BACKGROUND: Excretion of gadolinium-ethoxybenzyl-diethyl- enetriamine pentaacetic acid (Gd-EOB-DTPA) in the bile may be related to liver function, because of elimination from the liver after preferential uptake by hep...BACKGROUND: Excretion of gadolinium-ethoxybenzyl-diethyl- enetriamine pentaacetic acid (Gd-EOB-DTPA) in the bile may be related to liver function, because of elimination from the liver after preferential uptake by hepatocytes. The purpose of this study was to investigate the relation between liver and biliary enhancement in patients with or without liver dysfunction, and to compare the tumor-to-liver contrast in these patients. METHODS: Forty patients [group 1: normal liver and Child Pugh class A in 20 patients, group 2: Child-Pugh class B in 18 patients and Child-Pugh C in 2] were evaluated. All patients underwent MR imaging of the liver using a 1.5-Tesla system. T1 weighted 3D images were obtained at 5, 10, 15 and 20 minutes after Gd-EOB-DTPA injection. The relation between group 3 (total bilirubin <1.8 mg/dL) and group 4 (total bilirubin ≥1.8 mg/dL) was investigated at 20 minutes. Liver and biliary signals were measured, and compared between groups 1 and 2 or groups 3 and 4. Tumor-to-liver ratio was also evaluated between groups 1 and 2. Scheffé’s post-hoc test after two-way repeated measures ANOVA and Pearson’s correlation test were used for statistical analysis. RESULTS: Liver enhancement showed significant difference at all time points between groups 1 and 2. Biliary enhancement did not show a significant difference between groups 1 and 2 at 5 minutes, but did at 10, 15 and 20 minutes. At 20 minutes significant differences between groups 3 and 4 were seen for liver and biliary enhancement. At all time points, liver enhancement correlated with biliary enhancement in both groups. At 5 minutes and 20 minutes, statistical differences between groups 1 and 2 were seen for tumor-to-liver ratio.CONCLUSIONS: The degree of biliary enhancement has a close correlation to that of liver enhancement. It is especially important that insufficient liver enhancement causes lower tumor-to-liver contrast in the hepatobiliary phase of Gd-EOB- DTPA.展开更多
Background:Prediction models for the histological grade of hepatocellular carcinoma(HCC)remain unsatisfactory.The purpose of this study is to develop preoperative models to predict histological grade of HCC based on g...Background:Prediction models for the histological grade of hepatocellular carcinoma(HCC)remain unsatisfactory.The purpose of this study is to develop preoperative models to predict histological grade of HCC based on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced magnetic resonance imaging(MRI)radiomics.And to compare the performance between artificial neural network(ANN)and logistic regression model.Methods:A total of 122 HCCs were randomly assigned to the training set(n=85)and the test set(n=37).There were 242 radiomic features extracted from volumetric of interest(VOI)of arterial and hepatobiliary phases images.The radiomic features and clinical parameters[gender,age,alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),alanine aminotransferase(ALT),aspartate transaminase(AST)]were selected by permutation test and decision tree.ANN of arterial phase(ANN-AP),logistic regression model of arterial phase(LR-AP),ANN of hepatobiliary phase(ANN-HBP),logistic regression mode of hepatobiliary phase(LR-HBP),ANN of combined arterial and hepatobiliary phases(ANN-AP+HBP),and logistic regression model of combined arterial and hepatobiliary phases(LR-AP+HBP)were built to predict HCC histological grade.Those prediction models were assessed and compared.Results:ANN-AP and LR-AP were composed by AST and radiomic features based on arterial phase.ANN-HBP and LR-HBP were composed by AFP and radiomic features based on hepatobiliary phase.ANN-AP+HBP and LR-AP+HBP were composed by AST and radiomic features based on arterial and hepatobiliary phases.The prediction models could distinguish between high-grade tumors[Edmondson-Steiner(E-S)grade III and IV]and low-grade tumors(E-S grade I and II)in both training set and test set.In the test set,the AUCs of ANN-AP,LR-AP,ANN-HBP,LR-HBP,ANN-AP+HBP and LR-AP+HBP were 0.889,0.777,0.941,0.819,0.944 and 0.792 respectively.The ANN-HBP was significantly superior to LR-HBP(P=0.001).And the ANN-AP+HBP was significantly superior to LR展开更多
