Correlation between magnetic resonance images of peritumor margin enhancement and prognosis in hepatocellular carcinoma after drug-eluting bead transcatheter arterial chemoembolization

Donglin Kuang; Nan Zhang; Mengfan Zhang; Hao Li; Xinwei Han; Jianzhuang Ren; Xuhua Duan

doi:10.3389/fonc.2023.957710

Correlation between magnetic resonance images of peritumor margin enhancement and prognosis in hepatocellular carcinoma after drug-eluting bead transcatheter arterial chemoembolization

Front Oncol. 2023 Apr 4:13:957710. doi: 10.3389/fonc.2023.957710. eCollection 2023.

Authors

Donglin Kuang¹, Nan Zhang¹, Mengfan Zhang¹, Hao Li¹, Xinwei Han¹, Jianzhuang Ren¹, Xuhua Duan¹

Affiliation

¹ Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China.

Abstract

Purpose: The aim of this study is to investigate the morphological characteristics and clinical significance of magnetic resonance (MR) images of peritumor margin enhancement in hepatocellular carcinoma (HCC) after drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE).

Methods: From January 2017 to December 2020, a total of 162 patients who received a diagnosis of HCC were included in our study. We began the follow-up with magnetic resonance imaging (MRI) for complete response assessment, and peritumor margin enhancements were classified as sharp and rough types according to morphology. During the follow-up, data such as progression or remission of the two enhancement modalities, morphological changes in terms of margin enhancements observed in MR images, and alpha-fetoprotein (AFP) levels were recorded.

Results: In the follow-up period of 36 months, 70 and 92 patients with sharp- and rough-type peritumor margins, respectively, were observed. At the end of the follow-up, patients with sharp-type margins had lower AFP levels and longer progression-free survival than those with rough-type margins (P < 0.05). Furthermore, the sharp-type margin was thinner than the rough-type margin (all P < 0.05). Moreover, the sharp-type group had a high incidence of tumors with a diameter of < 5 cm, whereas the rough-type group had a high incidence of tumors with a diameter of ≥ 5 cm. Continuous enhancements of peritumor margins in MRI were greater in the sharp-type group than in the rough-type group. Most of the patients with a sharp-type margin achieved disease remission (94.3%, P < 0.05), whereas most of those with a rough-type margin experienced disease progression (84.8%, P < 0.05).

Conclusions: Patients with HCC with a sharp-type margin enhancement on MRI after DEB-TACE mostly demonstrated benign lesions with a good prognosis, whereas those with a rough-type margin mostly demonstrated malignant growth.

Keywords: drug-eluting bead transcatheter arterial chemoembolization; hepatocellular carcinoma; magnetic resonance imaging; margin enhancement; morphology.

Grants and funding

This work was supported by the National Natural Science Foundation of China (No. U2004119) and the National Natural Science Foundation of Henan Province (No. 202300410361).