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Clinical Article
Correlation between Gd-EOB-DTPA enhanced MRI T1 mapping and Ki-67 expression in hepatocellular carcinoma
LIU Ziwei  YANG Shaomin  CHEN Haixiong  GUO Baoliang  ZHANG Rong  ZHOU Cuiru  LI Xiaohong  HU Qiugen 

Cite this article as: Liu ZW, Yang SM, Chen HX, et al. Correlation between Gd-EOB-DTPA enhanced MRI T1 mapping and Ki-67 expression in hepatocellular carcinoma[J]. Chin J Magn Reson Imaging, 2022, 13(9): 35-40, 52. DOI:10.12015/issn.1674-8034.2022.09.007.

[Abstract] Objective To investigate the correlation between gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI T1 mapping and Ki-67 expression in hepatocellular carcinoma (HCC).Materials and Methods The data of 74 patients diagnosed with HCC in Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde) from July 2019 to December 2020 were retrospectively collected, and multiphase enhanced MRI scans with Gd-EOB-DTPA were performed before surgery, including pre-enhancement (Pre), arterial phase (AP), portal venous phase (PP), equilibrium phase (EP), hepatobiliary phase (HBP), T1 mapping, while Ki-67 staining was performed. Quantitative parameters including T1 relaxation time (T1rt), reduction rate of T1 relaxation time (rrT1rt), tumor to liver contrast ratio (TLR), contrast enhancement ratio (CER) were measured. The correlations between each quantitative parameter and the expression of pathological Ki-67 were analyzed using Spearman correlation coefficient. In addition, patients were divided into low Ki-67 expression group (≤25%, 40 cases) and high Ki-67 expression group (>25%, 34 cases), and the differences of quantitative parameters between the two groups were compared by independent samples t test or Mann-Whitney U test. The diagnostic efficacy of each parameter was analyzed according to the receiver operating characteristic curve, and the difference of the area under the curve (AUC) of each parameter was compared by DeLong test (P<0.05).Results T1rt-Pre, T1rt-20min are strongly positively correlated with Ki-67 [r=0.668 (95% CI: 0.515-0.780),r=0.659 (95% CI: 0.494-0.784),all P<0.001]; TLR-Pre, TLR-HBP are moderately negatively correlated with Ki-67 [r=-0.495 (95% CI: -0.647--0.300), r=-0.497 (95% CI: -0.670--0.288), all P<0.001]; TLR-PP, TLR-EP was weakly negatively correlated with Ki-67 [r=-0.272 (95% CI: -0.483--0.035), P=0.019; r=-0.362 (95% CI: -0.568--0.142), P=0.002]. There were significant differences in T1rt-Pre, T1rt-20min, TLR-Pre, TLR-AP, TLR-EP, TLR-HBP between the two groups (all P<0.05). The AUC of T1rt-Pre, T1rt-20min, TLR-Pre, TLR-AP, TLR-EP, TLR-HBP were 0.868 (95% CI: 0.769-0.936); 0.890 (95% CI: 0.795-0.951); 0.717 (95% CI: 0.670-0.869); 0.646 (95% CI: 0.527-0.754); 0.680 (95% CI: 0.561-0.784); 0.782 (95% CI: 0.670-0.869), respectively. The AUC values of T1rt-Pre and T1rt-20min were significantly different from those of TLR-Pre, TLR-AP and TLR-EP respectively (all P<0.05), but had no statistical difference with TLR-HBP.Conclusions T1rt-Pre, T1rt-20min on Gd-EOB-DTPA enhanced MRI combined with T1 mapping were strong positive correlation with the expression of Ki-67 in HCC, and T1rt-Pre and T1rt-20min has a high evaluation value for the expression of Ki-67 in HCC.
[Keywords] hepatocellular carcinoma;magnetic resonance imaging;Gd-EOB-DTPA;T1 mapping;Ki-67

LIU Ziwei1   YANG Shaomin2   CHEN Haixiong1   GUO Baoliang1   ZHANG Rong1   ZHOU Cuiru1   LI Xiaohong1   HU Qiugen1*  

1 Department of Radiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan 528308, China

2 Department of Radiology, the Affiliated Shunde Hospital of Guangzhou Medical University, Foshan 528315, China

*Hu QG, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Guangdong Medical Science and Technology Research Fund (No. A2021483); Foshan Self-Funded Science and Technology Project (No. 2020001005216).
Received  2022-05-16
Accepted  2022-09-07
DOI: 10.12015/issn.1674-8034.2022.09.007
Cite this article as: Liu ZW, Yang SM, Chen HX, et al. Correlation between Gd-EOB-DTPA enhanced MRI T1 mapping and Ki-67 expression in hepatocellular carcinoma[J]. Chin J Magn Reson Imaging, 2022, 13(9): 35-40, 52. DOI:10.12015/issn.1674-8034.2022.09.007.

