BANG-BIN CHENCHAO-YU HSUCHIH-WEI YUPO-CHIN LIANGCHIUN HSUCHIH-HUNG HSUANN-LII CHENGTIFFANY TING-FANG SHIH2020-04-282020-04-2820160033-8419https://www.scopus.com/inward/record.uri?eid=2-s2.0-84992163560&doi=10.1148%2fradiol.2016152659&partnerID=40&md5=8dd28767e85ddc5bfa21a1b4fc69fc5ehttps://scholars.lib.ntu.edu.tw/handle/123456789/487281Purpose: To retrospectively compare the perfusion parameters of advanced hepatocellular carcinoma (HCC) measured with dynamic contrast material-enhanced (DCE) magnetic resonance (MR) imaging with surrounding liver parenchyma to determine the relationship between these parameters and uncensored overall survival (OS). Materials and Methods: This retrospective study had institutional review board approval, and informed consent was waived. DCE MR imaging was performed in 92 patients with advanced HCC before systemic treatment was administered (19 patients received a placebo). Three semiquantitative (peak, slope, and area under the gadolinium concentration-time curve [AUC]) and six quantitative (arterial fraction, arterial flow, portal flow, total blood flow, distribution volume, and mean transit time) parameters were calculated by placing regions of interest in the largest area of the tumor and background liver parenchyma. The DCE MR imaging parameters between the tumor and normal liver were compared with paired Wilcoxon test. By using the Cox proportional hazards model for univariate and multivariate analyses, the association of DCE MR imaging parameters and OS was investigated. Results: HCC demonstrated significantly higher peak, slope, AUC, arterial fraction, and arterial flow but lower portal flow, distribution volume, and mean transit time than did the background liver (all P< .05). Patients with high peak in the tumor had longer OS (P = .005) than did those with low peak. Cox multivariate analysis identified peak as an independent predictor of OS (P = .032) after adjusting for age, sex, treatment, tumor size, and portal vein thrombosis. Conclusion: DCE MR imaging parameters can be used to differentiate advanced HCC from the background liver, and peak, a semiquantitative parameter, is associated with outcome in patients with advanced HCC before systemic therapy. ? RSNA, 2016.[SDGs]SDG3gadodiamide; placebo; sorafenib; tegafur; uracil; vandetanib; antineoplastic agent; contrast medium; gadolinium pentetate; adult; advanced cancer; age; aged; cancer chemotherapy; cancer mortality; cancer prognosis; cancer survival; comparative study; controlled study; disease association; dynamic contrast-enhanced magnetic resonance imaging; female; gender; human; liver cell carcinoma; liver parenchyma; major clinical study; male; overall survival; phase 2 clinical trial (topic); portal vein thrombosis; priority journal; retrospective study; Review; risk factor; survival time; systemic therapy; tumor volume; Carcinoma, Hepatocellular; diagnostic imaging; Liver Neoplasms; middle aged; nuclear magnetic resonance imaging; pathology; procedures; survival rate; treatment outcome; very elderly; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Hepatocellular; Contrast Media; Gadolinium DTPA; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Middle Aged; Retrospective Studies; Survival Rate; Treatment Outcomereview10.1148/radiol.2016152659271710202-s2.0-84992163560