Atsushi Higaki MD, Presenter: Nothing to Disclose

Tsutomu Tamada MD, PhD, Abstract Co-Author: Nothing to Disclose

Teruki Sone MD, PhD, Abstract Co-Author: Nothing to Disclose

Akira Yamamoto MD, Abstract Co-Author: Nothing to Disclose

Yasufumi Noda, Abstract Co-Author: Nothing to Disclose

Kazuya Yasokawa, Abstract Co-Author: Nothing to Disclose

Katsuyoshi Ito MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to evaluate the relationships between signal intensity in the three hepatobiliary phases (10, 15, 20 minutes) of Gd-EOB-DTPA enhanced MR imaging and the degree of histopathologic grades in hepatocellular carcinoma (HCC).

A retrospective analysis of 64 HCCs (well-differentiated, n = 15; moderately, n = 36; poorly, n = 13) in 60 patients who underwent preoperative Gd-EOB-DTPA-enhanced MRI was performed. Hepatobiliary phase (HP) images were obtained at 3 times (10, 15, 20 minutes) after Gd-EOB-DTPA administration. Signal intensity of the lesion in all phases was measured using region-of-interest for the calculation of contrast enhancement ratio (CER). A two-factor repeated-measures analysis of variance (ANOVA) model was used for statistical analysis.

The mean CER was 36.8 (range, 17.1 to 68.9) at 10 minutes, 42.8 (range, 20 to 88.5) at 15 minutes and 48.1 (range, 21.6 to 95.8) at 20 minutes in the well-differentiated HCC (w-HCC), 36.7 (range, 15.7 to 68.2), 32.04 (range, 9.3 to 47.3) and 29.49 (range, 7.6 to 51.6), respectively, in the moderately differentiated HCC (m-HCC) and 30.4 (range, 10.8 to 53.8), 25.89 (range, 8.7 to 44.8) and 19.93 (range, 5.3 to 37.2), respectively, in the poorly differentiated HCC (p-HCC). The results of a multiple comparison assuming time as a factor show that the CER of w-HCCs (P < 0.001) increased significantly with time until 20-min HP, whereas the CER of m-HCCs (P < 0.02–0.001) and p-HCCs (P < 0.01–0.001) showed significant decreases with time until 20-min HP. When degree of differentiation was assumed as a factor, the multiple comparison results showed that there were no significant differences among the 3 groups at 10 minutes, whereas there were significant differences between w-HCCs and m-HCCs at 15 minutes (P = 0.011), and between w-HCCs and m-HCCs, and w-HCCs and p-HCCs at 20 minutes (P < 0.001, P < 0.001, respectively).

In the hepatobiliary phase of Gd-EOB-DTPA enhanced MR imaging, the CER increased with time in w-HCCs, but decreased with time in both m-HCCs and p-HCCs, probably reflecting the difference in contrast enhancement behavior of the lesion.

W-HCCs may be distinguished from m-HCCs/p-HCCs based on CER changes during the hepatobiliary phase.

Higaki, A, Tamada, T, Sone, T, Yamamoto, A, Noda, Y, Yasokawa, K, Ito, K, The Relationships between Signal Changes with Time in the Hepatobiliary Phase of Gd-EOB-DTPA Enhanced MR Imaging and the Degree of Histopathologic Grades in Hepatocellular Carcinomas.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14004735.html