Keywords: Liver, Liver

Motivation: The prognostic value of component percentage in combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) was verified, but the identification of percentage of each component relies on extensive tumor sampling.

Goal(s): Therefore, the aim of this study was to investigate if MRI-based habitat imaging helps to predict component percentage in cHCC-CCA preoperatively,

Approach:  and to further verify the biologic underpinnings of habitat imaging in cHCC-CCA by analyzing RNA sequencing data.

Results: We found that preoperative prediction of HCC percentage in patients with cHCC-CCA can be achieved using an MRI-based habitat imaging model, which was also associated with signaling pathways regulating cell migration and tumor metastasis.

Impact: We achieved prediction of HCC percentage through an MRI-based habitat imaging model, and revealed the biologic underpinnings of habitat imaging, that is, habitat imaging may identify patients at risk of metastasis. These results may guide individual management in cHCC-CCA patients.

Keywords: Liver, Liver

Motivation: Enhance precision in hepatocellular carcinoma (HCC) diagnosis by determining the superior contrast agent.

Goal(s): Compare Gd-EOB-DTPA and Gd-BOPTA efficiency in displaying LI-RADS-recommended HCC features.

Approach: Retrospective analysis of 98 HCC lesions using Gd-EOB-DTPA-MR and Gd-BOPTA-MR, assessing enhancement patterns and lesion-to-liver contrast.

Results: Significantly varied capsule enhancement and lesion-to-liver contrast were observed in specific phases. Both agents demonstrated effective display capabilities (AUC>0.750) and excellent overall performance (AUC>0.950) across all phases.

Impact: These findings offer crucial insights for clinicians and researchers, facilitating informed selection of contrast agents for accurate HCC diagnosis. Future investigations may focus on refining imaging protocols, ultimately improving patient care and management decisions.

Keywords: Pancreas, Pancreas, Radiomics, dynamic contrast enhanced MRI, liver metastasis

Motivation: Prediction of subsequent liver metastasis of pancreatic ductal adenocarcinoma (PDAC) is important for patient management and current prediction performance is insufficient.

Goal(s): To improve the prediction of subsequent liver metastasis from PDAC by integrated radiomic analysis of whole pancreas and PDAC using dynamic contrast enhanced (DCE) MRI.

Approach: Radiomic features were extracted from whole pancreas and PDAC on DCE MRI. Logistic regression model was applied to predict likelihood of subsequent liver metastasis.

Results: Combination of radiomics from whole pancreas and tumor improved liver metastasis prediction than that of tumor alone.

Impact: Improved prediction of subsequent liver metastases with PDAC may allow better management of PDAC patients, potentially saving costs and lives.   

Keywords: Liver, Diffusion/other diffusion imaging techniques

Motivation: The purpose of this study is to assess the microstructural parameters of hepatocellular carcinoma by the time-dependent diffusion MRI technique.

Goal(s): Demonstrate the feasibility of TDD-MRI for evaluating hepatocellular cancer cell size with little difference from pathological verification.

Approach: This prospective study will perform TDD-MRI scans for HCC patients before surgery; the cell size of tumor tissue samples obtained from surgery was measured and set as the gold standard.

Results: Data of 13 patients was collected, while there was no remarkable relationship between the TDD-MRI extracted results and histological measurements.

Impact: Although our results show no statistically significant for now, TDD-MRI has still got certain potential values in the application of liver tumors, while the measurement of pathological samples need to be optimized further.

Keywords: Liver, Liver, Phosphorus Magnetic Resonance Spectroscopy

Motivation: The clinical need for noninvasive tools to assess the metabolism of hepatocellular carcinoma (HCC), which contributes to treatment guidance, therapy response assessment and prognostic prediction. This study aimed to investigate the value of phosphorus (31P)-magnetic resonance spectroscopy (MRS) as a supplementary metabolism-related alternative in clinic.

Goal(s): The goal of this study was to evaluate the metabolism status of HCC, compared with healthy controls. 

Approach: Three HCC patients  and three healthy volunteers were analyzed with a 3.0-T MRI scanner, using 31P MRS.

Results: The study revealed an elevated phomonoester (PME) / phosphodiester (PDE) ratio in patients with HCC, suggesting potential metabolic changes in HCC.

Impact: This study highlights the promising value of 31P MRS as a noninvasive alternative in patients with HCC. Elevated PME/PDE ratio offers valuable insights into hepatocellular carcinoma, enhancing the diagnostic and treatment strategies of HCC.

Keywords: Liver, Cancer, Gd-EOB-DTPA；ADC；CD34；Glypican-3

Motivation: The quantitative magnetic resonance imaging of Gd-EOB-DTPA has been employed to predict liver reserve function, tolerance, and postoperative recovery in patients with primary liver cancer.

Goal(s): To investigate the relationship between quantitative parameters, liver reserve function of primary liver cancer and the expression levels of CD34 and Glypican-3.

