Preoperative Gd-EOB-DTPA-enhanced MRI may help predict macrotrabecular-massive subtype and postoperative recurrence in small hepatocellular carcinoma (≤ 3 cm).

Li Yang, Fei Wu, Wentao Wang, Shengxiang Rao, Ying Ding

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Article in European radiology, 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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Li Yang *Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China.

Fei Wu *Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China.

Wentao WangDepartment of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China.

Shengxiang RaoDepartment of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China.

Ying DingDepartment of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China. ding.ying@zs-hospital.sh.cn.ORCID http://orcid.org/0000-0002-4478-3436

Funding

National Outstanding Youth Science Fund Project of National Natural Science Foundation of China Grant No. 82202112Youth Project of Natural Science Foundation of Fujian Province Grant No. 2023J05293

6 · The paper itself

Abstract

objectiveTo assess the preoperative Gd-EOB-DTPA-enhanced MRI findings of macrotrabecular-massive (MTM) subtype and 3-year recurrence after surgery in small hepatocellular carcinoma (sHCC). MATERIALS AND

methodsThree hundred and fifteen consecutive patients (training cohort: n = 226; validation cohort: n = 89) with surgically confirmed sHCC (≤ 3 cm) and preoperative Gd-EOB-DTPA-enhanced MRI were retrospectively included. Significant predictors for MTM-sHCC were identified by univariate and multivariate analyses; a logistic regression model and nomogram were built. Kaplan-Meier analysis, log-rank test, and Cox proportional hazard regression were employed to assess 3-year recurrence after hepatectomy.

resultsHypovascular component ≥ 20%, intratumoral artery, and incomplete capsule in Gd-EOB-DTPA-enhanced MRI were independent factors for predicting MTM-sHCC. Areas under the curves of the logistic regression model of combining three predictors were 0.73 (95% CI: 0.67-0.79) and 0.75 (95% CI: 0.65-0.84) in the training and validation sets, respectively, and the sensitivity and specificity in validation set were 77.4% and 72.4%. Combining two or three significant imaging predictors was significantly associated with 3-year recurrence (HR = 2.55, 95% CI: 1.24-5.22; p = 0.011). Recurrence-free survival was significantly lower in patients with two or three significant predictors than in those with none in both the training (p = 0.028) and validation cohorts (p = 0.002).

conclusionsPreoperative Gd-EOB-DTPA-enhanced MRI findings, including hypovascular component ≥ 20%, intratumoral artery, and incomplete capsule, may help noninvasive prediction of MTM-sHCC and 3-year recurrence after surgery. KEY POINTS: Question It is to assess the imaging findings of MTM subtype and 3-year recurrence after surgery in sHCC. Findings Hypovascular component ≥ 20%, intratumoral artery, and incomplete capsule were independent factors for predicting MTM-sHCC. Clinical relevance Gd-EOB-DTPA-enhanced MRI findings for MTM-sHCC may be a useful predictor for 3-year recurrence.

Indexed as

Gd-EOB-DTPAHepatocellular carcinomaMagnetic resonance imagingRecurrence

Identifiers

PMID42734666

DOI10.3350/cmh.2022.0212

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.