Journal
EUROPEAN RADIOLOGY
Volume 30, Issue 8, Pages 4182-4192Publisher
SPRINGER
DOI: 10.1007/s00330-020-06792-y
Keywords
Magnetic resonance elastography; Hepatocellular carcinoma; Liver fibrosis; Recurrence; Prognosis
Funding
- Bio & Medical Technology Development Program of the NRF - Korean government (MSIT) [NRF-2018M3A9E8023861, NRF-017R1D1A1B03033996, NRF-2017R1D1A1B03029959]
- Ajou University School of Medicine
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Objectives Magnetic resonance elastography (MRE) is a non-invasive tool for measuring liver stiffness (LS) with high diagnostic accuracy. This study investigated whether quantified LS by MRE could predict early recurrence of patients with hepatocellular carcinoma (HCC) within the Milan criteria. Methods A prospectively collected cohort, which included the HCC patients who underwent MRE before treatment (an HCC-MRE cohort), was analyzed. In the HCC-MRE cohort, only patients under the Milan criteria, who underwent hepatic resection, radiofrequency ablation (RFA), or transarterial chemoembolization (TACE), were reviewed. We investigated whether LS assessed by MRE was an independent predictor of early recurrence using Cox regressions and Kaplan-Meier analyses. Results A total of 192 HCC patients under the Milan criteria who underwent hepatic resection (n = 96), RFA (n = 23), or TACE (n = 73) were included. Higher LS ratings (kPa; hazard ratio [HR] = 1.12; 95% confidence interval [CI] = 1.01-1.25; p = 0.040) emerged as an independent risk factor for early tumor recurrence. In the subgroup analysis, higher LS ratings were associated with higher risks of early HCC recurrence in both the resection/RFA group (> 4.5 kPa; HR = 2.95; 95% CI = 1.26-6.94; p = 0.013) and the TACE group (> 6 kPa; HR = 2.94; 95% CI = 1.27-6.83; p = 0.012). Conclusion LS assessed by MRE was an independent predictor of early recurrence among HCC patients under the Milan criteria after achieving a complete response.
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