Hypovascular hepatic nodules showing hypointense on the hepatobiliary-phase image of Gd-EOB-DTPA-enhanced MRI to develop a hypervascular hepatocellular carcinoma: A nationwide retrospective study on their natural course and risk factors

Tatsuo Inoue, Tomoko Hyodo, Takamichi Murakami, Yukihisa Takayama, Akihiro Nishie, Atsushi Higaki, Keiko Korenaga, Azusa Sakamoto, Yukio Osaki, Hiroshi Aikata, Kazuaki Chayama, Takeshi Suda, Toru Takano, Kennichi Miyoshi, Masahiko Koda, Kazushi Numata, Hironori Tanaka, Hiroko Iijima, Hironori Ochi, Masashi HirookaYasuharu Imai, Masatoshi Kudo

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Abstract

Objective: We aimed to investigate the natural outcome of nonhypervascular lesions detected in the hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI by performing a longitudinal study retrospectively enrolled in a nationwide manner. Methods: Between February 2008 and March 2011, 224 patients with 504 nodules that were diagnosed as nonhypervascular by imaging were recruited from institutions that participated in the present study. We examined the natural outcome of nonhypervascular lesions and evaluated the risk factors. Results: Of the 504 nodules, 173 (34.3%) showed hypervascular transformation. The overall cumulative incidence of hypervascular transformation was 14.9% at 12 months and 45.8% at 24 months. Multivariate analysis using the Cox regression model revealed previous treatment history for hepatocellular carcinoma (HCC; relative risk = 1.498; p = 0.036, 95% CI 1.03-2.19) and hyperintensity on T2-weighted images (relative risk = 1.724; p = 0.015, 95% CI 1.11-2.67) were identified as independent factors for hypervascular transformation. Conclusions: Patients who have a previous treatment history for HCC and with hypointense nodules showing hyperintensity on T2-weighted images need careful follow-up because of the high incidence of hypervascular transformation.

Original languageEnglish
Pages (from-to)472-479
Number of pages8
JournalDigestive Diseases
Volume31
Issue number5-6
DOIs
Publication statusPublished - Jan 1 2013

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All Science Journal Classification (ASJC) codes

  • Gastroenterology

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