AIM To optimize the hepatobiliary phase delay time(HBPDT) of Gd-EOB-DTPA-enhanced magnetic resonance imaging(GED-MRI) for more efficient identification of hepatocellular carcinoma(HCC) occurring in different degrees o...AIM To optimize the hepatobiliary phase delay time(HBPDT) of Gd-EOB-DTPA-enhanced magnetic resonance imaging(GED-MRI) for more efficient identification of hepatocellular carcinoma(HCC) occurring in different degrees of cirrhosis assessed by Child-Pugh(CP) score.METHODS The liver parenchyma signal intensity(LPSI), the liver parenchyma(LP)/HCC signal ratios, and the visibility of HCC at HBP-DT of 5, 10, 15, 20, and 25 min(i.e., DT-5, DT-10, DT-15, DT-20, and DT-25) after injection of GdEOB-DTPA were collected and analyzed in 73 patients with cirrhosis of different degrees of severity(including 42 patients suffering from HCC) and 18 healthy adult controls.RESULTS The LPSI increased with HBP-DT more significantly in the healthy group than in the cirrhosis group(F = 17.361, P < 0.001). The LP/HCC signal ratios had a significant difference(F = 12.453, P < 0.001) among various HBP-DT points, as well as between CP-A and CP-B/C subgroups(F = 9.761, P < 0.001). The constituent ratios of HCC foci identified as obvious hypointensity(+++), moderate hypointensity(++), and mild hypointensity or isointensity(+/-) kept stable from DT-10 to DT-25: 90.6%, 9.4%, and 0.0% in the CP-A subgroup; 50.0%, 50.0%, and 0.0% in the CP-B subgroup; and 0.0%, 0.0%, and 100.0% in the CP-C subgroup, respectively.CONCLUSION The severity of liver cirrhosis has significant negative influence on the HCC visualization by GED-MRI. DT-10 is more efficient and practical than other HBP-DT points to identify most of HCC foci emerging in CP-A cirrhosis, as well as in CP-B cirrhosis; but an HBP-DT of 15 min or longer seems more appropriate than DT-10 for visualization of HCC in patients with CP-C cirrhosis.展开更多
BACKGROUND Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma(HCC)has great significance for patient prognosis.AIM To explore the value of gadolinium ethoxybenzyl diethylenetriami...BACKGROUND Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma(HCC)has great significance for patient prognosis.AIM To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced magnetic resonance imaging(MRI)combined with clinical features in predicting early recurrence of HCC after resection.METHODS A total of 161 patients with pathologically confirmed HCC were enrolled.The patients were divided into early recurrence and non-early recurrence group based on the follow-up results.The clinical,laboratory,pathological results and Gd-EOB-DTPA enhanced MRI imaging features were analyzed.RESULTS Of 161 patients,73 had early recurrence and 88 were had non-early recurrence.Univariate analysis showed that patient age,gender,serum alpha-fetoprotein level,the Barcelona Clinic Liver Cancer stage,China liver cancer(CNLC)stage,microvascular invasion(MVI),pathological satellite focus,tumor size,tumor number,tumor boundary,tumor capsule,intratumoral necrosis,portal vein tumor thrombus,large vessel invasion,nonperipheral washout,peritumoral enhancement,hepatobiliary phase(HBP)/tumor signal intensity(SI)/peritumoral SI,HBP peritumoral low signal and peritumoral delay enhancement were significantly associated with early recurrence of HCC after operation.Multivariate logistic regression analysis showed that patient age,MVI,CNLC stage,tumor boundary and large vessel invasion were independent predictive factors.External data validation indicated that the area under the curve of the combined predictors was 0.861,suggesting that multivariate logistic regression was a reasonable predictive model for early recurrence of HCC.CONCLUSION Gd-EOB-DTPA enhanced MRI combined with clinical features would help predicting the early recurrence of HCC after operation.展开更多
