Investig Magn Reson Imaging.  2016 Dec;20(4):231-240. 10.13104/imri.2016.20.4.231.

Clinical Utility of Liver Stiffness Measurements on Magnetic Resonance Elastrography in Patients with Hepatocellular Carcinoma Treated with Radiofrequency Ablation

• Kim JE
• Lee JM
• Lee DH
• Chang W
• Yoon JH
• Han JG

• KMID: 2366405
• DOI: http://doi.org/10.13104/imri.2016.20.4.231

Abstract

PURPOSE
To determine whether liver stiffness (LS) measured by magnetic resonance elastography (MRE) can predict the outcome of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients.
MATERIALS AND METHODS
A total of 107 patients with Child-Pugh class A liver function who were treated with RFA for single HCC and who had undergone a gradient-echo MRE within 6 months before RFA were included. We evaluated the relationship between the LS values and the ablation volume, local tumor progression (LTP), and intrahepatic distant recurrence (IDR). We also constructed receiver operating characteristic (ROC) curves to examine the role of LS in predicting liver function deterioration, which was defined as an increase of Child-Pugh score by one point or more at 1 year after RFA.
RESULTS
There was no significant correlation between LS and ablation volume, and neither time to LTP nor IDR was associated with LS. Among the 66 patients who did not have recurrence 1 year after RFA, 5 patients (7.6%) developed liver function deterioration. A high LS value was significantly associated with development of liver function deterioration after RFA and the area under the ROC curve was 0.764 (95% CI 0.598-0.929, P = 0.003).
CONCLUSION
LS measured by MRE could not predict ablation volume and tumor recurrence. However, high LS values were significantly associated with development of liver function deterioration.

Keyword

MR elastography; Liver stiffness; Hepatocellular carcinoma; Radiofrequency ablation; Ablation volume; Liver function

MeSH Terms

Carcinoma, Hepatocellular*
Catheter Ablation*
Elasticity Imaging Techniques
Humans
Liver*
Recurrence
ROC Curve

Figure

• 

  Fig. 1 Patient selection. A total of 107 hepatocellular carcinoma (HCC) patients who underwent radiofrequency ablation (RFA) and magnetic resonance elastography (MRE) were included in this study.

• 

  Fig. 2 Correlation between ablation volume and liver stiffness (LS) value. There was no significant correlation between LS value and ablation volume.

• 

  Fig. 3 Visual comparison of the ablation volume in patients with the same tumor size (2.0 cm), but different levels of liver stiffness (LS) on magnetic resonance elastography (MRE). (a) Arterial phase image shows a 2.0 cm hypervascular hepatocellular carcinoma (HCC) and (b) LS was measured as 2.6 kPa. (c) The calculated ablation volume obtained from post-procedural liver computed tomography (CT) was 26.1 cm3. (d) Arterial phase image of another patient shows a 2.0 cm hypervascular HCC and (e) LS was measured as 7.6 kPa. (f) The calculated ablation volume obtained from post-procedural liver CT was 47.0 cm3.

• 

  Fig. 4 Receiver operating characteristic (ROC) curves for liver function deterioration according to liver stiffness (LS). The area under the curve (AUC) was 0.764.

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