Risk Factors for Early Recurrence of Solitary Hepatocellular Carcinoma After Radiofrequency Ablation Based on Gd-EOB-DTPA-Enhanced MRI
10.3969/j.issn.1005-5185.2025.03.004
- VernacularTitle:基于钆塞酸二钠增强MRI对孤立性肝细胞癌射频消融术后早期复发的危险因素分析
- Author:
Qian XU
1
;
Lan ZHANG
;
Tingting HUANG
;
Yu GAO
;
Xiaoyang ZHAI
;
Jiacheng ZHANG
;
Xu HE
;
Fukun SHI
Author Information
1. 河南中医药大学，河南 郑州 450046;河南中医药大学第一附属医院MRI科,河南 郑州 45000
- Publication Type:Journal Article
- Keywords:
Carcinoma,hepatocellular;
Recurrence;
Magnetic resonance imaging;
Radiofrequency ablation;
Gadoxetic acid disodium;
Risk factors
- From:
Chinese Journal of Medical Imaging
2025;33(3):238-244,259
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the independent risk factors for early recurrence of solitary hepatocellular carcinoma after radiofrequency ablation based on gadoxetic acid disodium(Gd-EOB-DTPA)-enhanced MRI combined with clinical features.Materials and Methods Clinical and imaging data of hepatocellular carcinoma patients who underwent radiofrequency ablation at the First Affiliated Hospital of Henan University of Chinese Medicine from January 2019 to June 2022 were retrospectively collected.All patients underwent preoperative Gd-EOB-DTPA-enhanced MRI and were followed up for up to two years post-surgery.Univariate and multivariate Cox proportional hazards regression were performed to identify independent risk factors for recurrence after radiofrequency ablation.Results A total of 58 patients were finally included,including early recurrence group(n=22)and non-early recurrence group(n=36).Multivariate Cox regression analysis revealed that preoperative alpha-fetoprotein(AFP)levels(HR=1.103,95%CI 1.008-1.206,P=0.033),arterial-phase irregular margin enhancement(HR=4.647,95%CI 1.527-14.110,P=0.007),peritumoral arterial-phase enhancement(HR=11.575,95%CI 3.575-37.478,P=0.001)and peritumoral hepatobiliary phase hypointensity(HR=5.058,95%CI 1.129-22.668,P=0.034)were independent risk factors for early recurrence.The area under the curve for AFP combined with arterial-phase irregular margin enhancement,peritumoral arterial-phase enhancement and peritumoral hepatobiliary phase hypointensity were 0.896,0.842 and 0.860,with accuracy rates of 81.0%,84.5%and 82.8%,respectively.Conclusion Preoperative serum AFP levels,arterial-phase irregular margin enhancement,peritumoral arterial-phase enhancement and peritumoral hepatobiliary phase hypointensity are independent risk factors for early recurrence after radiofrequency ablation in hepatocellular carcinoma patients.The combination of AFP and any of these MRI features significantly improves predictive efficacy.
