Prognostic performance of preoperative gadoxetic acid-enhanced MRI in resectable hepatocellular carcinoma.
OBJECTIVE
To assess the impact of preoperative evaluation by gadoxetic acid-enhanced magnetic resonance imaging (MRI) on early recurrence outcomes after hepatocellular carcinoma (HCC) resection.


METHODS
The retrospective study included two groups of Child-Pugh class A patients who underwent curative liver resection for a single HCC; in one group the HCC was identified by dynamic computed tomography (CT) and gadoxetic acid-enhanced MRI (n = 174; MRI group); in the other by dynamic CT only (n = 416; non-MRI group). We compared the two groups with respect to recurrence-free survival after propensity score matching (162 pairs).


RESULTS
In the matched cohorts, disease-free survival rates for overall and intrahepatic recurrence were 92.6% and 91.9% at 1 year and 78.3% and 79.4% at 2 years, respectively, for the MRI group versus 82.7% and 82.7% at 1 year and 67.2% and 70.4% at 2 years, respectively, for the non-MRI group (P < 0.05). Multivariate Cox analyses revealed that the MRI group was independently superior to the non-MRI group in terms of risk of overall and intrahepatic recurrence at 1 and 2 years in the pooled cohort (P < 0.05).


CONCLUSIONS
Gadoxetic acid-enhanced MRI evaluation is more useful than dynamic CT for identifying good surgical candidates at low risk of early recurrence following hepatic resection for HCC. J. Magn. Reson. Imaging 2015;41:1115-1123. © 2014 Wiley Periodicals, Inc.
Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ju Hyun
JH
Shim
Seungbong
S
Han
Yong Moon
YM
Shin
Young-Joo
YJ
Lee
Sung-Gyu
SG
Lee
Kang Mo
KM
Kim
Young-Suk
YS
Lim
Han Chu
HC
Lee
D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D003287:Contrast Media; D018572:Disease-Free Survival; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
gadoxetic acid; hepatocellular carcinoma; liver resection; magnetic resonance imaging; multi-detector computed tomography