Magnetic resonance pharmacokinetic imaging clusterization of hepatocellular carcinomas as a means to grade tumor aggressiveness

Expert Rev Gastroenterol Hepatol. 2012 Dec;6(6):711-6. doi: 10.1586/egh.12.51.

Abstract

Hepatocellular carcinoma (HCC) management takes into account clinical and radiological findings, such as tumor stage, hepatic functional status and clinical symptoms. It is necessary to evaluate the number, size and location of the lesions. However, lesion aggressiveness is not considered in this therapeutic workflow, although the biology and the growth rate of the lesions have an important impact on survival. The aim of this work was to establish if the quantitative pharmacokinetic assessment of dynamic contrast-enhanced magnetic resonance images of HCC can separate lesions with different microvascular properties and biological evolution. Forty five patients with HCC and dynamic contrast-enhanced MRI examinations were included and several pharmacokinetic parameters were calculated. Statistical clusterization techniques were applied and two clearly distinct groups were obtained by using vascular properties and average lesion size. These groups differed by the proportion of deceased patients, although no statistically significant differences were found between the average survival times of both groups.

MeSH terms

  • Aged
  • Biomarkers, Tumor / physiology*
  • Capillary Permeability*
  • Carcinoma, Hepatocellular / blood supply
  • Carcinoma, Hepatocellular / pathology*
  • Cluster Analysis
  • Contrast Media / pharmacokinetics*
  • Disease Progression
  • Female
  • Humans
  • Image Enhancement
  • Kaplan-Meier Estimate
  • Liver Neoplasms / blood supply
  • Liver Neoplasms / pathology*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neoplasm Grading

Substances

  • Biomarkers, Tumor
  • Contrast Media