Quantitative analysis of multiphase magnetic resonance images may assist prediction of histopathological grade of small hepatocellular carcinoma.

Abstract

BackgroundThe aim of the study was to investigate whether preoperative quantitative analysis of multiphase magnetic resonance images may assist in predicting the pathological grade of small hepatocellular carcinoma (HCC).MethodsA total of 49 patients with small HCCs (≤3 cm) underwent multiphase magnetic resonance imaging (MRI) and were retrospectively reviewed. Routine unenhanced and post gadobenate dimeglumine (Gd-BOPTA)-enhanced MRI were preoperatively performed. Signal intensity (SI) was measured within the designated region of interest (ROI) including those of the lesion and paraspinous muscles. The lesion-to-paraspinous muscle relative contrast ratio (RCR) on T2-weighted (T2W) imaging, diffusion-weighted (DW) imaging, and dynamic phase Gd-BOPTA-enhanced T1W (T1-weighted) imaging were calculated, and statistical analysis was performed to determine the predictive power for the histological grade.ResultsIn all, 49 cases were included comprising 3 well-differentiated (WD) HCCs, 36 moderately differentiated (MD) HCCs, and 10 poorly differentiated (PD) HCCs. There was a negative correlation between the RCR and pathological grade of small HCC in the arterial phase [correlation coefficient (ρ)=−0.305, P<0.05]. However, there was no correlation between RCR in other phases and pathological grade (P>0.05 for all). There was also no correlation between tumor margin, tumor location, cystic/necrotic change, intratumoral fat, enhancement pattern, tumor capsule, tumor boundary or tumor size, and any of the differentiation categories (P>0.05 for all).ConclusionsThe lesion-to-paraspinous muscle RCR on arterial phase Gd-BOPTA-enhanced T1W imaging may be useful for the prediction of the histological characteristics of small HCC.