title: Hepatocellular Carcinoma with β-Catenin Mutation: Imaging and Pathologic Characteristics.
abstract: OBJECTIVE
  To identify the imaging features of hepatocellular carcinoma (HCC) associated with β-catenin mutation and their relationship to pathologic findings.
  
  
  METHODS
  Institutional ethics committee approval and informed consent were obtained. One hundred thirty-eight surgically resected HCCs were analyzed in this study. Immunohistochemical expression of β-catenin and its transcriptional product, glutamine synthetase (GS), were graded and classified into three groups: the β-catenin positive and GS positive group (HCC with β-catenin mutation), the β-catenin negative and GS positive group (intermediate HCC), and the β-catenin negative and GS negative group (HCC without β-catenin mutation). Clinical, pathologic, and imaging findings from dynamic computed tomography (CT) and gadoxetic acid-enhanced magnetic resonance (MR) imaging (T1-weighted, T2-weighted, diffusion-weighted, and hepatobiliary phase imaging) were evaluated. Correlations among immunohistochemical expression of β-catenin, GS, and organic anion transporting polypeptide 1B3 (uptake transporter of gadoxetic acid) were evaluated. The χ(2), Kruskal-Wallis, and Spearman correlation tests were used.
  
  
  RESULTS
  HCCs with β-catenin mutation (n = 27) showed a lower median contrast-to-noise ratio at diffusion-weighted imaging than did intermediate HCCs (n = 23) and HCCs without β-catenin mutation (n = 84) (13.2, 24.4, and 27.0, respectively; P = .02), higher apparent diffusion coefficient (1.33, 1.13, and 1.12, respectively; P < .0001), higher contrast-to-noise ratio (0.58, -28.7, and -45.0, respectively; P < .0001) and higher enhancement ratio during the hepatobiliary phase (0.90, 0.50, and 0.42, respectively; P < .0001). At pathologic examination, HCCs with β-catenin mutation showed pseudoglandular proliferation and bile production with a higher grade of differentiation (P = .04, .001, and .005, respectively). There were significant positive correlations among expression of β-catenin, GS, and organic anion transporting polypeptide 1B3 (P < .0001).
  
  
  CONCLUSIONS
  HCCs with β-catenin mutation showed a higher grade of differentiation with frequent pseudoglandular patterns and bile production, and characteristic imaging findings included a high enhancement ratio at gadoxetic acid-enhanced MR imaging and a high apparent diffusion coefficient at diffusion-weighted imaging. Online supplemental material is available for this article.
authors: From the Departments of Radiology (A.K., O.M., N.Y., K.K., S.K., J.S., W.K., T.M., D.I., K.Y., T.G.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S.K.), Gastroenterologic Surgery (H.T., T.O.), and Human Pathology (H.I., Y.N.), Kanazawa University Graduate School of Medical Science13-1 Takaramachi, Kanazawa 920-8640, Japan; and Department of Gastroenterology, Osaka Red Cross Hospital, Osaka, Japan (R.K.).
authors: Azusa
authors: A
authors: Kitao
authors: Osamu
authors: O
authors: Matsui
authors: Norihide
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authors: Yoneda
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authors: Kozaka
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authors: Kobayashi
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authors: Sanada
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authors: Inoue
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authors: Yoshida
authors: Taro
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authors: Yamashita
authors: Tatsuya
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authors: Yamashita
authors: Shuichi
authors: S
authors: Kaneko
authors: Hiroyuki
authors: H
authors: Takamura
authors: Tetsuo
authors: T
authors: Ohta
authors: Hiroko
authors: H
authors: Ikeda
authors: Yasuni
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authors: Nakanuma
authors: Ryuichi
authors: R
authors: Kita
authors: Toshifumi
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authors: Gabata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000235:genetics*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009154:Mutation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D051176:beta Catenin / Q000235:genetics*
chemical_list: D051176:beta Catenin