Approach: Evaluate the correlation between RE_HBP, ADC, liver function classification, and immune markers CD34 and Glypican-3

Results: In comparison to patients with benign liver nodules, patients with primary liver cancer exhibited significantly lower RE_HBP and ADC values.

Impact: The combination DCE-MRI with Gd-EOB-DTPA  and DWI has a predictive value for liver reserve function and prognostic molecular marker expression in patients with primary liver cancer. It can also serve as a useful reference index for clinical preoperative planning.

Keywords: Liver, Liver

Motivation: VETC and MVI have a synergistic effect on prognosis assessment and treatment selection of HCC. Preoperative noninvasive evaluation of VETC and MVI is important.

Goal(s): To explore the diagnosis value of nomograms based on preoperative gadoxetic acid (GA)-enhanced MRI features for MVI, VETC, and RFS in patients with HCC.

Approach: Retrospective study explored the relationship between the clinical and imaging features of MVI, VETC, and MVI+/VETC+ using the same dataset.

Results: Nomograms incorporating independent indicators showed good performance in the training and internal validation cohorts. Significant differences in recurrence rates between the nomogram-evaluated high- and low-risk stratification were found.

Impact: Through the in-depth exploration of the combination of MVI and VETC, we can deepen the understanding of tumor metastasis heterogeneity, and the diagnosis and treatment plan, prognosis prediction and risk stratification of tumor patients can be formulated.

Keywords: Liver, Tumor, LI-RADS, AFP

Motivation: The MRI LI-RADS v2018 table is complex and has insufficient sensitivity.

Goal(s): To evaluate the diagnostic performance of the simplified LI-RADS table for HCC on ECA-MRI, and to determine the value of AFP level as an additional major feature.

Approach: We developed and compared the per-lesion sensitivity for HCC defined by LI-RADS v2018, simplified LI-RADS table, and both of them combined with AFP ≥ 200 ng/mL.

Results: Compared with LR-5 v2018, the simplified LI-RADS table provided higher sensitivity and comparable specificity for HCC. AFP ≥ 200 ng/mL may be a suitable additional major feature for further improving LR-5 v2018 and sLR-5 classification.

Impact: Our simplified LI-RADS table may be more convenient and clinically helpful, and the AFP ≥ 200 ng/mL may be a suitable additional major feature for accurate LR-5 and sLR-5 classification.

Keywords: Pancreas, Pancreas

Motivation: Differentiation between ITPNs and IPMNs is important because even ITPNs with an invasive component are associated with a better prognosis than invasive IPMNs. Potentially targetable genetic alterations in ITPNs and reveal new therapeutic targets for patients with ITPN.

Goal(s): Aimed to compare the MRI characteristics of  ITPN and IPMN of the pancreas to differentiate between these two types of invasive carcinomas.

Approach: Preoperative MR images of pathologically confirmed ITPN and IPMN were retrospectively reviewed.

Results: Age, 2-tone duct sign and none cysitc lesion were independent predictors for invasive ITPN.

Impact: The combined model based on MRI characteristics shows high diagnostic performance.

Keywords: Liver, Diffusion/other diffusion imaging techniques, oncologic imaging, rapid protocol, T2 weighted, neuroendocrine tumor, hepatic metastasis, multi-shot DWI, surveillance imaging, tumor assessment, Gadoxetate

Motivation: Liver metastasis detection without intravenous contrast has potential applications in MRI surveillance and whole-body imaging.

Goal(s): To compare multishot DWI (msDWI) and T2w imaging with fat suppression (T2w+FS) in detecting neuroendocrine tumor (NET) liver metastases. 

Approach: We retrospectively determined the visibility of 114 lesions (35 patients) on msDWI and multiplanar T2w+FS. Sensitivities were calculated. 

Results: msDWI outperforms T2w+FS, with sensitivity approaching 90% for lesions <=5mm. 

Impact: HBP (Gadoxetate) imaging is the gold standard for detecting liver metastases, however rapid MRI without intravenous contrast is attractive from a cost and patient perspective. msDWI alone may prove sufficient for NET metastasis detection. 

Keywords: Liver, Liver, HCC, VETC, MVI

Motivation: Vessels encapsulating tumor clusters (VETC) and microvascular invasion (MVI) are distinct vascular patterns of metastasis in hepatocellular carcinoma (HCC). Studies have indicated that patients with VETC+/MVI+ HCC have the worst long-term outcomes.

Goal(s): To establish a model based on MRI features of Liver Imaging Reporting and Data System (LI-RADS) v2018 for predicting VM (+) (VETC+/MVI+) HCC and assess its prognostic value.

Approach: Retrospective study.

Results: Size, arterial peritumoral enhancement, and peritumoral hypointensity on hepatobilary phase (HBP) are independent predictors of VM (+) HCC. The high-risk and low-risk groups predicted by the combined model show significant differences in recurrence-free survival (RFS) and early recurrence.

Impact: Preoperative non-invasive identification of VETC+/MVI+ HCC assists clinical physicians in formulating individualized treatment plans, thereby improving patient survival rates.

