Prognostic performance of preoperative gadoxetic acid-enhanced MRI in resectable hepatocellular carcinoma

Purpose To assess the impact of preoperative evaluation by gadoxetic acid-enhanced magnetic resonance imaging (MRI) on early recurrence outcomes after hepatocellular carcinoma (HCC) resection. Materials and Methods The retrospective study included two groups of Child-Pugh class A patients who underwent curative liver resection for a single HCC; in one group the HCC was identified by dynamic computed tomography (CT) and gadoxetic acid-enhanced MRI (n = 174; MRI group); in the other by dynamic CT only (n = 416; non-MRI group). We compared the two groups with respect to recurrence-free survival after propensity score matching (162 pairs). Results In the matched cohorts, disease-free survival rates for overall and intrahepatic recurrence were 92.6% and 91.9% at 1 year and 78.3% and 79.4% at 2 years, respectively, for the MRI group versus 82.7% and 82.7% at 1 year and 67.2% and 70.4% at 2 years, respectively, for the non-MRI group (P < 0.05). Multivariate Cox analyses revealed that the MRI group was independently superior to the non-MRI group in terms of risk of overall and intrahepatic recurrence at 1 and 2 years in the pooled cohort (P < 0.05). Conclusion Gadoxetic acid-enhanced MRI evaluation is more useful than dynamic CT for identifying good surgical candidates at low risk of early recurrence following hepatic resection for HCC.