J Korean Soc Magn Reson Med.  2011 Dec;15(3):208-218. 10.13104/jksmrm.2011.15.3.208.

Usefulness of Gadobenate Dimeglumine - Enhanced Hepatobiliary Phase MR Imaging on Predicting Histological Grade of Hepatocellular Carcinoma

• Park SH
• Kim MJ
• Choi JY
• Lim JS
• Kim KW

• KMID: 2000049
• DOI: http://doi.org/10.13104/jksmrm.2011.15.3.208

Abstract

PURPOSE
To assess the usefulness of gadobenate dimeglumine-enhanced hepatobiliary phase MR imaging for evaluation of histological characteristics of hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
57 HCCs histopathologically proved by surgery in 51 patients were retrospectively evaluated. All patients underwent gadobenate dimeglumine-enhanced MR imaging prior to surgery. The signal-to-noise ratio (SNR) of lesion and liver, and the liver-to-lesion contrast-to-noise ratio (CNR) for both pre- and postcontrast hepatobiliary phase were measured and contrast enhancement ratio (CER) of lesion and liver were calculated to correlate with three groups stratified by histological grades (Edmondson-Steiner classification) of the lesions. The differences between means of each group were statistically analyzed with one-way analysis of variance test.
RESULTS
The liver-to-lesion CNRs of well-differentiated HCCs (n=9) on pre- (-0.8+/-13.2) and postcontrast hepatobiliary phase images (13.2+/-30.4) were significantly lower (p<0.05) compared to those of moderately (14.2+/-9.4 and 39.1+/-15.4 on pre- and postcontrast, respectively) (n=37) and poorly differentiated HCCs (18.6+/-11.3 and 39.3+/-27.9) (n=11), respectively. There were no significant difference for CERs between three histological tumor grades.
CONCLUSION
Gadobenate dimeglumine-enhanced hepatobiliary phase MR imaging can help predict the histological grades of hepatocellular carcinomas preoperatively, especially differentiating well- from moderately and poorly differentiated HCCs.

Keyword

Hepatocellular carcinoma; Magnetic resonance imaging; Gadobenate dimeglumine; Histological grade; Hepatobiliary phase

MeSH Terms

Carcinoma, Hepatocellular
Humans
Liver
Magnetic Resonance Imaging
Meglumine
Organometallic Compounds
Retrospective Studies
Signal-To-Noise Ratio
Meglumine
Organometallic Compounds

Figure

• 

  Fig. 1 The liver-to-lesion contrast-to-noise ratio (CNR) of well- (grade 1), moderately (grade 2), and poorly differentiated (grade 3) hepatocellular carcinomas on precontrast (a) and postcontrast hepatobiliary T1-weighted three dimensional-gradient echo images (b).

• 

  Fig. 2 A 65-year-old patient with well-differentiated HCC. (a) Precontrast T1-weighted three-dimentional gradient-echo image shows a slightly hyperintense signal mass (arrow) in the right lobe of the liver. (b) Gadobenate dimeglumine-enhanced hepatobiliary phase image demonstrates the lesion (arrow) shows markedly increased uptake of the contrast agent. Consequently the liver-to-lesion CNR of lesion on postcontrast hepatobiliary phase has a negative value.

• 

  Fig. 3 A 52-year-old patient with well-differentiated HCC. (a) Precontrast T1-weighted three-dimentional gradient-echo image shows a slightly hypointense signal mass (arrow) in the right lobe of the liver. (b) Gadobenate dimeglumine-enhanced hepatobiliary phase image demonstrates the lesion (arrow) shows slightly hypointense to surrounding liver parenchyma. Thus the lesion-to-liver CNR of lesion on postcontrast hepatobiliary phase has a low positive value.

• 

  Fig. 4 A 54-year-old patient with moderately differentiated HCC. (a) Precontrast T1-weighted three-dimentional gradient-echo image shows that a mass (arrow) in the right lobe of the liver has apparent hypointense signal intensity. (b) Gadobenate dimeglumine-enhanced hepatobiliary phase image demonstrates the lesion (arrow) is markedly hypointense signal intensity to surrounding liver parenchyma.

• 

  Fig. 5 A 56-year-old patient with poorly differentiated HCC. (a) Precontrast T1-weighted three-dimentional gradient-echo image shows that a mass (arrow) in the right lobe of the liver has apparent hypointense signal intensity. (b) Gadobenate dimeglumine-enhanced hepatobiliary phase image demonstrates the lesion (arrow) is markedly hypointense to surrounding liver parenchyma.

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