Significance of the signal intensity of gadoxetic acid-enhanced MR imaging for predicting the efficacy of hepatic arterial infusion chemotherapy in hepatocellular carcinoma

nobuhiro fujita, Akihiro Nishie, Yoshiki Asayama, Kosei Ishigami, yasuhiro ushijima, Yukihisa Takayama, daisuke okamoto, Koichiro Morita, Ken Shirabe, Kazuhiro Koto, yuichiro kubo, Yoshinao Oda, Hiroshi Honda

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Abstract

Purpose: We attempted to clarify the relationship between the signal intensity (SI) in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance (MR) imaging and the efficacy of hepatic arterial infusion chemotherapy (HAIC) in hepatocellular carcinomas (HCCs). Methods: We enrolled 14 patients with HCCs who underwent gadoxetic acid-enhanced MR imaging prior to HAIC using cisplatin and 5-fluorouracil. In the hepatobiliary phase, we calculated the SI of the HCCs and the background liver. In cases with multiple HCCs, we calculated the SI of the largest lesion. Patients were classified into high (n = 7) and low intensity (n = 7) groups based on the median value of the SI ratio (SI of the tumor/SI of the background liver). We analyzed progression-free survival using the Kaplan-Meier method and the log-rank test. In the 5 patients with a history of HCC surgery, we compared the expression of immunohistochemical organic anion-transporting polypeptide (OATP) 8 between the high and low intensity groups by chi-square test. Results: The SI ratios were 0.568 ± 0.093 (mean ± standard deviation) in the high intensity group and 0.251 ± 0.086 in the low intensity group. Compared to the group with low signal intensity, the group with high signal intensity demonstrated significantly lower serum levels of alpha fetoprotein (AFP) (P = 0.0350), significantly higher progression-free survival (P = 0.0108), better differentiation of tumor grade at histologic examination (P = 0.0253), and significantly higher OATP8 expression (P = 0.0253). Conclusion: Patients with HCCs of high SI ratio in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging can respond better to HAIC.

Original languageEnglish
Pages (from-to)111-120
Number of pages10
JournalMagnetic Resonance in Medical Sciences
Volume15
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

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Hepatocellular Carcinoma
Magnetic Resonance Imaging
Drug Therapy
Liver
Disease-Free Survival
alpha-Fetoproteins
Chi-Square Distribution
Fluorouracil
Cisplatin
Anions
gadolinium ethoxybenzyl DTPA
Neoplasms
Peptides
Serum

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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Significance of the signal intensity of gadoxetic acid-enhanced MR imaging for predicting the efficacy of hepatic arterial infusion chemotherapy in hepatocellular carcinoma. / fujita, nobuhiro; Nishie, Akihiro; Asayama, Yoshiki; Ishigami, Kosei; ushijima, yasuhiro; Takayama, Yukihisa; okamoto, daisuke; Morita, Koichiro; Shirabe, Ken; Koto, Kazuhiro; kubo, yuichiro; Oda, Yoshinao; Honda, Hiroshi.

In: Magnetic Resonance in Medical Sciences, Vol. 15, No. 1, 01.01.2016, p. 111-120.

Research output: Contribution to journalArticle

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abstract = "Purpose: We attempted to clarify the relationship between the signal intensity (SI) in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance (MR) imaging and the efficacy of hepatic arterial infusion chemotherapy (HAIC) in hepatocellular carcinomas (HCCs). Methods: We enrolled 14 patients with HCCs who underwent gadoxetic acid-enhanced MR imaging prior to HAIC using cisplatin and 5-fluorouracil. In the hepatobiliary phase, we calculated the SI of the HCCs and the background liver. In cases with multiple HCCs, we calculated the SI of the largest lesion. Patients were classified into high (n = 7) and low intensity (n = 7) groups based on the median value of the SI ratio (SI of the tumor/SI of the background liver). We analyzed progression-free survival using the Kaplan-Meier method and the log-rank test. In the 5 patients with a history of HCC surgery, we compared the expression of immunohistochemical organic anion-transporting polypeptide (OATP) 8 between the high and low intensity groups by chi-square test. Results: The SI ratios were 0.568 ± 0.093 (mean ± standard deviation) in the high intensity group and 0.251 ± 0.086 in the low intensity group. Compared to the group with low signal intensity, the group with high signal intensity demonstrated significantly lower serum levels of alpha fetoprotein (AFP) (P = 0.0350), significantly higher progression-free survival (P = 0.0108), better differentiation of tumor grade at histologic examination (P = 0.0253), and significantly higher OATP8 expression (P = 0.0253). Conclusion: Patients with HCCs of high SI ratio in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging can respond better to HAIC.",
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T1 - Significance of the signal intensity of gadoxetic acid-enhanced MR imaging for predicting the efficacy of hepatic arterial infusion chemotherapy in hepatocellular carcinoma

