A nomogram based on clinical factors and gadobenate dimeglumine-enhanced MRI for prediction of GPC-3 expression in hepatocellular carcinoma / 中华放射学杂志

Objective:To investigate the predictive value of a nomogram based on clinical factors and gadobenate dimeglumine (Gd-BOPTA)-enhanced MRI for predicting the expression of Glypican-3 (GPC-3) in hepatocellular carcinoma (HCC).Methods:The clinical and imaging data of 85 patients with HCC confirmed by pathology in the Provincial Hospital of Shandong First Medical University from July 2018 to June 2021 were retrospectively collected. All the patients underwent Gd-BOPTA-enhanced MRI scan before operation. According to the expression of GPC-3 by immunohistochemistry, the patients were divided into GPC-3 positive group (55 cases) and GPC-3 negative group (30 cases). The clinical data of patients were collected, including gender, age, hepatitis, cirrhosis, alpha-fetoprotein (AFP), alanine aminotransferase, aspartate aminotransferase, and glutamine transferase levels. The MRI qualitative signs including tumor margin, ring enhancement, intratumoral hemorrhage, enhanced capsule, and satellite nodules were reviewed. MRI quantitative parameters including the largest tumor diameter, Gd-BOPTA-enhanced tumor-to-liver parenchyma signal ratio (TLR) and tumor enhancement ratio (TER) in arterial phase (AP), portal venous phase (PP), and hepatobiliary phase (HBP) were calculated. The independent sample t-test or Mann-Whitney U test were used to compare the quantitative data between the two groups, and the χ2 test was used to compare the qualitative data between the two groups. Multivariate logistic regression analysis was used to identify the independent predictors of GPC-3 expression, and a nomogram model was established. The receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of each independent factor and nomogram, and DeLong test was used to compare differences in area under the curve (AUC). Results:There were significant differences in AFP, tumor margin, intratumoral hemorrhage, and TLR-AP, TLR-PP and TLR-HBP between GPC-3 positive and negative groups (all P<0.05). Multivariate logistic regression results showed that AFP≥20 μg/L, intratumoral hemorrhage and TLR-HBP were independent predictors of GPC-3 positive expression in HCC (OR=3.816, 4.788, 0.001, all P<0.05). The preoperative clinical and Gd-BOPTA-enhanced MRI nomogram model for predicting GPC-3 expression in hepatocellular carcinoma was established. The AUC of AFP≥20 μg/L, intratumoral hemorrhage, TLR-HBP and nomogram model in predicting GPC-3 positive expression were 0.688, 0.697, 0.808, and 0.879, respectively. The AUC of nomogram model was significantly better than those of the other three single indicator ( Z=3.82, 4.13, 2.04, P<0.001,<0.001,=0.042). Conclusion:The nomogram model based on indicators of clinical and qualitative and quantitative Gd-BOPTA-enhanced MRI has better performance in predicting the expression of HCC GPC-3 before surgery, which is higher than those of each single indicator.

Gd-BOPTA enhanced MRI in evaluation of reserved liver function / 中国医学影像技术

Objective To investigate the value of gadobenate dimeglumine (Gd-BOPTA) enhanced MRI in evaluation of reserved liver function.Methods Totally 68 patients were included among 143 patients who underwent Gd-BOPTA en hanced MRI.The enhancement ratios of SNR and CNR of right lobe,left lobe and caudal lobe were calculated on the ima ges from liver acquisition with volume acceleration flex sequence (LAVA-Flex) of hepatobiliary phase.The average values of right and left lobes and of three lobes were calculated and compared.According to Child-TurcottePugh (CTP) classification,the patients were divided into Class A and Class B.Integrated model of end-stage liver disease (iMELD) was applied to divide the patients into iMELD≤30 and iMELD＞30.The differences of SNR and CNR enhanced ratios were com pared,and the relationship between enhancement ratios and iMELD scores was analyzed.Results There were no significant differences in the enhancement ratios of SNR and CNR among each lobe,the average of two or three lobes (all P＞0.05).The SNR and CNR enhancement ratios of Class A were higher than those of Class B (both P＜0.05).The SNR and CNR enhancement ratios of iMELD≤≤30 were higher than those of iMELD＞30 (both P＜0.05).The SNR and CNR enhancement ratios showed negative correlations with iMELD scores (SNR:r=0.29,P-0.02;CNR:r=-0.32,P=0.01).Conclusion The intracellular uptake of Gd-BOPTA decreases with impaired liver function.Measurement of the de gree of parenchymal enhancement of any lobe or the whole liver on the images of Gd-BOPTA enhancement MRI in the hepatobiliary phase might reflect the reserved liver function.

