Early perfusion changes within 1 week of systemic treatment measured by dynamic contrast-enhanced MRI may predict survival in patients with advanced hepatocellular carcinoma

Abstract

Objectives: To correlate early changes in the parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) within 1?week of systemic therapy with overall survival (OS) in patients with advanced hepatocellular carcinoma (HCC). Methods: Eighty-nine patients with advanced HCC underwent DCE-MRI before and within 1?week following systemic therapy. The relative changes of six DCE-MRI parameters (Peak, Slope, AUC, Ktrans, Kep and Ve) of the tumours were correlated with OS using the Kaplan–Meier model and the double-sided log-rank test. Results: All patients died and the median survival was 174?days. Among the six DCE-MRI parameters, reductions in Peak, AUC, and Ktrans, were significantly correlated with one another. In addition, patients with a high Peak reduction following treatment had longer OS (P = 0.023) compared with those with a low Peak reduction. In multivariate analysis, a high Peak reduction was an independent favourable prognostic factor in all patients [hazard ratio (HR), 0.622; P = 0.038] after controlling for age, sex, treatment methods, tumour size and stage, and Eastern Cooperative Oncology Group performance status. Conclusions: Early perfusion changes within 1?week following systemic therapy measured by DCE-MRI may aid in the prediction of the clinical outcome in patients with advanced HCC. Key points: ? DCE-MRI is helpful to evaluate perfusion changes of HCC after systemic treatment. ? Early perfusion changes within 1?week after treatment may predict overall survival. ? High Peak reduction was an independent favourable prognostic factor after systemic treatment. ? 2016, European Society of Radiology.