Comparison of computed tomography and magnetic resonance imaging findings and histopathological features of macrotrabecular-massive hepatocellular carcinoma

Gong，Qishu1,2; Zhang，Yusen1,2; Wu，Tianchong1,2; Du，Zhiyong1,2; Zhang，Yue1,2

2023-07-01

10.21037/qims-22-940

Quantitative Imaging in Medicine and Surgery   Impact Factor & Quartile

2223-4292

2223-4306

Background: Macrotrabecular-massive hepatocellular carcinoma (MTM-HCC) is a novel subtype of HCC, one of eight distinct subtypes, that accounts for 5% of all cases of HCC and is associated with a worse prognosis. Preoperative diagnosis of MTM-HCCs using imaging findings can facilitate patient treatment decision-making. The purpose of this study was to describe computed tomography (CT) and magnetic resonance imaging (MRI) findings of MTM-HCCs and compare these findings with histopathological features. Methods: This retrospective case-control study was performed at Shenzhen People's Hospital. The cohort included 17 patients with surgically confirmed MTM-HCCs and 232 patients with surgically confirmed non-MTM-HCCs who were enrolled by searching the pathological database from January 2018 to June 2022. CT and MRI findings were retrospectively analyzed and compared with pathological features. Student's t-test or Mann-Whitney U test for continuous variables and χ2 test or Fisher's exact test for categorical variables were implemented to compare imaging manifestations between MTM-HCCs and non-MTM-HCCs, as appropriate. Results: Seventeen tumors with a mean diameter of 8.58±2.83 cm were identified in the 17 patients. In addition to the typical findings of hepatocellular carcinomas (HCCs), such as arterial phase hyperenhancement (APHE), wash out, restricted diffusion, capsule and non-uptake at the hepatobiliary phase (HBP), the most common findings in MTM-HCCs were necrosis in 11 patients (64.7%, 11/17), followed by intratumoral arteries in 6 patients (35.3%, 6/17), peritumoral arterial transitive enhancement in 3 patients (17.6%, 3/17) and peritumoral hypointensive areas at the HBP in 3 of 8 patients (37.5%, 3/8) who received gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (Gd-EOB-DTPA) enhancement. The tumor size of non-MTM-HCCs was 5.26±1.94 cm, which was smaller than the 8.58±2.83 cm of MTM-HCCs (P<0.001). The frequency of necrosis and intratumoral arteries was significantly higher in MTM-HCCs than in non-MTM-HCCs (necrosis: 64.7% vs. 34.6%, P=0.012; intratumoral arteries: 47.1% vs. 19.7%, P=0.008). Conclusions: MTM-HCCs tend to be large in size with intratumoral artery and intratumoral necrosis, which are characteristics that may distinguish them from non-MTM-HCCs.

Computed tomography (CT) hepatocellular carcinoma (HCC) macrotrabecular-massive magnetic resonance imaging (MRI)

SCI

English

Corresponding

Radiology, Nuclear Medicine & Medical Imaging

Radiology, Nuclear Medicine & Medical Imaging

WOS:000995757200001

AME PUBLISHING COMPANY

2-s2.0-85166356358

Scopus

1.Department of Hepatobiliary Surgery,Shenzhen People's Hospital,The Second Clinical Medical College,Jinan University,Shenzhen,China
2.The First Affiliated Hospital,Southern University of Science and Technology,Shenzhen,China

Gong，Qishu,Zhang，Yusen,Wu，Tianchong,et al. Comparison of computed tomography and magnetic resonance imaging findings and histopathological features of macrotrabecular-massive hepatocellular carcinoma[J]. Quantitative Imaging in Medicine and Surgery,2023,13(7):4633-4640.

Gong，Qishu,Zhang，Yusen,Wu，Tianchong,Du，Zhiyong,&Zhang，Yue.(2023).Comparison of computed tomography and magnetic resonance imaging findings and histopathological features of macrotrabecular-massive hepatocellular carcinoma.Quantitative Imaging in Medicine and Surgery,13(7),4633-4640.

Gong，Qishu,et al."Comparison of computed tomography and magnetic resonance imaging findings and histopathological features of macrotrabecular-massive hepatocellular carcinoma".Quantitative Imaging in Medicine and Surgery 13.7(2023):4633-4640.