PMID- 25914467 OWN - NLM STAT- MEDLINE DCOM- 20160203 LR - 20181113 IS - 2219-2840 (Electronic) IS - 1007-9327 (Print) IS - 1007-9327 (Linking) VI - 21 IP - 15 DP - 2015 Apr 21 TI - Factors predicting aggressiveness of non-hypervascular hepatic nodules detected on hepatobiliary phase of gadolinium ethoxybenzyl diethylene-triamine-pentaacetic-acid magnetic resonance imaging. PG - 4583-91 LID - 10.3748/wjg.v21.i15.4583 [doi] AB - AIM: To establish a prognostic formula that distinguishes non-hypervascular hepatic nodules (NHNs) with higher aggressiveness from less hazardous one. METHODS: Seventy-three NHNs were detected in gadolinium ethoxybenzyl diethylene-triamine-pentaacetic-acid magnetic resonance imaging (Gd-EOB-DTPA-MRI) study and confirmed to change 2 mm or more in size and/or to gain hypervascularity. All images were interpreted independently by an experienced, board-certified abdominal radiologist and hepatologist; both knew that the patients were at risk for hepatocellular carcinoma development but were blinded to the clinical information. A formula predicting NHN destiny was developed using a generalized estimating equation model with thirteen explanatory variables: age, gender, background liver diseases, Child-Pugh class, NHN diameter, T1-weighted imaging/T2-weighted imaging detectability, fat deposition, lower signal intensity in arterial phase, lower signal intensity in equilibrium phase, alpha-fetoprotein, des-gamma-carboxy prothrombin, alpha-fetoprotein-L3, and coexistence of classical hepatocellular carcinoma. The accuracy of the formula was validated in bootstrap samples that were created by resampling of 1000 iterations. RESULTS: During a median follow-up period of 504 d, 73 NHNs with a median diameter of 9 mm (interquartile range: 8-12 mm) grew or shrank by 68.5% (fifty nodules) or 20.5% (fifteen nodules), respectively, whereas hypervascularity developed in 38.4% (twenty eight nodules). In the fifteen shrank nodules, twelve nodules disappeared, while 11.0% (eight nodules) were stable in size but acquired vascularity. A generalized estimating equation analysis selected five explanatories from the thirteen variables as significant factors to predict NHN progression. The estimated regression coefficients were 0.36 for age, 6.51 for lower signal intensity in arterial phase, 8.70 or 6.03 for positivity of hepatitis B virus or hepatitis C virus, 9.37 for des-gamma-carboxy prothrombin, and -4.05 for fat deposition. A formula incorporating the five coefficients revealed sensitivity, specificity, and accuracy of 88.0%, 86.7%, and 87.7% in the formulating cohort, whereas these of 87.2% +/- 5.7%, 83.8% +/- 13.6%, and 87.3% +/- 4.5% in the bootstrap samples. CONCLUSION: These data suggest that the formula helps Gd-EOB-DTPA-MRI detect a trend toward hepatocyte transformation by predicting NHN destiny. FAU - Kanefuji, Tsutomu AU - Kanefuji T AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Takano, Toru AU - Takano T AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Suda, Takeshi AU - Suda T AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Akazawa, Kouhei AU - Akazawa K AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Yokoo, Takeshi AU - Yokoo T AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Kamimura, Hiroteru AU - Kamimura H AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Kamimura, Kenya AU - Kamimura K AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Tsuchiya, Atsunori AU - Tsuchiya A AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Takamura, Masaaki AU - Takamura M AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Kawai, Hirokazu AU - Kawai H AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Yamagiwa, Satoshi AU - Yamagiwa S AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Aoyama, Hidefumi AU - Aoyama H AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Nomoto, Minoru AU - Nomoto M AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. FAU - Terai, Shuji AU - Terai S AD - Tsutomu Kanefuji, Takeshi Suda, Deparatment of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan. LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - World J Gastroenterol JT - World journal of gastroenterology JID - 100883448 RN - 0 (Contrast Media) RN - 0 (gadolinium ethoxybenzyl DTPA) RN - K2I13DR72L (Gadolinium DTPA) SB - IM MH - Aged MH - Carcinoma, Hepatocellular/*pathology MH - Cell Transformation, Neoplastic/*pathology MH - Chi-Square Distribution MH - *Contrast Media MH - Decision Support Techniques MH - Diagnosis, Differential MH - Disease Progression MH - Early Detection of Cancer/*methods MH - Female MH - *Gadolinium DTPA MH - Humans MH - Liver Neoplasms/*pathology MH - Magnetic Resonance Imaging/*methods MH - Male MH - Predictive Value of Tests MH - Prognosis MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - Tumor Burden PMC - PMC4402305 OTO - NOTNLM OT - Ethoxybenzyl moiety OT - Fate prediction OT - Hepatocellular carcinoma OT - Magnetic resonance imaging OT - Non-hypervascular hepatic nodule EDAT- 2015/04/29 06:00 MHDA- 2016/02/04 06:00 PMCR- 2015/04/21 CRDT- 2015/04/28 06:00 PHST- 2014/09/07 00:00 [received] PHST- 2014/11/29 00:00 [revised] PHST- 2015/01/16 00:00 [accepted] PHST- 2015/04/28 06:00 [entrez] PHST- 2015/04/29 06:00 [pubmed] PHST- 2016/02/04 06:00 [medline] PHST- 2015/04/21 00:00 [pmc-release] AID - 10.3748/wjg.v21.i15.4583 [doi] PST - ppublish SO - World J Gastroenterol. 2015 Apr 21;21(15):4583-91. doi: 10.3748/wjg.v21.i15.4583.