Department of Medical Administration National Health and Health Commission of the People's Republic of China. Guidelines for diagnosis and treatment of primary liver cancer in China (2019 edition)[J]. Chin J Hepatol, 2020, 28(2): 112-128. DOI: 10.3760/cma.j.issn.1007-3418.2020.02.004.
Renzulli M, Brocchi S, Cucchetti A, et al. Can Current preoperative imaging Be used to detect microvascular invasion of hepatocellular carcinoma?[J]. Radiology, 2016, 279(2): 432-442. DOI: 10.1148/radiol.2015150998.
Chen B, Wu JX, Cheng SH, et al. Phase 2 study of adjuvant radiotherapy following narrow-margin hepatectomy in patients with HCC[J]. Hepatology, 2021, 74(5): 2595-2604. DOI: 10.1002/hep.31993.
Zhang X, Wu Z, Peng Y, et al. Correlationship between Ki67, VEGF, and p53 and Hepatocellular Carcinoma Recurrence in Liver Transplant Patients[J/OL]. Biomed Res Int, 2021[2022-05-16]. DOI: 10.1155/2021/6651397.
Li HH, Qi LN, Ma L, et al. Effect of KI-67 positive cellular index on prognosis after hepatectomy in Barcelona Clinic Liver Cancer stage A and B hepatocellular carcinoma with microvascular invasion[J]. Onco Targets Ther, 2018, 11: 4747-4754. DOI: 10.2147/OTT.S165244.
Tian G, Kong DX, Jiang TA, et al. Complications after percutaneous ultrasound-guided liver biopsy: a systematic review and Meta-analysis of a population of more than 12, 000 patients from 51 cohort studies[J]. J Ultrasound Med, 2020, 39(7): 1355-1365. DOI: 10.1002/jum.15229.
Dubé JP, Azzi Z, Semionov A, et al. Imaging of post transthoracic needle biopsy complications[J]. Can Assoc Radiol J, 2019, 70(2): 156-163. DOI: 10.1016/j.carj.2018.08.006.
Wang LL, Li JF, Lei JQ, et al. The value of the signal intensity of peritumoral tissue on Gd-EOB-DTPA dynamic enhanced MRI in assessment of microvascular invasion and pathological grade of hepatocellular carcinoma[J/OL]. Medicine (Baltimore). 2021, 100(20) [2022-05-16]. DOI: 10.1097/MD.0000000000025804.
Huang XZ, Xiao ZB, Zhang YY, et al. Hepatocellular carcinoma: retrospective evaluation of the correlation between gadobenate dimeglumine-enhanced magnetic resonance imaging and pathologic grade[J]. J Comput Assist Tomogr, 2018, 42(3): 365-372. DOI: 10.1097/RCT.0000000000000707.
Fan Y, Yu Y, Hu M, et al. Imaging features based on Gd-EOB-DTPA-enhanced MRI for predicting vessels encapsulating tumor clusters (VETC) in patients with hepatocellular carcinoma[J/OL]. Br J Radiol, 2021, 94(1119) [2022-05-16]. DOI: 10.1259/bjr.20200950.
Nakagawa M, Namimoto T, Shimizu K, et al. Measuring hepatic functional reserve using T1 mapping of Gd-EOB-DTPA enhanced 3T MR imaging: a preliminary study comparing with 99mTc GSA scintigraphy and signal intensity based parameters[J]. Eur J Radiol, 2017, 92: 116-123. DOI: 10.1016/j.ejrad.2017.05.011.
Haimerl M, Fuhrmann I, Poelsterl S, et al. Gd-EOB-DTPA-enhanced T1 relaxometry for assessment of liver function determined by real-time 13C-methacetin breath test[J]. Eur Radiol, 2018, 28(9): 3591-3600. DOI: 10.1007/s00330-018-5337-y.
Cheng G, Dong Y, Yu XY, et al. The value of Gd-EOB-DTPA enhanced T1 mapping in hepatocellular carcinoma with different degrees of differentiation[J]. J Clin Radiol, 2021, 40(4): 717-722. DOI: 10.13437/j.cnki.jcr.2021.04.021.
Rao C, Wang X, Li M, et al. Value of T1 mapping on gadoxetic acid-enhanced MRI for microvascular invasion of hepatocellular carcinoma: a retrospective study[J/OL]. BMC Med Imaging, 2020, 20(1) [2022-05-16]. DOI: 10.1186/s12880-020-00433-y.
