Predicting Progression to Hypervascular HCC in Hypovascular Hypointense Nodules in Gadoxetic Acid-enhanced MR Images in Patients with Chronic Liver Disease
Issued Date
2023-01-01
Resource Type
eISSN
22288082
Scopus ID
2-s2.0-85171286693
Journal Title
Siriraj Medical Journal
Volume
75
Issue
9
Start Page
680
End Page
687
Rights Holder(s)
SCOPUS
Bibliographic Citation
Siriraj Medical Journal Vol.75 No.9 (2023) , 680-687
Suggested Citation
Teerasamit W., Hongpinyo S., Tongdee R., Suvannarerg V. Predicting Progression to Hypervascular HCC in Hypovascular Hypointense Nodules in Gadoxetic Acid-enhanced MR Images in Patients with Chronic Liver Disease. Siriraj Medical Journal Vol.75 No.9 (2023) , 680-687. 687. doi:10.33192/smj.v75i9.262021 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/90175
Title
Predicting Progression to Hypervascular HCC in Hypovascular Hypointense Nodules in Gadoxetic Acid-enhanced MR Images in Patients with Chronic Liver Disease
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Objective: To identify patient characteristics and MR imaging features of hypovascular hypointense nodules in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MR imaging in patients with chronic liver disease associated with progression to hypervascular hepatocellular carcinoma (HCC). Materials and Methods: The institutional review board approved this retrospective review of 40 patients with 60 hypovascular hypointense nodules in the HBP of gadoxetic acid-enhanced MR imaging. Univariate and multivariate Cox regression analyses for hypervascular HCC development were used to define variables, including initial nodule size, cause of cirrhosis, history of locoregional therapy of HCC, fat-containing, signal intensity on T1W, T2W, portal and equilibrium phases of dynamic phase, and DW images. The cumulative percentage incidence of hypervascularity and growth rate were calculated using the receiver operating characteristic (ROC) curve. Results: The prevalence of progression to hypervascular HCC was 45% (27 out of 60). The Multivariable Cox analysis of developing hypervascularization was an initial nodule diameter more than 1 cm. (P=0.027; HR 2.52; 95% CI: 1.11,5.74) The mean growth rate was significantly higher in subsequent hypervascular nodules than in those without hypervascularization (P < 0.001). The cumulative risk incidence of hypervascularization at 3, 6, 12, 24 months was 5%, 20%, 35%, 44 %, respectively. Conclusion: An initial nodule diameter of more than 1 cm and nodules with higher growth rates are significant predictive factors for hypervascular transformation of hypovascular hypointense nodules in the HBP of gadoxetic acid-enhanced MR imaging.