ArticleQuantitative imaging in medicine and surgery2026
Magnetic resonance imaging R2* mapping for evaluating Ki-67 proliferation index and cytokeratin 19 expression in solitary iron-sparing hepatocellular carcinoma: a retrospective single-center study.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Iron may be involved in the occurrence and development of hepatocellular carcinoma (HCC), and R2* relaxometry is the preferred noninvasive method for iron quantification. However, whether hepatic and intratumoral R2* values are associated with Ki-67 proliferation index (PI) and cytokeratin 19 (CK19) expression in iron-sparing HCC remains unclear. This study aimed to determine the associations of preoperative hepatic and intratumoral R2* values with Ki-67 PI and CK19 expression in patients with solitary iron-sparing HCC. Methods: Consecutive adult patients with solitary HCC who underwent surgery at a single center between May 2018 and May 2025 were retrospectively enrolled. All patients had intratumoral iron-sparing as indicated on preoperative 3.0-T magnetic resonance imaging (MRI) R2* imaging and had complete postoperative pathological data for Ki-67 and CK19 expression. Hepatic and intratumoral R2* values were measured via region of interest (ROI) analysis. According to the cohort median, a high Ki-67 PI was defined as Ki-67 positivity in >20% of tumor cells, and CK19 positivity was defined membranous/cytoplasmic staining in ≥5% of tumor cells. Meanwhile, hepatic R2* was categorized at a cutoff of 136 s Results: Eighty patients were enrolled (mean age 55.11±9.69 years; 93.75% male). A high Ki-67 PI was present in 43 (53.75%) patients, and positive CK19 expression was present in 16 (20.00%) patients. The high Ki-67 PI group, as compared to the low Ki-67 PI group, had higher AFP levels (P=0.035) and lower hepatic R2* values (P=0.038). According to multivariate exact logistic analysis, the independent predictors of a high Ki-67 PI were AFP >400 ng/mL [odds ratio (OR) =19.04; 95% confidence interval (CI): 2.98-121.46, P=0.002] and a hepatic R2* value ≥136 s Conclusions: In this retrospective single-center study of patients with solitary iron-sparing HCC, it was found that a combination of hepatic R2* (≥136 s
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