title: Local recurrence after chemoembolization of hepatocellular carcinoma: uptake of gadoxetic acid as a new prognostic factor.
abstract: OBJECTIVE
  The purpose of this article is to investigate whether there is a difference in susceptibility to transcatheter arterial chemoembolization between hepatocellular carcinomas (HCCs) showing high uptake and those showing low uptake of gadoxetic acid in the hepatobiliary phase of MRI.
  
  
  METHODS
  One hundred HCCs that achieved optimal chemoembolization, as assessed by immediate CT in 60 patients, were classified as having high (n = 19) or low (n = 81) uptake of gadoxetic acid on MRI performed before chemoembolization. The local recurrence rates were estimated using the Kaplan-Meier method, and differences between the groups were compared using the log-rank test. The following factors were also correlated with the local recurrence rate using the Cox proportional hazards model for a univariate analysis: high uptake of gadoxetic acid, number of feeding arteries, extrahepatic arterial supply, Child-Pugh class, clinical tumor stage, size, location, and iodized oil accumulation in the noncancerous tissue surrounding the lesion. Parameters that were significant at p < 0.05 were entered into a multivariate model.
  
  
  RESULTS
  The 1- and 3-year local recurrence-free rates were 95% in high-uptake HCCs and 66% and 54%, respectively, in low-uptake HCCs (log-rank test, p < 0.01). The low uptake of gadoxetic acid was the only significant predictor of early local recurrence (hazard ratio = 9.24; p = 0.03) by multivariate analysis.
  
  
  CONCLUSIONS
  HCCs showing high uptake of gadoxetic acid appear to be susceptible to chemoembolization.
authors.affiliation: 1 Department of Radiology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishimaru
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Nakashima
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sakugawa
authors.forename: Ayami
authors.initials: A
authors.lastname: Sakamoto
authors.forename: Yohjiro
authors.initials: Y
authors.lastname: Matsuoka
authors.forename: Kazuto
authors.initials: K
authors.lastname: Ashizawa
authors.forename: Masataka
authors.initials: M
authors.lastname: Uetani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA