Magnetic resonance elastography as a preoperative assessment for predicting intrahepatic recurrence in patients with...

Area of Science:

• Hepatobiliary imaging
• Medical physics
• Oncology

Background:

• Hepatocellular carcinoma (HCC) recurrence after resection poses a significant clinical challenge.
• Accurate prediction of intrahepatic recurrence is crucial for patient management.
• Noninvasive imaging techniques are sought to improve prognostication.

Purpose of the Study:

• To identify preoperative clinical and imaging predictors of intrahepatic recurrence following curative HCC resection.
• To evaluate the efficacy of Magnetic Resonance Elastography (MRE) in predicting intrahepatic recurrence.

Main Methods:

• Retrospective analysis of 80 treatment-naïve HCC patients undergoing preoperative MRI and MRE.
• Liver stiffness (LS) measurement via MRE, with ROC analysis to determine recurrence prediction cutoff.
• Assessment of MRI-based tumor features, including LI-RADS and microvascular invasion (MVI).
• Kaplan-Meier and Cox proportional hazards modeling for recurrence-free survival (RFS) analysis.

Main Results:

• Intrahepatic recurrence occurred in 16.3% of patients during a median 32-month follow-up.
• An LS cutoff of ≥4.35 kPa identified MRE-recurrence.
• MRE-recurrence was associated with significantly lower 4-year RFS rates (48.9% vs. 93.4%, p=0.001).
• MRE-recurrence (HR, 5.9) and MVI (HR, 3.4) were independent predictors of recurrence.

Conclusions:

• MRE-recurrence is a significant predictor of intrahepatic recurrence after HCC resection.
• MRE, alongside MVI, offers valuable preoperative prognostic information.
• These findings support the use of MRE for risk stratification in HCC patients.