3D MR Elastography of Hepatocellular Carcinomas as a Potential Biomarker for Predicting Tumor Recurrence

Jin Wang, Qungang Shan, Yong Liu, Hao Yang, Sichi Kuang, Bingjun He, Yao Zhang, Jingbiao Chen, Tianhui Zhang, Kevin J. Glaser, Cairong Zhu, Jun Chen, Meng Yin, Sudhakar K Venkatesh, Richard Lorne Ehman

Research output: Contribution to journalArticle

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Abstract

Background: Preoperative prediction of tumor recurrence is important in the management of patients with hepatocellular carcinoma (HCC). Purpose: To investigate whether tumor stiffness derived by magnetic resonance elastography (MRE) could predict early recurrence of HCC after hepatic resection. Study Type: Retrospective. Population: In all, 99 patients with pathologically confirmed HCCs after surgical resection. Field Strength/Sequence: 3.0T; preoperative MRE with 60-Hz mechanical vibrations using an active acoustic driver. Assessment: Regions of interest (ROIs) were manually drawn in the tumors to measure mean tumor stiffness. Surgical specimens were reviewed for histological grade, capsule, vascular invasion, and surgical margins. The early recurrence of HCC was defined as that occurring within 2 years after resection. Statistical Tests: Cox proportional hazard models were used to evaluate risk factors associated with the time to early recurrence. Results: HCCs with recurrence had higher tumor stiffness, higher rate of advanced T stage, vascular invasion, lower rate of capsule formation, larger tumor size, higher aspartate aminotransferase (AST), and hepatitis B virus (HBV)-DNA level and aspartate aminotransferase / alanine aminotransferase ratio (P = 0.031, 0.007, 0.01, <0.001, 0.015, 0.034, 0.01, and 0.014, respectively) than HCCs without recurrence. Vascular invasion (hazard ratio [HR] = 2.922; 95% confidence interval [CI]: [1.079, 7.914], P = 0.035) and mean tumor stiffness (HR = 1.163; 95% CI: [1.055, 1.282], P = 0.002) were risk factors associated with early recurrence. Each 1-kPa increase in tumor stiffness was associated with a 16.3% increase in the risk for tumor recurrence. Data Conclusion: The mean stiffness of HCCs may be a useful, noninvasive, quantitative biomarker for the prediction of early HCC recurrence after hepatic resection. Level of Evidence: 4. Technical Efficacy: Stage 5. J. MAGN. RESON. IMAGING 2018.

Original languageEnglish (US)
JournalJournal of Magnetic Resonance Imaging
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Elasticity Imaging Techniques
Tumor Biomarkers
Hepatocellular Carcinoma
Recurrence
Neoplasms
Blood Vessels
Aspartate Aminotransferases
Capsules
Confidence Intervals
Liver
Vibration
Alanine Transaminase
Proportional Hazards Models
Acoustics
Hepatitis B virus
Retrospective Studies
Biomarkers

Keywords

  • hepatocellular carcinoma
  • histological grade
  • recurrence
  • tumor capsule
  • tumor stiffness

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

3D MR Elastography of Hepatocellular Carcinomas as a Potential Biomarker for Predicting Tumor Recurrence. / Wang, Jin; Shan, Qungang; Liu, Yong; Yang, Hao; Kuang, Sichi; He, Bingjun; Zhang, Yao; Chen, Jingbiao; Zhang, Tianhui; Glaser, Kevin J.; Zhu, Cairong; Chen, Jun; Yin, Meng; Venkatesh, Sudhakar K; Ehman, Richard Lorne.

In: Journal of Magnetic Resonance Imaging, 01.01.2018.

Research output: Contribution to journalArticle

Wang, Jin ; Shan, Qungang ; Liu, Yong ; Yang, Hao ; Kuang, Sichi ; He, Bingjun ; Zhang, Yao ; Chen, Jingbiao ; Zhang, Tianhui ; Glaser, Kevin J. ; Zhu, Cairong ; Chen, Jun ; Yin, Meng ; Venkatesh, Sudhakar K ; Ehman, Richard Lorne. / 3D MR Elastography of Hepatocellular Carcinomas as a Potential Biomarker for Predicting Tumor Recurrence. In: Journal of Magnetic Resonance Imaging. 2018.
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abstract = "Background: Preoperative prediction of tumor recurrence is important in the management of patients with hepatocellular carcinoma (HCC). Purpose: To investigate whether tumor stiffness derived by magnetic resonance elastography (MRE) could predict early recurrence of HCC after hepatic resection. Study Type: Retrospective. Population: In all, 99 patients with pathologically confirmed HCCs after surgical resection. Field Strength/Sequence: 3.0T; preoperative MRE with 60-Hz mechanical vibrations using an active acoustic driver. Assessment: Regions of interest (ROIs) were manually drawn in the tumors to measure mean tumor stiffness. Surgical specimens were reviewed for histological grade, capsule, vascular invasion, and surgical margins. The early recurrence of HCC was defined as that occurring within 2 years after resection. Statistical Tests: Cox proportional hazard models were used to evaluate risk factors associated with the time to early recurrence. Results: HCCs with recurrence had higher tumor stiffness, higher rate of advanced T stage, vascular invasion, lower rate of capsule formation, larger tumor size, higher aspartate aminotransferase (AST), and hepatitis B virus (HBV)-DNA level and aspartate aminotransferase / alanine aminotransferase ratio (P = 0.031, 0.007, 0.01, <0.001, 0.015, 0.034, 0.01, and 0.014, respectively) than HCCs without recurrence. Vascular invasion (hazard ratio [HR] = 2.922; 95{\%} confidence interval [CI]: [1.079, 7.914], P = 0.035) and mean tumor stiffness (HR = 1.163; 95{\%} CI: [1.055, 1.282], P = 0.002) were risk factors associated with early recurrence. Each 1-kPa increase in tumor stiffness was associated with a 16.3{\%} increase in the risk for tumor recurrence. Data Conclusion: The mean stiffness of HCCs may be a useful, noninvasive, quantitative biomarker for the prediction of early HCC recurrence after hepatic resection. Level of Evidence: 4. Technical Efficacy: Stage 5. J. MAGN. RESON. IMAGING 2018.",
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author = "Jin Wang and Qungang Shan and Yong Liu and Hao Yang and Sichi Kuang and Bingjun He and Yao Zhang and Jingbiao Chen and Tianhui Zhang and Glaser, {Kevin J.} and Cairong Zhu and Jun Chen and Meng Yin and Venkatesh, {Sudhakar K} and Ehman, {Richard Lorne}",
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T1 - 3D MR Elastography of Hepatocellular Carcinomas as a Potential Biomarker for Predicting Tumor Recurrence

