Gadoxetic acid-enhanced magnetic resonance imaging can predict the pathologic stage of solitary hepatocellular carcinoma

Table 1 Comparison of demographic and other characteristics between the pathologic stage T2 and T1 groups, n (%)

Characteristics	pT2, n = 39	pT1, n = 75	P value
Age, mean ± SD	60.54 ± 11.17	58.32 ± 10.95	0.3101
Gender			0.375
Male	26 (66.7)	57 (76.0)
Female	13 (33.3)	18 (24.0)
Hepatitis virus subtype
HBV	21 (53.8)	50 (66.7)	0.223
HCV	15 (38.5)	21 (28.0)	0.292
HBV and HCV	3 (7.7)	3 (4.0)	0.385
Tumor marker
AFP	415.3 ± 1536.1	812.3 ± 5922.0	0.5683
CA-19-9	116.2 ± 606.2	14.1 ± 15.6	0.2998
Interval between the dates of imaging and surgery, mean ± SD	17.69 ± 30.80	18.09 ± 20.58	0.9419
METAVIR score of liver fibrosis			0.7852
F0-F3	28 (71.79)	52 (69.33)
F4	11 (28.21)	23 (30.67)

HBV and HCV: Hepatitis viruses B and C; AFP: Alpha-fetoprotein; CA-19-9: Cancer antigen 19-9; pT1: Pathologic stage T1; pT2: Pathologic stage T2.

Table 2 Imaging characteristics compared between the pathologic stage T2 group and T1 group, n (%)

Characteristics	pT2, n = 39	pT1, n = 75	P value
T2 hyperintensity	37 (94.9)	68 (90.7)	0.716
T1 hypointensity	35 (89.7)	69 (92.0)	0.733
Arterial enhancement	38 (97.4)	70 (93.3)	0.662
Corona enhancement	14 (35.9)	13 (17.3)	0.037
Washout appearance	36 (92.3)	69 (92.0)	1.000
Capsular appearance	14 (35.9)	38 (50.7)	0.167
Hypointensity of tumor in the HB phase	37 (94.9)	74 (98.7)	0.269
Peritumoral hypointensity in the HB phase	16 (41.0)	18 (24.0)	0.084
Hypointense-rim in the HB phase	5 (12.8)	21 (28.0)	0.099
Intratumoral fat	8 (20.5)	18 (24.0)	0.815
Hyperintensity on DWI	39 (100.0)	72 (96.0)	0.550
Hypointensity on ADC map	16 (41.0)	32 (42.7)	1.000
Mosaic architecture	27 (69.2)	48 (64.0)	0.679
Margin type			0.503
Smooth	27 (69.2)	57 (76.0)
Irregular	12 (30.8)	18 (24.0)
AJCC v.7	39 (100.0)	75 (100.0)
AJCC v.8			0.005
cT1a (≤ 2 cm)	3 (7.7)	24 (32.0)
cT1b (> 2 cm)	36 (92.3)	51 (68.0)

HB: Hepatobiliary; DWI: Diffusion weighted imaging; ADC: Apparent diffusion coefficient; AJCC: American Joint Committee on Cancer; pT1: Pathologic stage T1; pT2: Pathologic stage T2.

Table 3 The odds ratios for imaging features favoring a diagnosis of pathologic stage T2 over pT1

Features	Crude OR	95%CI	P value
T2 hyperintensity	1.904	(0.376-9.639)	0.436
T1 hypointensity	0.761	(0.201-2.874)	0.687
Arterial enhancement	2.714	(0.306-24.085)	0.370
Corona enhancement	2.671	(1.101-6.480)	0.030
Washout appearance	1.043	(0.246-4.419)	0.954
Capsular appearance	0.545	(0.246-1.208)	0.135
Hypointensity of tumor in the HB phase	0.250	(0.022-2.847)	0.264
Peritumoral hypointensity in HB phase	2.203	(0.961-5.049)	0.062
Hypointense-rim in the HB phase	0.378	(0.130-1.098)	0.074
Intratumoral fat	0.817	(0.319-2.093)	0.674
Mosaic architecture	1.266	(0.553-2.895)	0.577
Hyperintensity on DWI	N/A	N/A	N/A
Hypointensity ADC map	0.935	(0.426-2.050)	0.866
Tumor margin
Smooth (baseline)
Non-smooth	1.407	(0.594-3.333)	0.437
AJCC v.8
cT1a (baseline)	1.00	Reference
cT1b	6.727	(1.483-30.517)	0.014

Because all patients in the study group demonstrated hyperintensity on diffusion weighted imaging, we were not able to calculate the odds ratio and P value. HB: Hepatobiliary; DWI: Diffusion weighted imaging; ADC: Apparent diffusion coefficient; AJCC: American Joint Committee on Cancer; pT1: Pathologic stage T1; pT2: Pathologic stage T2; OR: Odds ratio; CI: Confidence interval.

Table 4 Logistic regression estimates of odds ratios for pathologic stage T2 hepatocellular carcinoma in patients with solitary tumor on Gd-EOB-DTPA-enhanced magnetic resonance imaging

Combinations of aggressive features	Number of pT2 patients	OR (95%CI)
A = 0 and B = 0 and C = 0	4	Reference
Only A or Only B or Only C	10	1.037 (0.285-3.766)
A + B or B + C or A + C or A + B + C	25	6.250 (1.788-21.845)

Gd-EOB-DTPA: Gadolinium ethoxybenzyl diethylene-triaminepentaacetic acid; A = 0: Tumor size < 2.3 cm; B = 0: No peritumoral hypointensity on hepatobiliary phase; C = 0: No corona enhancement; A: Tumor size ≥ 2.3 cm; B: Presence of peritumoral hypointensity on hepatobiliary phase; C: Presence of corona enhancement; OR: Odds ratio; CI: Confidence interval.