Pharmacokinetic analysis of different contrast agents on multiphase enhanced MRI for microvascular invasion: preoperative prediction in hepatocellular carcinoma.

Abstract

The preoperative diagnosis of microvascular invasion (MVI) for the solitary small hepatocellular carcinoma (sHCC) is crucial for the decision of surgical strategies. To compare the kinetic parameters and diagnostic effects of two contrast agents for preoperatively predicting MVI of sHCC on multiphase enhanced magnetic resonance imaging (MRI). Two groups of patients with known solitary sHCC underwent an enhanced MRI examination before hepatic resection: Data A (n = 61) patients underwent Gd-EOB-DTPA-enhanced MRI, and Data B (n = 41) patients had a normal contrast agent. The two sets of data were processed in the same way. Arterial peritumoral enhancement measured from multiphase enhanced MRI was analyzed using quantitative kinetic parameters, including initial signal enhancement (SE1), peak signal enhancement (SEpeak), and calculation of the signal enhancement ratio (SER). The statistical analysis showed that the average SE1 and SER (Data A) for the MVI-positive group were significantly higher (P < 0.05) than those in the MVI-negative group. The SER (Data B) and SEpeak showed no significant difference for either group. In Data A, the receiver operating characteristic analysis between the two groups had an area under the curve of 0.74 and 0.71 for SE1 and SER, respectively, which was higher than that of Data B. The different contrast agents had the same enhancement curve trend. Gd-EOB-DTPA-enhanced MRI had a better quantitative kinetic parameter analysis effect for arterial peritumoral enhancement on predicting MVI of sHCC in clinical practice.