Hepatology research : the official journal of the Japan Society of Hepatology · 2025
Liver-to-spleen ratio obtained from gadoxetate disodium-enhanced magnetic resonance imaging predicts intrahepatic recurrence after curative resection of hepatocellular carcinoma.
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Notake Tsuyoshi, Shimizu Akira, Kubota Koji, Kitagawa Noriyuki, Sugenoya Shinsuke, Yoshizawa Takahiro, Sakai Hiroki, Hayashi Hikaru, Tomida Hidenori, Yamazaki Shiori, Hayashi Shigeki, Yamada Akira, Fujinaga Yasunari, Soejima Yuji
Аннотация
AIM: The purpose of this study was to evaluate whether parameters obtained from gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) could predict intrahepatic tumor recurrence in patients who underwent curative hepatectomy for hepatocellular carcinoma (HCC).
METHODS: This study included 208 patients who underwent EOB-MRI before hepatectomy for HCC. The mean signal intensity of the liver (L20) and spleen (S20) was obtained from preoperative EOB-MRI, and liver-to-spleen ratio (LSR) was calculated from these values as: LSR = L20/S20. The association of LSR value with intrahepatic recurrence of HCC after curative hepatectomy was analyzed.
RESULTS: Intrahepatic recurrence in the remnant liver developed in 111 (53%) patients during the median follow-up period of 52.0 (range, 7.0-134.9) months after hepatectomy. Cumulative incidence of intrahepatic recurrence was significantly higher in patients with low LSR (<2.0) than in those with high LSR (≥2.0) (p < 0.001). In multivariable analysis, low LSR was identified as an independent predictor of intrahepatic recurrence (hazard ratio, 1.83; 95% confidence interval [CI], 1.23-2.72; p = 0.002), together with multiple tumors, macroscopic vascular invasion, and high-grade fibrosis of the background liver. Subgroup analysis according to the time of recurrence (within 1 year or more) revealed that low LSR was significantly associated with late recurrence (hazard ratio, 2.35; 95% CI, 1.40-3.94; p = 0.001), but not with early recurrence.
CONCLUSIONS: Low LSR was an independent risk factor of intrahepatic recurrence after curative hepatectomy for HCC, and was especially associated with late recurrence developing more than 1 year after curative hepatectomy.
METHODS: This study included 208 patients who underwent EOB-MRI before hepatectomy for HCC. The mean signal intensity of the liver (L20) and spleen (S20) was obtained from preoperative EOB-MRI, and liver-to-spleen ratio (LSR) was calculated from these values as: LSR = L20/S20. The association of LSR value with intrahepatic recurrence of HCC after curative hepatectomy was analyzed.
RESULTS: Intrahepatic recurrence in the remnant liver developed in 111 (53%) patients during the median follow-up period of 52.0 (range, 7.0-134.9) months after hepatectomy. Cumulative incidence of intrahepatic recurrence was significantly higher in patients with low LSR (<2.0) than in those with high LSR (≥2.0) (p < 0.001). In multivariable analysis, low LSR was identified as an independent predictor of intrahepatic recurrence (hazard ratio, 1.83; 95% confidence interval [CI], 1.23-2.72; p = 0.002), together with multiple tumors, macroscopic vascular invasion, and high-grade fibrosis of the background liver. Subgroup analysis according to the time of recurrence (within 1 year or more) revealed that low LSR was significantly associated with late recurrence (hazard ratio, 2.35; 95% CI, 1.40-3.94; p = 0.001), but not with early recurrence.
CONCLUSIONS: Low LSR was an independent risk factor of intrahepatic recurrence after curative hepatectomy for HCC, and was especially associated with late recurrence developing more than 1 year after curative hepatectomy.