title: Prediction of microvascular invasion of hepatocellular carcinomas with gadoxetic acid-enhanced MR imaging: Impact of intra-tumoral fat detected on chemical-shift images.
abstract: OBJECTIVE
  To investigate the impact of intra-tumoral fat detected by chemical-shift MR imaging in predicting the MVI of HCC.
  
  
  METHODS
  Gadoxetic acid-enhanced MR imaging of 365 surgically proven HCCs from 365 patients (306 men, 59 women; mean age, 55.6 years) were evaluated. HCCs were classified into two groups, fat-containing and non-fat-containing, based on the presence of fat on chemical-shift images. Fat-containing HCCs were subdivided into diffuse or focal fatty change groups. Logistic regression analyses were used to identify clinical and MR findings associated with MVI.
  
  
  RESULTS
  Based on MR imaging, 66 tumors were classified as fat-containing HCCs and 299 as non-fat-containing HCCs. Among the 66 fat-containing HCCs, 38 (57.6%) showed diffuse fatty changes and 28 (42.4%) showed focal fatty changes. MVI was present in 18 (27.3%) fat-containing HCCs and in 117 (39.1%) non-fat-containing HCCs (P=0.07). Univariate analysis revealed that serum alpha-fetoprotein (AFP) and tumor size were significantly associated with MVI (P<0.001). A multiple logistic regression analysis showed that log AFP (odds ratio 1.178, P=0.0016), tumor size (odds ratio 1.809, P<0.001), and intra-tumoral fat (odds ratio 0.515, P=0.0387) were independent variables associated with MVI.
  
  
  CONCLUSIONS
  Intra-tumoral fat detected with MR imaging may suggest lower risk for MVI of HCC and, therefore, a possibly more favorable prognosis, but the clinical value of this finding is uncertain.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Min
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: jmyr@dreamwiz.com.
authors.forename: Young Kon
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Radiology, Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea.
authors.forename: Sanghyeok
authors.initials: S
authors.lastname: Lim
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Woo Kyoung
authors.initials: WK
authors.lastname: Jeong
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Dongil
authors.initials: D
authors.lastname: Choi
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Lee
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D003287:Contrast Media; D003952:Diagnostic Imaging; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Fat; Gd-EOB-DTPA; Hepatocellular carcinoma; Magnetic resonance imaging; Microvascular invasion