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Value of tumor stiffness measured with MR elastography for assessment of response of hepatocellular carcinoma to locoregional therapy

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Abstract

Purpose

The aim of the study was to correlate tumor stiffness (TS) measured with MR elastography (MRE) with degree of tumor enhancement and necrosis on contrast-enhanced T1-weighted imaging (CE-T1WI) in hepatocellular carcinomas (HCC) treated with Yttrium-90 radioembolization (RE) or transarterial chemoembolization plus radiofrequency ablation (TACE/RFA).

Material and methods

This retrospective study was IRB-approved and the requirement for informed consent was waived. 52 patients (M/F 38/14, mean age 67 years) with HCC who underwent RE (n = 22) or TACE/RFA (n = 30) and 11 controls (M/F 6/5, mean age 64 years) with newly diagnosed untreated HCC were included. The MRI protocol included a 2D MRE sequence. TS and LS (liver stiffness) were measured on stiffness maps. Degree of tumor necrosis was assessed on subtraction images by two observers, and tumor enhancement ratios (ER) were calculated on CE-T1WI by one observer.

Results

63 HCCs (mean size 3.2 ± 1.6 cm) were evaluated. TS was significantly lower in treated vs. untreated tumors (3.9 ± 1.8 vs. 6.9 ± 3.4 kPa, p = 0.006) and also compared to LS (5.3 ± 2.2 kPa, p = 0.002). There were significant correlations between TS and each of enhancement ratios (r = 0.514, p = 0.0001), and percentage of necrosis (r = −0.540, p = 0.0001). The observed correlations were stronger in patients treated with RE (TS vs. ER, r = 0.636, TS vs. necrosis, r = −0.711, both p = 0.0001). Percentage of necrosis and T1-signal in native T1WI were significant independent predictors of TS (p = 0.0001 and 0.001, respectively).

Conclusion

TS measured with MRE shows a significant correlation with tumor enhancement and necrosis, especially in HCCs treated with RE.

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Authors and Affiliations

  1. Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA

    Sonja Gordic, Paul Kennedy, Cecilia Besa, Mathilde Wagner, Octavia Bane & Bachir Taouli

  2. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland

    Sonja Gordic

  3. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jad Bou Ayache, Edward Kim & Bachir Taouli

  4. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Richard L. Ehman

Authors
  1. Sonja Gordic
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  2. Jad Bou Ayache
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  3. Paul Kennedy
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  4. Cecilia Besa
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  5. Mathilde Wagner
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  6. Octavia Bane
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  9. Bachir Taouli
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Corresponding author

Correspondence to Bachir Taouli.

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Funding

This study was funded by National Institutes of Health (NIH R01 Grant EB001981), Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (Fellowship P2ZHP3_161691).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Gordic, S., Ayache, J.B., Kennedy, P. et al. Value of tumor stiffness measured with MR elastography for assessment of response of hepatocellular carcinoma to locoregional therapy. Abdom Radiol 42, 1685–1694 (2017). https://doi.org/10.1007/s00261-017-1066-y

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