The value of paradoxical uptake of hepatocellular carcinoma on the hepatobiliary phase of gadoxetic acid-enhanced liver magnetic resonance imaging for the prediction of lipiodol uptake after transcatheter arterial chemoembolization

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Abstract

Purpose To compare the response to transcatheter arterial chemoembolization (TACE) between hepatocellular carcinoma (HCC) with paradoxical uptake on the hepatobiliary phase (HBP) (HCCpara) and HCC with defect on the HBP (HCCdef), and to identify some imaging features that can differentiate between two groups. Materials and methods Ninety-three HCCs from 54 patients who underwent gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) prior to TACE were included. HCCs were classified into two groups according to the signal intensity (SI) on the HBP: HCCpara and HCCdef. Using post-TACE computed tomography (CT) as a reference standard, initial compact lipiodol uptake was assessed and compared between groups. The arterial enhancement ratio (AER), SI ratios of the arterial phase and HBP, and presence of the capsule appearance were compared between groups. After initial response, local tumor recurrence within 6 and 18 months was evaluated based on follow-up CT or MRI. Results Fifteen HCCpara and 78 HCCdef were included. Compared to HCCdef, HCCpara showed more frequent initial compact lipiodol uptake (p = 0.009), larger mean size (p = 0.019), lower AER (p = 0.005), higher SI ratio of the HBP (p < 0.0001), and more frequent capsule appearance (p < 0.0001). Local tumor recurrence rate within 6 months was also significantly lower in HCCpara than in HCCdef (p = 0.008). Conclusion Despite larger size and lower AER, HCCpara showed more frequent initial compact lipiodol uptake and lower early local recurrence rate after TACE than did HCCdef.

Original languageEnglish
Pages (from-to)169-176
Number of pages8
JournalEuropean Journal of Radiology
Volume89
DOIs
Publication statusPublished - 2017 Apr 1

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Ethiodized Oil
Hepatocellular Carcinoma
Magnetic Resonance Imaging
Recurrence
Capsules
Liver
Tomography
Neoplasms
gadolinium ethoxybenzyl DTPA

Keywords

  • Gadoxetic acid
  • Hepatocellular carcinoma
  • Lipiodol uptake
  • Magnetic resonance imaging
  • Transcatheter arterial chemoembolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{26575df9d9b04783a186172a6cf74468,
title = "The value of paradoxical uptake of hepatocellular carcinoma on the hepatobiliary phase of gadoxetic acid-enhanced liver magnetic resonance imaging for the prediction of lipiodol uptake after transcatheter arterial chemoembolization",
abstract = "Purpose To compare the response to transcatheter arterial chemoembolization (TACE) between hepatocellular carcinoma (HCC) with paradoxical uptake on the hepatobiliary phase (HBP) (HCCpara) and HCC with defect on the HBP (HCCdef), and to identify some imaging features that can differentiate between two groups. Materials and methods Ninety-three HCCs from 54 patients who underwent gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) prior to TACE were included. HCCs were classified into two groups according to the signal intensity (SI) on the HBP: HCCpara and HCCdef. Using post-TACE computed tomography (CT) as a reference standard, initial compact lipiodol uptake was assessed and compared between groups. The arterial enhancement ratio (AER), SI ratios of the arterial phase and HBP, and presence of the capsule appearance were compared between groups. After initial response, local tumor recurrence within 6 and 18 months was evaluated based on follow-up CT or MRI. Results Fifteen HCCpara and 78 HCCdef were included. Compared to HCCdef, HCCpara showed more frequent initial compact lipiodol uptake (p = 0.009), larger mean size (p = 0.019), lower AER (p = 0.005), higher SI ratio of the HBP (p < 0.0001), and more frequent capsule appearance (p < 0.0001). Local tumor recurrence rate within 6 months was also significantly lower in HCCpara than in HCCdef (p = 0.008). Conclusion Despite larger size and lower AER, HCCpara showed more frequent initial compact lipiodol uptake and lower early local recurrence rate after TACE than did HCCdef.",
keywords = "Gadoxetic acid, Hepatocellular carcinoma, Lipiodol uptake, Magnetic resonance imaging, Transcatheter arterial chemoembolization",
author = "Kim, {Jeong Woo} and Chang-Hee Lee and Park, {Yang Shin} and Tae-Seok Seo and Song, {Myung Gyu} and Kim, {Ji Hoon} and Kim, {Kyeong Ah} and Park, {Cheol Min}",
year = "2017",
month = "4",
day = "1",
doi = "10.1016/j.ejrad.2017.02.004",
language = "English",
volume = "89",
pages = "169--176",
journal = "European Journal of Radiology",
issn = "0720-048X",
publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - The value of paradoxical uptake of hepatocellular carcinoma on the hepatobiliary phase of gadoxetic acid-enhanced liver magnetic resonance imaging for the prediction of lipiodol uptake after transcatheter arterial chemoembolization