AU - Wang, Jin

AU - Shan, Qungang

AU - Liu, Yong

AU - Yang, Hao

AU - Kuang, Sichi

AU - He, Bingjun

AU - Zhang, Yao

AU - Chen, Jingbiao

AU - Zhang, Tianhui

AU - Glaser, Kevin J.

AU - Zhu, Cairong

AU - Chen, Jun

AU - Yin, Meng

AU - Venkatesh, Sudhakar K

AU - Ehman, Richard Lorne

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Preoperative prediction of tumor recurrence is important in the management of patients with hepatocellular carcinoma (HCC). Purpose: To investigate whether tumor stiffness derived by magnetic resonance elastography (MRE) could predict early recurrence of HCC after hepatic resection. Study Type: Retrospective. Population: In all, 99 patients with pathologically confirmed HCCs after surgical resection. Field Strength/Sequence: 3.0T; preoperative MRE with 60-Hz mechanical vibrations using an active acoustic driver. Assessment: Regions of interest (ROIs) were manually drawn in the tumors to measure mean tumor stiffness. Surgical specimens were reviewed for histological grade, capsule, vascular invasion, and surgical margins. The early recurrence of HCC was defined as that occurring within 2 years after resection. Statistical Tests: Cox proportional hazard models were used to evaluate risk factors associated with the time to early recurrence. Results: HCCs with recurrence had higher tumor stiffness, higher rate of advanced T stage, vascular invasion, lower rate of capsule formation, larger tumor size, higher aspartate aminotransferase (AST), and hepatitis B virus (HBV)-DNA level and aspartate aminotransferase / alanine aminotransferase ratio (P = 0.031, 0.007, 0.01, <0.001, 0.015, 0.034, 0.01, and 0.014, respectively) than HCCs without recurrence. Vascular invasion (hazard ratio [HR] = 2.922; 95% confidence interval [CI]: [1.079, 7.914], P = 0.035) and mean tumor stiffness (HR = 1.163; 95% CI: [1.055, 1.282], P = 0.002) were risk factors associated with early recurrence. Each 1-kPa increase in tumor stiffness was associated with a 16.3% increase in the risk for tumor recurrence. Data Conclusion: The mean stiffness of HCCs may be a useful, noninvasive, quantitative biomarker for the prediction of early HCC recurrence after hepatic resection. Level of Evidence: 4. Technical Efficacy: Stage 5. J. MAGN. RESON. IMAGING 2018.

AB - Background: Preoperative prediction of tumor recurrence is important in the management of patients with hepatocellular carcinoma (HCC). Purpose: To investigate whether tumor stiffness derived by magnetic resonance elastography (MRE) could predict early recurrence of HCC after hepatic resection. Study Type: Retrospective. Population: In all, 99 patients with pathologically confirmed HCCs after surgical resection. Field Strength/Sequence: 3.0T; preoperative MRE with 60-Hz mechanical vibrations using an active acoustic driver. Assessment: Regions of interest (ROIs) were manually drawn in the tumors to measure mean tumor stiffness. Surgical specimens were reviewed for histological grade, capsule, vascular invasion, and surgical margins. The early recurrence of HCC was defined as that occurring within 2 years after resection. Statistical Tests: Cox proportional hazard models were used to evaluate risk factors associated with the time to early recurrence. Results: HCCs with recurrence had higher tumor stiffness, higher rate of advanced T stage, vascular invasion, lower rate of capsule formation, larger tumor size, higher aspartate aminotransferase (AST), and hepatitis B virus (HBV)-DNA level and aspartate aminotransferase / alanine aminotransferase ratio (P = 0.031, 0.007, 0.01, <0.001, 0.015, 0.034, 0.01, and 0.014, respectively) than HCCs without recurrence. Vascular invasion (hazard ratio [HR] = 2.922; 95% confidence interval [CI]: [1.079, 7.914], P = 0.035) and mean tumor stiffness (HR = 1.163; 95% CI: [1.055, 1.282], P = 0.002) were risk factors associated with early recurrence. Each 1-kPa increase in tumor stiffness was associated with a 16.3% increase in the risk for tumor recurrence. Data Conclusion: The mean stiffness of HCCs may be a useful, noninvasive, quantitative biomarker for the prediction of early HCC recurrence after hepatic resection. Level of Evidence: 4. Technical Efficacy: Stage 5. J. MAGN. RESON. IMAGING 2018.

KW - hepatocellular carcinoma

KW - histological grade

KW - recurrence

KW - tumor capsule

KW - tumor stiffness

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