Diagnostic Value of Gd-EOB-DTPA-Enhanced MRI for the Expression of Ki67 and Microvascular Density in Hepatocellular Carcinoma.

Contract Grant Sponsor: National Natural Science Foundation of China; Contract grant number: 81260214.

Background: Recent studies have highlighted the diagnostic value of Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI in small hepatocellular carcinoma (HCC). Ki67 and CD34 are histologic markers that reflect the proliferation of tumor cells and the microvascular density (MVD).

Purpose: To explore the diagnostic value of Gd-EOB-DTPA-enhanced MRI for Ki67 expression and MVD in HCC.

Study Type: Retrospective.

Subjects: In all, 180 patients with HCC.

Field Strength/sequence: 3.0T, Gd-EOB-DTPA-enhanced T WI volumetric interpolated breath-hold examination (VIBE) axial fat suppression plain, and enhanced scanning.

Assessment: The T relaxation time (T rt) and signal intensity (SI) of the lesion were measured. The Ki67 expressions and MVD were evaluated by immunohistochemistry.

Statistical Test: Receiver operating characteristic (ROC) curves were used to analyze the diagnostic efficacy of T rt for high Ki67 expression (≥50%) and high MVD (≥100).

Results: The T rt-20min, rrT rt-20min, and SI-hepatobiliary phase (SI-HBP) were strongly correlated with Ki67, the r values were 0.846, -0.765, and -0.760 (P < 0.05), respectively. There were moderate correlations with CD34, with r values -0.444, 0.336, and -0.463 (P < 0.05), respectively. The T rt-Pre, T rt-20min, SI-Pre, and SI-HBP were significantly different both between the high and low ki67 expression groups (P < 0.05) and between the high MVD and low MVD groups (P < 0.05). In the two groups the T rt-20min and SI-HBP was 800.06 ± 128.91 vs. 530.06 ± 139.29 (P < 0.05) and 122.29 ± 39.39 vs. 173.49 ± 46.15 (P < 0.05); T rt-20min was found to have high diagnostic efficiency for high ki67 expression (area under the curve [AUC], 0.937; P < 0.05) T rt-20min had moderate diagnostic value for high MVD (AUC, 0.716; P < 0.05).

Data Conclusion: The T rt and SI of Gd-EOB-DTPA-enhanced MRI were correlated with Ki67 expression and MVD. T rt-20min has a high diagnostic value for high ki67 expression and high MVD in HCC tissues.

Level Of Evidence: 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1755-1763.