AU - Kim, Jeong Woo

AU - Lee, Chang-Hee

AU - Park, Yang Shin

AU - Seo, Tae-Seok

AU - Song, Myung Gyu

AU - Kim, Ji Hoon

AU - Kim, Kyeong Ah

AU - Park, Cheol Min

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Purpose To compare the response to transcatheter arterial chemoembolization (TACE) between hepatocellular carcinoma (HCC) with paradoxical uptake on the hepatobiliary phase (HBP) (HCCpara) and HCC with defect on the HBP (HCCdef), and to identify some imaging features that can differentiate between two groups. Materials and methods Ninety-three HCCs from 54 patients who underwent gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) prior to TACE were included. HCCs were classified into two groups according to the signal intensity (SI) on the HBP: HCCpara and HCCdef. Using post-TACE computed tomography (CT) as a reference standard, initial compact lipiodol uptake was assessed and compared between groups. The arterial enhancement ratio (AER), SI ratios of the arterial phase and HBP, and presence of the capsule appearance were compared between groups. After initial response, local tumor recurrence within 6 and 18 months was evaluated based on follow-up CT or MRI. Results Fifteen HCCpara and 78 HCCdef were included. Compared to HCCdef, HCCpara showed more frequent initial compact lipiodol uptake (p = 0.009), larger mean size (p = 0.019), lower AER (p = 0.005), higher SI ratio of the HBP (p < 0.0001), and more frequent capsule appearance (p < 0.0001). Local tumor recurrence rate within 6 months was also significantly lower in HCCpara than in HCCdef (p = 0.008). Conclusion Despite larger size and lower AER, HCCpara showed more frequent initial compact lipiodol uptake and lower early local recurrence rate after TACE than did HCCdef.

AB - Purpose To compare the response to transcatheter arterial chemoembolization (TACE) between hepatocellular carcinoma (HCC) with paradoxical uptake on the hepatobiliary phase (HBP) (HCCpara) and HCC with defect on the HBP (HCCdef), and to identify some imaging features that can differentiate between two groups. Materials and methods Ninety-three HCCs from 54 patients who underwent gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) prior to TACE were included. HCCs were classified into two groups according to the signal intensity (SI) on the HBP: HCCpara and HCCdef. Using post-TACE computed tomography (CT) as a reference standard, initial compact lipiodol uptake was assessed and compared between groups. The arterial enhancement ratio (AER), SI ratios of the arterial phase and HBP, and presence of the capsule appearance were compared between groups. After initial response, local tumor recurrence within 6 and 18 months was evaluated based on follow-up CT or MRI. Results Fifteen HCCpara and 78 HCCdef were included. Compared to HCCdef, HCCpara showed more frequent initial compact lipiodol uptake (p = 0.009), larger mean size (p = 0.019), lower AER (p = 0.005), higher SI ratio of the HBP (p < 0.0001), and more frequent capsule appearance (p < 0.0001). Local tumor recurrence rate within 6 months was also significantly lower in HCCpara than in HCCdef (p = 0.008). Conclusion Despite larger size and lower AER, HCCpara showed more frequent initial compact lipiodol uptake and lower early local recurrence rate after TACE than did HCCdef.

KW - Gadoxetic acid

KW - Hepatocellular carcinoma

KW - Lipiodol uptake

KW - Magnetic resonance imaging

KW - Transcatheter arterial chemoembolization

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U2 - 10.1016/j.ejrad.2017.02.004

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VL - 89

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JO - European Journal of Radiology

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SN - 0720-048X

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