Value of T1 mapping on gadoxetic acid-enhanced MRI for microvascular invasion of hepatocellular carcinoma: a retrospective study

Abstract

Background: To evaluate the utility of non-invasive parameters derived from T1 mapping and diffusion-weighted imaging (DWI) on gadoxetic acid-enhanced MRI for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC).

Methods: A total of 94 patients with single HCC undergoing partial hepatectomy was analyzed in this retrospective study. Preoperative T1 mapping and DWI on gadoxetic acid-enhanced MRI was performed. The parameters including precontrast, postcontrast and reduction rate of T1 relaxation time and apparent diffusion coefficient (ADC) values were measured for differentiating MVI-positive HCCs (n = 38) from MVI-negative HCCs (n = 56). The receiver operating characteristic curve (ROC) was analyzed to compare the diagnostic performance of the calculated parameters.

Results: MVI-positive HCCs demonstrated a significantly lower reduction rate of T1 relaxation time than that of MVI-negative HCCs (39.4% vs 49.9, P < 0.001). The areas under receiver operating characteristic curve (AUC) were 0.587, 0.728, 0.824, 0,690 and 0.862 for the precontrast, postcontrast, reduction rate of T1 relaxation time, ADC and the combination of reduction rate and ADC, respectively. The cut-off value of the reduction rate and ADC calculated through maximal Youden index in ROC analyses was 44.9% and 1553.5 s/mm². To achieve a better diagnostic performance, the criteria of combining the reduction rate lower than 44.9% and the ADC value lower than 1553.5 s/mm² was proposed with a high specificity of 91.8% and accuracy of 80.9%.

Conclusions: The proposed criteria of combining the reduction rate of T1 relaxation time lower than 44.9% and the ADC value lower than 1553.5 s/mm² on gadoxetic acid-enhanced MRI holds promise for evaluating MVI status of HCC.

Keywords: Gd-EOB-DTPA; Hepatocellular carcinoma; Magnetic resonance imaging; Microvascular invasion.

Fig. 1

Flow chart of patients selection

Fig. 2

The ROIs of HCC was drawn on the corresponding ADC maps and postcontrast T1 maps. a the HCC on right lobe of liver showing hyperintensity on DWI maps of b = 500 mm²/s; b ROI was drawn on corresponding ADC maps; c the HCC on right lobe of liver showing hypointensity on hepatobiliary phase; d ROI was drawn on postcontrast T1 maps

Fig. 3

Comparisons of mean values and standard deviation of precontrast and postcontrast T1 relaxation time between MVI-positive and MVI-negative HCCs. Each box shows the mean values and 25th and 75th percentiles. • represents outliers of more than 95th percentiles

Fig. 4

Comparisons of mean values and standard deviation of reduction rate T1 relaxation time between MVI-positive and MVI-negative HCCs. The box shows the mean value and 25th and 75th percentiles. • represents outliers of more than 95th percentiles

Fig. 5

The utility of receiver operating characteristic curve of precontrst, postcontrast and reduction rate of T1 relaxation time, the ADC value and the combination of the reduction rate and the ADC value to discriminate MVI-positive and MVI-negative HCCs