thompson RH, Webster WS, et al. Histologic coagulative tumor necrosis as a prognostic indicator of renal cell carcinoma aggressiveness. Cancer. 2005;104(3):511-20. https://doi.org/https://doi.org/10.1002/cncr.21206CrossRefPubMed

17.

Yee PP, Wei Y, Kim SY, Lu T, Chih SY, Lawson C, et al. Neutrophil-induced ferroptosis promotes tumor necrosis in glioblastoma progression. Nature communications. 2020;11(1):5424. https://doi.org/https://doi.org/10.1038/s41467-020-19193-yCrossRefPubMedPubMedCentral

18.

Cong WM, Bu H, Chen J, Dong H, Zhu YY, Feng LH, et al. Practice guidelines for the pathological diagnosis of primary liver cancer: 2015 update. World journal of gastroenterology. 2016;22(42):9279-87. https://doi.org/https://doi.org/10.3748/wjg.v22.i42.9279CrossRefPubMedPubMedCentral

19.

Du M, Chen L, Zhao J, Tian F, Zeng H, Tan Y, et al. Microvascular invasion (MVI) is a poorer prognostic predictor for small hepatocellular carcinoma. BMC cancer. 2014;14:38. https://doi.org/https://doi.org/10.1186/1471-2407-14-38CrossRefPubMedPubMedCentral

20.

Najmi Varzaneh F, Pandey A, Aliyari Ghasabeh M, Shao N, Khoshpouri P, Pandey P, et al. Prediction of post-TACE necrosis of hepatocellular carcinoma usingvolumetric enhancement on MRI and volumetric oil deposition on CT, with pathological correlation. Eur Radiol. 2018;28(7):3032-40. https://doi.org/https://doi.org/10.1007/s00330-017-5198-9CrossRefPubMed

21.

Chernyak V, Fowler KJ, Kamaya A, Kielar AZ, Elsayes KM, Bashir MR, et al. Liver Imaging Reporting and Data System (LI-RADS) Version 2018: Imaging of Hepatocellular Carcinoma in At-Risk Patients. Radiology. 2018;289(3):816-30. https://doi.org/https://doi.org/10.1148/radiol.2018181494CrossRefPubMed

22.

Wei Y, Pei W, Qin Y, Su D, Liao H. Preoperative MR imaging for predicting early recurrence of solitary hepatocellular carcinoma without microvascular invasion. European journal of radiology. 2021;138:109663. https://doi.org/https://doi.org/10.1016/j.ejrad.2021.109663CrossRefPubMed

23.

Wang LX, Liu K, Lin GW, Zhai RY. Solitary Necrotic Nodules of the Liver: Histology and Diagnosis With CT and MRI. Hepatitis monthly. 2012;12(8):e6212. https://doi.org/https://doi.org/10.5812/hepatmon.6212CrossRefPubMedPubMedCentral

24.

Barnes JE. Characteristics and control of contrast in CT. Radiographics : a review publication of the Radiological Society of North America, Inc. 1992;12(4):825–37. https://doi.org/10.1148/radiographics.12.4.1636042

25.

Goshima S, Kanematsu M, Kondo H, Watanabe H, Kawada H, Moriyama N, et al. Evaluation of optimal scan delay for gadoxetate disodium-enhanced hepatic arterial phase MRI using MR fluoroscopic triggering and slow injection technique. AJR American journal of roentgenology. 2013;201(3):578-82. https://doi.org/https://doi.org/10.2214/AJR.12.10034CrossRefPubMed

26.

Sabo E, Boltenko A, Sova Y, Stein A, Kleinhaus S, Resnick MB. Microscopic analysis and significance of vascular architectural complexity in renal cell carcinoma. Clinical cancer research : an official journal of the American Association for Cancer Research. 2001;7(3):533-7.PubMed

27.

Jain RK. Antiangiogenesis strategies revisited: from starving tumors to alleviating hypoxia. Cancer cell. 2014;26(5):605-22. https://doi.org/https://doi.org/10.1016/j.ccell.2014.10.006CrossRefPubMedPubMedCentral

Titel: Multiparametric MRI manifestations of the spontaneous intratumoral coagulative necrosis in HCC
verfasst von: Liping Zuo
Mingyuan Hou
Jinlei Fan
Fangxuan Li
Bowen Wang
Qian Zhao
Yanmin Yang
Deixin Yu
Publikationsdatum: 17.05.2024
Verlag: Springer US
Erschienen in: Abdominal Radiology
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-024-04355-z

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Multiparametric MRI manifestations of the spontaneous intratumoral coagulative necrosis in HCC

Abstract

Purpose

Methods

Results

Conclusion

Graphical Abstract

Neu im Fachgebiet Radiologie

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Klinikreform soll zehntausende Menschenleben retten

Darf man die Behandlung eines Neonazis ablehnen?

Update Radiologie

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Graphical Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Neu im Fachgebiet Radiologie

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Klinikreform soll zehntausende Menschenleben retten

Darf man die Behandlung eines Neonazis ablehnen?

Update Radiologie