Hepatocellular carcinoma with marginal superparamagnetic iron oxide uptake on T2*-weighted magnetic resonance
Kousei Ishigami1, Tsuyoshi Tajima, Nobuhiro Fujita
1Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. Ishigamikousei@aol.com
Purpose:
To evaluate the characteristics of hepatocellular carcinomas (HCCs) with marginal superparamagnetic iron oxide (SPIO) uptake on T2*-weighted MRI.
Materials And Methods:
The study group consisted of 73 patients with 83 surgically resected HCCs. Preoperative SPIO-enhanced MRI studies were retrospectively reviewed. Marginal SPIO uptake was considered positive if a rim-like or band-like low intensity area was present on SPIO-enhanced T2*-weighted images. The prevalence of marginal SPIO uptake was evaluated. Pathological specimens with hematoxylin and eosin staining and immunohistochemical staining of CD68 were reviewed in HCCs with marginal SPIO uptake and 33 HCCs without marginal SPIO uptake (control group).
Results:
Ten of 83 (12%) HCCs showed marginal SPIO uptake. All HCCs were hypervascular, and only one nodule showed a nodule-in-nodule appearance on imaging findings. The pathology specimens suggested possible causes of marginal SPIO uptake, including marginal macrophage infiltration in moderately or poorly differentiated HCC (n=4), residual normal hepatic tissue at the marginal area of confluent multinodular or single nodular with extranodular growth type HCC (n=3), and a well-differentiated HCC component in nodule-in-nodule type HCC (n=3). Marginal macrophage infiltration was not seen in the control group.
Conclusion:
SPIO-enhanced MRI may be able to demonstrate marginal macrophage infiltration in HCC.
Insights
Superparamagnetic iron oxide (SPIO)-enhanced MRI may identify marginal macrophage infiltration in hepatocellular carcinoma (HCC). This imaging technique shows characteristics of HCCs with marginal SPIO uptake, aiding in diagnosis.
Area of Science:
- Hepatobiliary imaging
- Oncologic imaging
- Magnetic resonance imaging
Background:
- Hepatocellular carcinoma (HCC) is a primary liver malignancy.
- Superparamagnetic iron oxide (SPIO) is an MRI contrast agent used in liver imaging.
- Marginal SPIO uptake on T2*-weighted MRI in HCC is not well characterized.
Purpose of the Study:
- To evaluate the imaging characteristics of HCCs exhibiting marginal SPIO uptake on T2*-weighted MRI.
- To correlate MRI findings with pathological features of HCCs.
Main Methods:
- Retrospective review of 83 surgically resected HCCs using preoperative SPIO-enhanced MRI.
- Definition of marginal SPIO uptake as rim-like or band-like low intensity on T2*-weighted images.
- Pathological analysis including H&E and CD68 immunohistochemistry for HCCs with and without marginal SPIO uptake.
Main Results:
- 12% (10/83) of HCCs demonstrated marginal SPIO uptake.
- Causes included marginal macrophage infiltration (n=4), residual normal hepatic tissue (n=3), and well-differentiated HCC components (n=3).
- Marginal macrophage infiltration was specifically associated with marginal SPIO uptake and absent in controls.
Conclusions:
- SPIO-enhanced MRI can potentially visualize marginal macrophage infiltration in HCC.
- This finding may contribute to understanding HCC heterogeneity and behavior.
