Diagnostic Value of Gd-EOB-DTPA-Enhanced MRI for the Expression of Ki67 and Microvascular Density in Hepatocellular Carcinoma.

CONTRACT GRANT SPONSOR: National Natural Science Foundation of China; Contract grant number: 81260214. BACKGROUND: Recent studies have highlighted the diagnostic value of Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI in small hepatocellular carcinoma (HCC). Ki67 and CD34 are histologic markers that reflect the proliferation of tumor cells and the microvascular density (MVD). PURPOSE: To explore the diagnostic value of Gd-EOB-DTPA-enhanced MRI for Ki67 expression and MVD in HCC. STUDY TYPE: Retrospective. SUBJECTS: In all, 180 patients with HCC. FIELD STRENGTH/SEQUENCE: 3.0T, Gd-EOB-DTPA-enhanced T1 WI volumetric interpolated breath-hold examination (VIBE) axial fat suppression plain, and enhanced scanning. ASSESSMENT: The T1 relaxation time (T1 rt) and signal intensity (SI) of the lesion were measured. The Ki67 expressions and MVD were evaluated by immunohistochemistry. STATISTICAL TEST: Receiver operating characteristic (ROC) curves were used to analyze the diagnostic efficacy of T1 rt for high Ki67 expression (≥50%) and high MVD (≥100). RESULTS: The T1 rt-20min, rrT1 rt-20min, and SI-hepatobiliary phase (SI-HBP) were strongly correlated with Ki67, the r values were 0.846, -0.765, and -0.760 (P < 0.05), respectively. There were moderate correlations with CD34, with r values -0.444, 0.336, and -0.463 (P < 0.05), respectively. The T1 rt-Pre, T1 rt-20min, SI-Pre, and SI-HBP were significantly different both between the high and low ki67 expression groups (P < 0.05) and between the high MVD and low MVD groups (P < 0.05). In the two groups the T1 rt-20min and SI-HBP was 800.06 ± 128.91 vs. 530.06 ± 139.29 (P < 0.05) and 122.29 ± 39.39 vs. 173.49 ± 46.15 (P < 0.05); T1 rt-20min was found to have high diagnostic efficiency for high ki67 expression (area under the curve [AUC], 0.937; P < 0.05) T1 rt-20min had moderate diagnostic value for high MVD (AUC, 0.716; P < 0.05). DATA CONCLUSION: The T1 rt and SI of Gd-EOB-DTPA-enhanced MRI were correlated with Ki67 expression and MVD. T1 rt-20min has a high diagnostic value for high ki67 expression and high MVD in HCC tissues. LEVEL OF EVIDENCE: 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1755-1763.