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Quantitative correlation between uptake of Gd-BOPTA on hepatobiliary phase and tumor molecular features in patients with benign hepatocellular lesions

  • Gastrointestinal
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Abstract

Purpose

The purpose of our study was to correlate the quantitative analysis of benign hepatocellular tumor uptake on delayed hepatobiliary phase (HBP) imaging with the quantitative level of OATP expression.

Methods

This single-center retrospective study, which took place between September 2009 and March 2015, included 20 consecutive patients with a proven pathologic and immunohistochemical (IHC) diagnosis of FNH or HCA, including quantification of the OATP expression. The patients underwent Gd-BOPTA-enhancement MRI, including an HBP. The analysis of HBP uptake was performed using the liver-to-lesion contrast enhancement ratio (LLCER). Mean LLCER and OATP expressions were compared between FNH and HCA, and the expression of OATP was correlated with the LLCER value.

Results

Of the 23 benign hepatocellular tumors, 9 (39%) were FNH and 14 (61%) were HCA, including 6 inflammatory, 2 HNF1a inactivated, 3 β-catenin-mutated and 3 unclassified HCAs. On HBP, 100% of the FNH appeared hyper- or isointense, and 79% of the adenomas appeared hypointense. The mean OATP expression of FNH (46.67 ± 26.58%) was significantly higher than that of HCA (22.14 ± 30.74%) (p = 0.0273), and the mean LLCER of FNH (10.66 ± 7.403%) was significantly higher than that of HCA (-13.5 ± 12.25%) (p < 0.0001). The mean LLCER of β-catenin-mutated HCA was significantly higher than that of other HCAs (p = 0.011). Significant correlation was found between the OATP expression and LLCER values (r = 0.661; p = 0.001).

Conclusion

In benign hepatocellular tumors, the quantitative analysis of hepatobiliary contrast agent uptake on HBP is correlated with the level of OATP expression and could be used as an imaging biomarker of the molecular background of HCA and FNH.

Key Points

• Gd-BOPTA uptake on HBP correlates with the OATP level in benign hepatocellular tumors

• FNH and β-catenin-mutated HCA showed an increased lesion-to-liver contrast enhancement ratio (LLCER)

• Increased LLCER may be explained by activation of the Wnt β-catenin pathway

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Abbreviations

CRP:

C-reactive protein

FNH:

Focal nodular hyperplasia

GS:

Glutamine synthetase

HBP:

Hepatobiliary phase

HCA:

Hepatocellular adenoma

IHC:

Immunohistochemistry

LFABP:

Liver fatty acid binding protein

LLCER:

Liver-to-lesion contrast enhancement ratio

OATP:

Organic anion transporting polypeptide

SAA:

Serum amyloid A

SI:

Signal intensity

VIBE:

Volumetric interpolated breath-hold examination

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Imagerie Medicale, AP-HP, Groupe Henri Mondor Albert Chenevier, 51 avenue du Marechal de Lattre de Tassigny, 94010, Créteil, France

    Edouard Reizine, Frederic Pigneur, Laurence Baranes, François Legou, Sebastien Mulé, Benhalima Zegai, Vincent Roche, Alain Rahmouni & Alain Luciani

  2. Hepatology Department, AP-HP, Groupe Henri Mondor Albert Chenevier, F-94010, Creteil, France

    Giuliana Amaddeo

  3. Faculté de Médecine, Universite Paris Est Creteil, F-94010, Creteil, France

    Giuliana Amaddeo, Alexis Laurent, Alain Rahmouni, Julien Calderaro & Alain Luciani

  4. INSERM Unit U 955, Equipe 18, F-94010, Creteil, France

    Giuliana Amaddeo, Alexis Laurent, Julien Calderaro & Alain Luciani

  5. Liver Surgery, AP-HP, Groupe Henri Mondor Albert Chenevier, F-94010, Creteil, France

    Alexis Laurent

  6. Pathology, AP-HP, Groupe Henri Mondor Albert Chenevier, F-94010, Creteil, France

    Julien Calderaro

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  1. Edouard Reizine
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  2. Giuliana Amaddeo
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Corresponding author

Correspondence to Edouard Reizine.

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Guarantor

The scientific guarantor of this publication is Prof. Alain Luciani.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in the Journal of Magnetic Resonance Imaging by Roux et al. (J MRI, Apr 2015) focusing on imaging analysis of HBP-MRI using a quantitative approach.

Methodology

• retrospective

• cross-sectional study

• performed at one institution

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Reizine, E., Amaddeo, G., Pigneur, F. et al. Quantitative correlation between uptake of Gd-BOPTA on hepatobiliary phase and tumor molecular features in patients with benign hepatocellular lesions. Eur Radiol 28, 4243–4253 (2018). https://doi.org/10.1007/s00330-018-5438-7

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