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18.03.2020 | Gastrointestinal | Ausgabe 8/2020

European Radiology 8/2020

Liver stiffness measured by MR elastography is a predictor of early HCC recurrence after treatment

Zeitschrift:
European Radiology > Ausgabe 8/2020
Autoren:
Hyo Jung Cho, Bohyun Kim, Hye Jin Kim, Jimi Huh, Jai Keun Kim, Jei Hee Lee, Chul Won Seo, Hye Ri Ahn, Jung Woo Eun, Soon Sun Kim, Sung Won Cho, Jae Youn Cheong
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00330-020-06792-y) contains supplementary material, which is available to authorized users.
Hyo Jung Cho and Bohyun Kim contributed equally to this work.

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Abstract

Objectives

Magnetic resonance elastography (MRE) is a non-invasive tool for measuring liver stiffness (LS) with high diagnostic accuracy. This study investigated whether quantified LS by MRE could predict early recurrence of patients with hepatocellular carcinoma (HCC) within the Milan criteria.

Methods

A prospectively collected cohort, which included the HCC patients who underwent MRE before treatment (an HCC-MRE cohort), was analyzed. In the HCC-MRE cohort, only patients under the Milan criteria, who underwent hepatic resection, radiofrequency ablation (RFA), or transarterial chemoembolization (TACE), were reviewed. We investigated whether LS assessed by MRE was an independent predictor of early recurrence using Cox regressions and Kaplan-Meier analyses.

Results

A total of 192 HCC patients under the Milan criteria who underwent hepatic resection (n = 96), RFA (n = 23), or TACE (n = 73) were included. Higher LS ratings (kPa; hazard ratio [HR] = 1.12; 95% confidence interval [CI] = 1.01–1.25; p = 0.040) emerged as an independent risk factor for early tumor recurrence. In the subgroup analysis, higher LS ratings were associated with higher risks of early HCC recurrence in both the resection/RFA group (> 4.5 kPa; HR = 2.95; 95% CI = 1.26–6.94; p = 0.013) and the TACE group (> 6 kPa; HR = 2.94; 95% CI = 1.27–6.83; p = 0.012).

Conclusion

LS assessed by MRE was an independent predictor of early recurrence among HCC patients under the Milan criteria after achieving a complete response.

Key Points

• Liver parenchymal stiffness measured by MRE predicts early recurrence of treated HCC under Milan criteria.
• A liver stiffness > 5.5 kPa was associated with worse recurrence-free survival.
• Patients with high pre-treatment LS may benefit from stringent follow-up.

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