Norihide Yoneda, Presenter: Nothing to Disclose

Osamu Matsui MD, Abstract Co-Author: Research Consultant, Kowa Company, Ltd Research Consultant, Otsuka Holdings Co, Ltd Research Consultant, Eisai Co, Ltd Speakers Bureau, Bayer AG Speakers Bureau, Eisai Co, Ltd

Azusa Kitao, Abstract Co-Author: Nothing to Disclose

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

Satoshi Kobayashi MD, Abstract Co-Author: Nothing to Disclose

Dai Inoue, Abstract Co-Author: Nothing to Disclose

Kotaro Yoshida MD, Abstract Co-Author: Nothing to Disclose

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

Wataru Koda, Abstract Co-Author: Nothing to Disclose

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

Peritumoral hyperintensity (PH) is occasionally seen in hepatocellular carcinoma (HCC) on the hepatobiliary phase (HB phase) of Gd-EOB-DTPA enhanced MRI (EOB-MRI). However, the mechanism of PH is still unknown. A recent study showed peritumoral hyperplasia (PTH) associated with over-expression of glutamine synthetase (GS) in HCC or metastatic carcinoma. The aim of this study was to analyze the correlation between PH on the HB phase of EOB-MRI and GS expression indicating PTH.

Seventy-seven surgically resected nodules (from 68 patients) were analyzed. Patients were grouped according to the degree of the peritumoral hyperintense signal on the HB phase: grade0 (no PH), grade1 (PH was seen on less than 50% of the tumor border), grade2 (50-80%), grade3 (80%-100%). Immunohistochemical staining for GS and organic anion transporter polypeptides(OATP)1B3 (uptake transporter of Gd-EOB-DTPA) was performed. In this study, PTH was defined as the peritumoral hepatocytes with high GS expression.

In the image evaluation of the HB phase of EOB-MRI, 39 nodules were classified as grade 0, 24 nodules as grade 1,11 nodules as grade 2, and 3 nodules as grade 3. An increased expression of GS relative to the surrounding liver was observed in 3/39 grade 0 nodules (7.7%), 17/24 grade 1 nodules (70.8%), 9/11 grade 2 nodules (81.8%) and 3/3 grade 3 nodules (100%). There was significant in the incidence of PTH between grade0 and grade1-3 (P<0.0001). Hepatocytes with GS expression in all PTH sites demonstrated definite expression of OATP1B3.

Peritumoral hyperintensity on HB phase of EOB-MRI in HCC may indicate peritumoral hyperplasia with GS and OATP1B3 expression.

Peritumoral hyperintensity on HB phase of EOB-MRI in HCC may indicate peritumoral hyperplasia. Understanding of this finding will be useful in the accurate diagnosis of liver tumors.

Yoneda, N, Matsui, O, Kitao, A, Kozaka, K, Kobayashi, S, Inoue, D, Yoshida, K, Minami, T, Koda, W, Gabata, T, Peritumoral Hyperintensity on Hepatobiliary Phase of Gd-EOB-DTPA Enhanced MRI in Hepatocellular Carcinomas: Correlation with Peritumoral Hyperplasia Showing Glutamine Synthetase Overexpression.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009161.html