Significance of the Signal Intensity of Gadoxetic Acid-enhanced MR Imaging for Predicting the Efficacy of Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma
Significance of the Signal Intensity of Gadoxetic Acid-enhanced MR Imaging for Predicting the Efficacy of Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma
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DOI：
10.2463/mrms.2015-0012
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发表时间：
2016-01-01
影响因子：
3
通讯作者：
Honda, Hiroshi
中科院分区：
文献类型：
--
作者：
Fujita, Nobuhiro;Nishie, Akihiro;Honda, Hiroshi
目的：我们试图阐明钆塞酸增强磁共振（MR）成像的肝胆相信号强度（SI）与肝动脉灌注化疗（HAIC）在肝细胞癌（HCC）中的疗效之间的关系。方法：我们纳入了14例HCC患者，他们在使用顺铂和5-氟尿嘧啶进行HAIC之前接受钆塞酸增强MR成像。在肝胆期，我们计算了HCC和背景肝脏的SI。在多个HCC病例中，我们计算了最大病灶的SI。根据SI比值（肿瘤SI/背景肝脏SI）的中位数，将患者分为高强度（n = 7）和低强度（n = 7）组。我们使用Kaplan-Meier方法和对数秩检验分析无进展生存期。结果：高强度组和低强度组的SI比值分别为0.568 ± 0.093（平均标准差）和0.251 ± 0.086（平均标准差）。与低信号组相比，高信号组的血清甲胎蛋白（AFP）水平明显降低（P = 0.0350），无进展生存期显著更高（P = 0.0108），组织学检查时肿瘤分级分化较好结论：钆塞酸增强MRI肝胆期高SI率的HCC患者对HAIC的反应较好。
Purpose: We attempted to clarify the relationship between the signal intensity (SI) in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance (MR) imaging and the efficacy of hepatic arterial infusion chemotherapy (HAIC) in hepatocellular carcinomas (HCCs).Methods: We enrolled 14 patients with HCCs who underwent gadoxetic acid-enhanced MR imaging prior to HAIC using cisplatin and 5-fluorouracil. In the hepatobiliary phase, we calculated the SI of the HCCs and the background liver. In cases with multiple HCCs, we calculated the SI of the largest lesion. Patients were classified into high (n = 7) and low intensity (n = 7) groups based on the median value of the SI ratio (SI of the tumor/SI of the background liver). We analyzed progression-free survival using the Kaplan-Meier method and the log-rank test. In the 5 patients with a history of HCC surgery, we compared the expression of immunohistochemical organic anion-transporting polypeptide (OATP) 8 between the high and low intensity groups by chi-square test.Results: The SI ratios were 0.568 +/- 0.093 (mean standard deviation) in the high intensity group and 0.251 +/- 0.086 in the low intensity group. Compared to the group with low signal intensity, the group with high signal intensity demonstrated significantly lower serum levels of alpha fetoprotein (AFP) (P = 0.0350), significantly higher progression-free survival (P = 0.0108), better differentiation of tumor grade at histologic examination (P = 0.0253), and significantly higher OATP8 expression (P = 0.0253).Conclusion: Patients with HCCs of high SI ratio in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging can respond better to HAIC.