Satoshi Kobayashi MD, Presenter: Nothing to Disclose

Osamu Matsui MD, Abstract Co-Author: Nothing to Disclose

Toshifumi Gabata MD, Abstract Co-Author: Nothing to Disclose

Wataru Koda, Abstract Co-Author: Nothing to Disclose

Tetsuya Minami MD, Abstract Co-Author: Nothing to Disclose

Yasuji Ryu MD, Abstract Co-Author: Nothing to Disclose

Kazuto Kozaka MD, Abstract Co-Author: Nothing to Disclose

Azusa Kitao, Abstract Co-Author: Nothing to Disclose

To elucidate the signal intensity patterns of borderline lesions of HCC on hepatobiliary phase Gd-EOB-DTPA (EOB) enhanced MRI and clarify the natural histories of these lesions.

Total 99 borderline lesions of HCC were identified by angiography-assisted CT in 63 patients. EOB-enhanced MRI was performed within 1 month before or after angiography-assisted CT, and the signal intensity of borderline lesions on hepatobiliary phase were analyzed. Progress rate from borderline lesions to hypervascular HCC were calculated with the Kaplan-Meier method among each signal intensity groups. Log-rank method was applied for comparison of progress rate from borderline lesions to HCC. A two-sided P value of less than 0.05 was considered statistically significant.

On hepatoboliary phase of EOB enhanced MRI, 41.4% of the borderline lesions showed hypo-, 42.4% showed iso-, and 16.2% showed hyperintense, compared to the background liver parenchyma. Within them, 78 were followed using multiphasic contrast-enhanced CT and/or MRI (follow up period range, 14 to 1240 days). Overall progress rate from borderline lesions to hypervascular HCC were 10% in 1 year, 14% in 2 year and 20% in 3 year follow up period. Eight of 32 hypointense borderline lesions and 2 of 35 isointense borderline lesions progressed to hypervascular HCC over a follow-up period of 134 to 985 days. Progress rates to HCC in hypointense borderline lesions were 17% in 1 year, 28% in 2 year and 41% in 3 year follow up period, and in isointense borderline lesions were 7% in 1 year, 7% in 2 year and 7% in 3 year follow up period. No hyperintense borderline lesions progressed to HCC in the follow up period. There are significant differences in progress rate from borderline lesions to HCC in both between “isointense and hypointense” and “hyperintense and hypointense” borderline lesions (P=.032 and P=0.037, respectively).

Although borderline lesions of HCC may show hypo-, iso- and hyperintensity on hepatobiliary phase of EOB-enhanced MRI, hypointense borderline lesions are high risk to progress overt HCC. 

Although borderline lesions of HCC may show hypo-, iso- and hyperintensity on hepatobiliary phase of EOB-enhanced MRI, hypointense borderline lesions are high risk to progress overt HCC. 

Kobayashi, S, Matsui, O, Gabata, T, Koda, W, Minami, T, Ryu, Y, Kozaka, K, Kitao, A, Gd-EOB-DTPA Enhanced MR Findings of Borderline Lesions of HCC; Relationship between Signal Intensity on Hepatobiliary Phase Images and Prognosis of the Lesions.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12020242.html