文摘BACKGROUND: Excretion of gadolinium-ethoxybenzyl-diethyl- enetriamine pentaacetic acid (Gd-EOB-DTPA) in the bile may be related to liver function, because of elimination from the liver after preferential uptake by hepatocytes. The purpose of this study was to investigate the relation between liver and biliary enhancement in patients with or without liver dysfunction, and to compare the tumor-to-liver contrast in these patients. METHODS: Forty patients [group 1: normal liver and Child Pugh class A in 20 patients, group 2: Child-Pugh class B in 18 patients and Child-Pugh C in 2] were evaluated. All patients underwent MR imaging of the liver using a 1.5-Tesla system. T1 weighted 3D images were obtained at 5, 10, 15 and 20 minutes after Gd-EOB-DTPA injection. The relation between group 3 (total bilirubin <1.8 mg/dL) and group 4 (total bilirubin ≥1.8 mg/dL) was investigated at 20 minutes. Liver and biliary signals were measured, and compared between groups 1 and 2 or groups 3 and 4. Tumor-to-liver ratio was also evaluated between groups 1 and 2. Scheffé’s post-hoc test after two-way repeated measures ANOVA and Pearson’s correlation test were used for statistical analysis. RESULTS: Liver enhancement showed significant difference at all time points between groups 1 and 2. Biliary enhancement did not show a significant difference between groups 1 and 2 at 5 minutes, but did at 10, 15 and 20 minutes. At 20 minutes significant differences between groups 3 and 4 were seen for liver and biliary enhancement. At all time points, liver enhancement correlated with biliary enhancement in both groups. At 5 minutes and 20 minutes, statistical differences between groups 1 and 2 were seen for tumor-to-liver ratio.CONCLUSIONS: The degree of biliary enhancement has a close correlation to that of liver enhancement. It is especially important that insufficient liver enhancement causes lower tumor-to-liver contrast in the hepatobiliary phase of Gd-EOB- DTPA.
基金This study has received funding by Outstanding Youth supported by Medical Science and Technology Development Foundation Nanjing(JQX16022)Jiangsu Province Key Medical Young Talents,“13th Five-Year”Health Promotion Project of Jiangsu Province(QNRC2016041)+2 种基金The study was conducted in accordance with the Declaration of Helsinki(as revised in 2013)The study was approved by local institutional review board(No.2019AE01036)informed consent from patients was waived due to its retrospective nature。
文摘Background:Prediction models for the histological grade of hepatocellular carcinoma(HCC)remain unsatisfactory.The purpose of this study is to develop preoperative models to predict histological grade of HCC based on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced magnetic resonance imaging(MRI)radiomics.And to compare the performance between artificial neural network(ANN)and logistic regression model.Methods:A total of 122 HCCs were randomly assigned to the training set(n=85)and the test set(n=37).There were 242 radiomic features extracted from volumetric of interest(VOI)of arterial and hepatobiliary phases images.The radiomic features and clinical parameters[gender,age,alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),alanine aminotransferase(ALT),aspartate transaminase(AST)]were selected by permutation test and decision tree.ANN of arterial phase(ANN-AP),logistic regression model of arterial phase(LR-AP),ANN of hepatobiliary phase(ANN-HBP),logistic regression mode of hepatobiliary phase(LR-HBP),ANN of combined arterial and hepatobiliary phases(ANN-AP+HBP),and logistic regression model of combined arterial and hepatobiliary phases(LR-AP+HBP)were built to predict HCC histological grade.Those prediction models were assessed and compared.Results:ANN-AP and LR-AP were composed by AST and radiomic features based on arterial phase.ANN-HBP and LR-HBP were composed by AFP and radiomic features based on hepatobiliary phase.ANN-AP+HBP and LR-AP+HBP were composed by AST and radiomic features based on arterial and hepatobiliary phases.The prediction models could distinguish between high-grade tumors[Edmondson-Steiner(E-S)grade III and IV]and low-grade tumors(E-S grade I and II)in both training set and test set.In the test set,the AUCs of ANN-AP,LR-AP,ANN-HBP,LR-HBP,ANN-AP+HBP and LR-AP+HBP were 0.889,0.777,0.941,0.819,0.944 and 0.792 respectively.The ANN-HBP was significantly superior to LR-HBP(P=0.001).And the ANN-AP+HBP was significantly superior to LR