Wang WT, Zhu S, Ding Y, et al. T1 mapping on gadoxetic acid-enhanced MR imaging predicts recurrence of hepatocellular carcinoma after hepatectomy[J]. Eur J Radiol, 2018, 103: 25-31. DOI: 10.1016/j.ejrad.2018.03.027.
Ye Z, Cao L, Wei Y, et al. Preoperative prediction of hepatocellular carcinoma with highly aggressive characteristics using quantitative parameters derived from hepatobiliary phase MR images[J/OL]. Ann Transl Med, 2020, 8(4) [2022-05-16]. DOI: 10.21037/atm.2020.01.04.
Fujita N, Nishie A, Asayama Y, et al. Significance of the signal intensity of gadoxetic acid-enhanced MR imaging for predicting the efficacy of hepatic arterial infusion chemotherapy in hepatocellular carcinoma[J]. Magn Reson Med Sci, 2016, 15(1): 111-120. DOI: 10.2463/mrms.2015-0012.
Bai K, Cao Y, Huang QJ, et al. Prognostic value of Ki67 expression for patients with surgically resected hepatocellular carcinoma: perspectives from a high incidence area[J]. Clin Lab, 2017, 63(2): 355-364. DOI: 10.7754/Clin.Lab.2016.160638.
Yao Z, Dong Y, Wu GQ, et al. Preoperative diagnosis and prediction of hepatocellular carcinoma: Radiomics analysis based on multi-modal ultrasound images[J]. BMC Cancer, 2018, 18(1) [2022-05-16]. DOI: 10.1186/s12885-018-5003-4.
Chen YD, Qin XL, Long LL, et al. Diagnostic value of Gd-EOB-DTPA-enhanced MRI for the expression of Ki67 and microvascular density in hepatocellular carcinoma[J]. J Magn Reson Imaging, 2020, 51(6): 1755-1763. DOI: 10.1002/jmri.26974.
Ba-Ssalamah A, Bastati N, Wibmer A, et al. Hepatic gadoxetic acid uptake as a measure of diffuse liver disease: where are we?[J]. J Magn Reson Imaging, 2017, 45(3): 646-659. DOI: 10.1002/jmri.25518.
Pan S, Wang XQ, Guo QY. Quantitative assessment of hepatic fibrosis in chronic hepatitis B and C: T1 mapping on Gd-EOB-DTPA-enhanced liver magnetic resonance imaging[J]. World J Gastroenterol, 2018, 24(18): 2024-2035. DOI: 10.3748/wjg.v24.i18.2024.
Ding Y, Rao SX, Zhu T, et al. Liver fibrosis staging using T1 mapping on gadoxetic acid-enhanced MRI compared with DW imaging[J]. Clin Radiol, 2015, 70(10): 1096-1103. DOI: 10.1016/j.crad.2015.04.014.
Kamimura K, Fukukura Y, Yoneyama T, et al. Quantitative evaluation of liver function with T1 relaxation time index on Gd-EOB-DTPA-enhanced MRI: comparison with signal intensity-based indices[J]. J Magn Reson Imaging, 2014, 40(4): 884-889. DOI: 10.1002/jmri.24443.
Jiang H, Jiang QL, Liu ZQ, et al. The value of Gd-BOPTA enhanced MRI for predicting the expression of Ki-67 in hepatocellular carcinoma[J]. J Med Imaging, 2021, 31(10): 1707-1711.
Hu MJ, Yu YX, Fan YF, et al. The value of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced MRI nomogram model for predicting Ki-67 expression of hepatocellular carcinoma[J]. Chin J Radiol, 2020, 54(12): 1185-1190. DOI: 10.3760/cma.j.cn112149-20191206-00968.
Li XQ, Wang X, Zhao DW, et al. Application of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma[J/OL]. World J Surg Oncol, 2020, 18(1) [2022-05-16]. DOI: 10.1186/s12957-020-01996-4.
Murakami T, Sofue K, Hori M. Diagnosis of hepatocellular carcinoma using Gd-EOB-DTPA MR imaging[J]. Magn Reson Med Sci, 2022, 21(1): 168-181. DOI: 10.2463/mrms.rev.2021-0031.
Zhou XJ, Long LL, Mo ZQ, et al. OATP1B3 expression in hepatocellular carcinoma correlates with intralesional Gd-EOB-DTPA uptake and signal intensity on Gd-EOB-DTPA-enhanced MRI[J]. Cancer Manag Res, 2021, 13: 1169-1177. DOI: 10.2147/CMAR.S292197.

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