AU - fujita, nobuhiro

AU - Nishie, Akihiro

AU - Asayama, Yoshiki

AU - Ishigami, Kosei

AU - ushijima, yasuhiro

AU - Takayama, Yukihisa

AU - okamoto, daisuke

AU - Morita, Koichiro

AU - Shirabe, Ken

AU - Koto, Kazuhiro

AU - kubo, yuichiro

AU - Oda, Yoshinao

AU - Honda, Hiroshi

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Purpose: We attempted to clarify the relationship between the signal intensity (SI) in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance (MR) imaging and the efficacy of hepatic arterial infusion chemotherapy (HAIC) in hepatocellular carcinomas (HCCs). Methods: We enrolled 14 patients with HCCs who underwent gadoxetic acid-enhanced MR imaging prior to HAIC using cisplatin and 5-fluorouracil. In the hepatobiliary phase, we calculated the SI of the HCCs and the background liver. In cases with multiple HCCs, we calculated the SI of the largest lesion. Patients were classified into high (n = 7) and low intensity (n = 7) groups based on the median value of the SI ratio (SI of the tumor/SI of the background liver). We analyzed progression-free survival using the Kaplan-Meier method and the log-rank test. In the 5 patients with a history of HCC surgery, we compared the expression of immunohistochemical organic anion-transporting polypeptide (OATP) 8 between the high and low intensity groups by chi-square test. Results: The SI ratios were 0.568 ± 0.093 (mean ± standard deviation) in the high intensity group and 0.251 ± 0.086 in the low intensity group. Compared to the group with low signal intensity, the group with high signal intensity demonstrated significantly lower serum levels of alpha fetoprotein (AFP) (P = 0.0350), significantly higher progression-free survival (P = 0.0108), better differentiation of tumor grade at histologic examination (P = 0.0253), and significantly higher OATP8 expression (P = 0.0253). Conclusion: Patients with HCCs of high SI ratio in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging can respond better to HAIC.

AB - Purpose: We attempted to clarify the relationship between the signal intensity (SI) in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance (MR) imaging and the efficacy of hepatic arterial infusion chemotherapy (HAIC) in hepatocellular carcinomas (HCCs). Methods: We enrolled 14 patients with HCCs who underwent gadoxetic acid-enhanced MR imaging prior to HAIC using cisplatin and 5-fluorouracil. In the hepatobiliary phase, we calculated the SI of the HCCs and the background liver. In cases with multiple HCCs, we calculated the SI of the largest lesion. Patients were classified into high (n = 7) and low intensity (n = 7) groups based on the median value of the SI ratio (SI of the tumor/SI of the background liver). We analyzed progression-free survival using the Kaplan-Meier method and the log-rank test. In the 5 patients with a history of HCC surgery, we compared the expression of immunohistochemical organic anion-transporting polypeptide (OATP) 8 between the high and low intensity groups by chi-square test. Results: The SI ratios were 0.568 ± 0.093 (mean ± standard deviation) in the high intensity group and 0.251 ± 0.086 in the low intensity group. Compared to the group with low signal intensity, the group with high signal intensity demonstrated significantly lower serum levels of alpha fetoprotein (AFP) (P = 0.0350), significantly higher progression-free survival (P = 0.0108), better differentiation of tumor grade at histologic examination (P = 0.0253), and significantly higher OATP8 expression (P = 0.0253). Conclusion: Patients with HCCs of high SI ratio in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging can respond better to HAIC.

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