文摘AIM To optimize the hepatobiliary phase delay time(HBPDT) of Gd-EOB-DTPA-enhanced magnetic resonance imaging(GED-MRI) for more efficient identification of hepatocellular carcinoma(HCC) occurring in different degrees of cirrhosis assessed by Child-Pugh(CP) score.METHODS The liver parenchyma signal intensity(LPSI), the liver parenchyma(LP)/HCC signal ratios, and the visibility of HCC at HBP-DT of 5, 10, 15, 20, and 25 min(i.e., DT-5, DT-10, DT-15, DT-20, and DT-25) after injection of GdEOB-DTPA were collected and analyzed in 73 patients with cirrhosis of different degrees of severity(including 42 patients suffering from HCC) and 18 healthy adult controls.RESULTS The LPSI increased with HBP-DT more significantly in the healthy group than in the cirrhosis group(F = 17.361, P < 0.001). The LP/HCC signal ratios had a significant difference(F = 12.453, P < 0.001) among various HBP-DT points, as well as between CP-A and CP-B/C subgroups(F = 9.761, P < 0.001). The constituent ratios of HCC foci identified as obvious hypointensity(+++), moderate hypointensity(++), and mild hypointensity or isointensity(+/-) kept stable from DT-10 to DT-25: 90.6%, 9.4%, and 0.0% in the CP-A subgroup; 50.0%, 50.0%, and 0.0% in the CP-B subgroup; and 0.0%, 0.0%, and 100.0% in the CP-C subgroup, respectively.CONCLUSION The severity of liver cirrhosis has significant negative influence on the HCC visualization by GED-MRI. DT-10 is more efficient and practical than other HBP-DT points to identify most of HCC foci emerging in CP-A cirrhosis, as well as in CP-B cirrhosis; but an HBP-DT of 15 min or longer seems more appropriate than DT-10 for visualization of HCC in patients with CP-C cirrhosis.
基金This study was reviewed and approved by the Meizhou People’s Hospital Institutional Review Board(Approval No.2022-C-36).
文摘BACKGROUND Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma(HCC)has great significance for patient prognosis.AIM To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced magnetic resonance imaging(MRI)combined with clinical features in predicting early recurrence of HCC after resection.METHODS A total of 161 patients with pathologically confirmed HCC were enrolled.The patients were divided into early recurrence and non-early recurrence group based on the follow-up results.The clinical,laboratory,pathological results and Gd-EOB-DTPA enhanced MRI imaging features were analyzed.RESULTS Of 161 patients,73 had early recurrence and 88 were had non-early recurrence.Univariate analysis showed that patient age,gender,serum alpha-fetoprotein level,the Barcelona Clinic Liver Cancer stage,China liver cancer(CNLC)stage,microvascular invasion(MVI),pathological satellite focus,tumor size,tumor number,tumor boundary,tumor capsule,intratumoral necrosis,portal vein tumor thrombus,large vessel invasion,nonperipheral washout,peritumoral enhancement,hepatobiliary phase(HBP)/tumor signal intensity(SI)/peritumoral SI,HBP peritumoral low signal and peritumoral delay enhancement were significantly associated with early recurrence of HCC after operation.Multivariate logistic regression analysis showed that patient age,MVI,CNLC stage,tumor boundary and large vessel invasion were independent predictive factors.External data validation indicated that the area under the curve of the combined predictors was 0.861,suggesting that multivariate logistic regression was a reasonable predictive model for early recurrence of HCC.CONCLUSION Gd-EOB-DTPA enhanced MRI combined with clinical features would help predicting the early recurrence of HCC after operation.