Study of relationship between liver function and the enhancement degree of liver parenchyma in the hepatobiliary phase with Gd-BOPTA / 实用放射学杂志

Objective To explore the relationship between the MRI enhancement ratios of liver parenchyma in hepatobiliary phase with gadobenate dimeglumine (Gd-BOPTA)and liver function.Methods Fifty-nine patients who underwent Gd-BOPTA-enhanced MRI were retrospectively enrolled in the study.The enhancement ratio of signal to noise ratio and enhancement ratio of the contrast ratio were calculated.The relationships between the enhancement ratio and CTP grading and MELD score were analyzed.Results The signal enhancement ratios in hepatobiliary phase in patients with CTP A classification were higher than those with CTP B classi-fication (P <0.01).Meanwhile,the ratios in patients with MELD scores less than 10 points were higher than those with MELD scores more than 10 points (P <0.01).Conclusion The MR enhancement degree of liver parenchyma in the hepatobiliary phase with Gd-BOPTA may reflect the liver function.

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

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.

Gadoxetic Acid (Gd-EOB-DTPA)-Enhanced MRI versus Gadobenate Dimeglumine (Gd-BOPTA)-Enhanced MRI for Preoperatively Detecting Hepatocellular Carcinoma: an Initial Experience

OBJECTIVE: This study was designed to compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with gadobenate dimeglumine-enhanced MRI for preoperatively detecting hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Eighteen consecutive patients (17 men and one woman, age range: 31-73 years) with 22 HCCs underwent examinations with gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI on a 3.0-Tesla unit. The diagnosis of HCC was established after surgical resection and pathological conformation. Three observers independently reviewed each MR image in a random order on a tumor-by-tumor basis. The diagnostic accuracy of these techniques for the detection of HCC was assessed by performing an alternative free-response receiver operating characteristic (ROC) analysis. The sensitivity and positive predictive values were evaluated. RESULTS: The average value of the area under the ROC curve (Az) for gadoxetic acid enhanced MRI (0.887) was not significantly different from the Az (0.899) for gadobenate dimeglumine-enhanced MRI (p > 0.05). The overall sensitivities of gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI were 80% and 83%, respectively, with no significant difference (p > 0.05). The differences of the positive predictive values for the two contrast agents for each observer were not statistically significant (p > 0.05). CONCLUSION: The diagnostic performance of gadoxetic acid-enhanced MRI and gadobenate dimeglumine-enhanced MRI for preoperatively detecting HCC is quite similar.

Hypointense Hepatic Lesions Depicted on Gadobenate Dimeglumine-Enhanced Three-Hour Delayed Hepatobiliary-Phase MR Imaging: Differentiation between Benignancy and Malignancy

Gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging simultaneously provides both morphological and functional information by the acquisition of dynamic and hepatobiliary-phase imaging. Focal lesions with no functioning hepatocytes, where hepatobiliary metabolism is blocked or inhibited, are generally unable to uptake and excrete gadobenate dimeglumine into the bile. Such lesions are typically malignant and usually appear hypointense as compared to the normal liver parenchyma as seen on hepatobiliary-phase imaging. However, various benign hepatic lesions may also be hypointense due to (a) the presence of no functioning hepatocytes, (b) damage to the functioning hepatocytes or (c) impairment of biliary function as depicted on hepatobiliary-phase imaging. All of these imaging features may result in recognition of the benign hepatic lesions as hepatic malignancies. As depicted on three-hour delayed hepatobiliary-phase imaging, peripheral iso/hyperintensity due to fibrotic tissue compared to the hypointense center with a fuzzy margin may be a clue for the presence of a benign hepatic lesion. In contrast, peripheral hypointensity due to rich tumoral cellularity compared to the center with a clear margin may favor an indication of the presence of a malignant hepatic lesion.

Value of Gd-BOPTA in Diagnosis of Focal Liver Lesion and Biliary System Disease / 中国普外基础与临床杂志

Objective To investigate the diagnostic value of a double action MR contrast agent——gadobenate dimeglumine (Gd-BOPTA) for focal liver lesion and biliary system disease.Methods Articles about Gd-BOPTA in CNKI and PubMed for the past few years were searched and the value of Gd-BOPTA in the diagnosis of focal liver lesion and biliary system disease was summarized.Results For focal liver lesion,Gd-BOPTA not only can reveal blood supply of the lesion,but also reveal the hepatocellular functional status in the lesion.For biliary system,biliary excretion of Gd-BOPTA can be used to evaluate the anatomic structure of bile duct,function of gallbladder and biliary system disease.Conclusions Gd-BOPTA has an important value in the diagnosis of focal liver lesion and biliary system disease.Gd-BOPTA may have wider applications in the future.