Keywords: Liver, Liver, HCC, MTM-HCC

Motivation: Macrotrabecular-Massive Subtype of Hepatocellular Carcinoma (MTM-HCC) has been confirmed to possess higher invasiveness and malignancy.

Goal(s): This study aims to compare the clinical parameters and imaging characteristics between MTM-HCC and non-MTM-HCC patients, construct a predictive model for the MTM-HCC subtype, and evaluate the model's value in risk stratification.

Approach: This study is a retrospective research.

Results: The ≥ 50% AP hypovascular component and peritumoral hypointensity on HBP images are independent predictive factors for diagnosing MTM-HCC, and the predictive model exhibits a significant difference in overall recurrence-free survival (RFS) and early recurrence (P < 0.05).

Impact: This study, based on the significant imaging features of LI-RADS v2018 and other imaging signs, offers clinical value for the diagnosis and prognosis prediction of the MTM-HCC pathological subtype, providing new insights for the personalized treatment of HCC patients.

Keywords: Liver, Data Analysis

Motivation: The detection efficiency of Multi-Phase Dynamic Gd-BOPTA Enhanced MR Imaging in liver metastases

Goal(s): To compare the detection efficiency of Multi-Phase Dynamic Gd-BOPTA Enhanced MR Imaging in liver metastases.

Approach: All patients underwent T1W, T2WI, DWI and Gd-BOPTA-enhanced MRI on a 3.0 T MR scanner. Signal intensity (SI), standard deviation (SD), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and liver-to-lesion ratio (LLR) were measured and compare the detection efficiency. 

Results: Gd-BOPTA-enhanced MR imaging in the hepatobiliary stage can significantly improve the detection efficiency of metastases, but its SNR and CNR are not as good as those in the transitional stage.

Impact: This experiment demonstrates Gd-BOPTA-enhanced MR imaging in the hepatobiliary stage can significantly improve the detection efficiency of metastases.

Keywords: Liver, Liver, Hepatocellular carcinoma, Magnetic resonance elastography, Wnt/β-catenin signal pathway, Microvascular invasion, Prognosis

Motivation: Non-invasive detection of MVI and Wnt/β-catenin pathway activation remains challenging for hepatocellular carcinoma (HCC).

Goal(s): To investigate Wnt/β-catenin pathway and MVI expression in HCC using preoperative magnetic resonance elastography (MRE). 

Approach: Totally, 210 HCC patients undergoing hepatectomy were recruited for preoperative MRE and recurrence-free survival was documented. Tumor c and φ value represented tissue stiffness and viscosity, respectively.

Results: The silence of Wnt/β-catenin pathway and the presence of MVI-positivity were markedly prone to postoperative recrudescence. Besides, an increased tumor c value was identified as independent risk factors for Wnt/β-catenin pathway activation, while a decreased tumor c value was strongly linked to MVI-positivity.

Impact: This study focuses on the contribution of biomechanics to HCC aggressiveness within the context of signal pathways and tumor microenvironment, and on clinical significances of integrating MRE into clinical practice for optimizing treatment decisions and enhancing risk stratification in HCC.

Keywords: Liver, Liver

Motivation: To explore the prognostic parameters related to microvascular invasion (MVI)-negative HCC patients.

Goal(s): The aim of this study was to establish a model for predicting the prognosis of patients with MVI-negative HCC based on qualitative and quantitative analyses of Gd-EOB-DTPA MRI.

Approach: Totally, 122 patients were retrospectively enrolled. Multivariate logistic regression analysis was performed to identify significant clinical parameters, and quantitative and qualitative MRI parameters associated with prognosis.  

Results: Multivariate analysis showed that lower RER, HBP hypointensity without APHE, LI-RADS category, mild-moderate T2 hyperintensity, and higher AST levels were risk factors associated with prognosis. The most appropriate threshold value for RER was 1.197. 

Impact: The nomogram incorporated preoperative qualitative and quantitative parameters and laboratory indices, namely LI-RADS category, HBP hypointensity without APHE, lower RER, mild-moderate T2 hyperintensity, and higher AST levels, can be a reliable tool for predicting prognosis in patients with MVI-negative HCC.

Keywords: Liver, Liver, Hepatocellular Carcinomas resection

Motivation: Individualized selection between wide (≥1 cm) and narrow (<1 cm) resection margins may help improve the postoperative survivals of hepatocellular carcinoma (HCC).

Goal(s): To develop an MRI-based model to support the selection between narrow and wide resection margins based on the prediction of postoperative early recurrence-free survival (RFS, ≤2 years) in patients with single HCC.

Approach: In patients with narrow resection margins, a predictive score (named “MARGIN”) was developed for early RFS rate with Cox regression analyses. 

Results: Improved early RFS rate was observed for wide resection margins for the MARGIN-predicted high-risk patients.

Impact: In patients with single HCC, the MARGIN score may serve as a promising decision-making too to inform the need for wide resection margins.