Cargando…

Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort

The value of gadoxetic acid in the diagnosis of hepatocellular carcinoma (HCC), based on perfusion criteria, is under dispute. This post-hoc analysis of the prospective, phase II, randomized, controlled SORAMIC study compared the accuracy of gadoxetic acid-enhanced dynamic magnetic resonance imaging...

Descripción completa

Detalles Bibliográficos
Autores principales: Seidensticker, Max, Steffen, Ingo G., Bargellini, Irene, Berg, Thomas, Benito, Alberto, Gebauer, Bernhard, Iezzi, Roberto, Loewe, Christian, Karçaaltincaba, Musturay, Pech, Maciej, Sengel, Christian, van Delden, Otto, Vandecaveye, Vincent, Zech, Christoph J., Ricke, Jens
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870455/
https://www.ncbi.nlm.nih.gov/pubmed/35200551
http://dx.doi.org/10.3390/curroncol29020051
_version_ 1784656754943983616
author Seidensticker, Max
Steffen, Ingo G.
Bargellini, Irene
Berg, Thomas
Benito, Alberto
Gebauer, Bernhard
Iezzi, Roberto
Loewe, Christian
Karçaaltincaba, Musturay
Pech, Maciej
Sengel, Christian
van Delden, Otto
Vandecaveye, Vincent
Zech, Christoph J.
Ricke, Jens
author_facet Seidensticker, Max
Steffen, Ingo G.
Bargellini, Irene
Berg, Thomas
Benito, Alberto
Gebauer, Bernhard
Iezzi, Roberto
Loewe, Christian
Karçaaltincaba, Musturay
Pech, Maciej
Sengel, Christian
van Delden, Otto
Vandecaveye, Vincent
Zech, Christoph J.
Ricke, Jens
author_sort Seidensticker, Max
collection PubMed
description The value of gadoxetic acid in the diagnosis of hepatocellular carcinoma (HCC), based on perfusion criteria, is under dispute. This post-hoc analysis of the prospective, phase II, randomized, controlled SORAMIC study compared the accuracy of gadoxetic acid-enhanced dynamic magnetic resonance imaging (MRI) (arterial, portovenous, and venous phase only) versus contrast-enhanced computed tomography (CT) for stratifying patients with HCC to curative ablation or palliative treatment. Two reader groups (radiologists, R1 and R2) performed blind reads of CT and gadoxetic acid-enhanced MRI (contrast dynamics only). A truth panel, with access to clinical and imaging follow-up data, served as reference. Primary endpoint was non-inferiority (margin: 5% points) of MRI vs. CT (lower 95% confidence interval [CI] > 0.75) in a first step and superiority (complete 95% CI > 1) in a second step. The intent-to-treat population comprised 538 patients. Accuracy of treatment decisions was 73.4% and 70.8% for CT (R1 and R2, respectively) and 75.1% and 70.3% for gadoxetic acid-enhanced dynamic MRI. Non-inferiority but not superiority of gadoxetic acid-enhanced dynamic MRI versus CT was demonstrated (odds ratio 1.01; CI 0.97–1.05). Despite a theoretical disadvantage in wash-out depiction, gadoxetic acid-enhanced dynamic MRI is non-inferior to CT in accuracy of treatment decisions for curative ablation versus palliative strategies. This outcome was not subject to the use of additional MR standard sequences.
format Online
Article
Text
id pubmed-8870455
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-88704552022-02-25 Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort Seidensticker, Max Steffen, Ingo G. Bargellini, Irene Berg, Thomas Benito, Alberto Gebauer, Bernhard Iezzi, Roberto Loewe, Christian Karçaaltincaba, Musturay Pech, Maciej Sengel, Christian van Delden, Otto Vandecaveye, Vincent Zech, Christoph J. Ricke, Jens Curr Oncol Article The value of gadoxetic acid in the diagnosis of hepatocellular carcinoma (HCC), based on perfusion criteria, is under dispute. This post-hoc analysis of the prospective, phase II, randomized, controlled SORAMIC study compared the accuracy of gadoxetic acid-enhanced dynamic magnetic resonance imaging (MRI) (arterial, portovenous, and venous phase only) versus contrast-enhanced computed tomography (CT) for stratifying patients with HCC to curative ablation or palliative treatment. Two reader groups (radiologists, R1 and R2) performed blind reads of CT and gadoxetic acid-enhanced MRI (contrast dynamics only). A truth panel, with access to clinical and imaging follow-up data, served as reference. Primary endpoint was non-inferiority (margin: 5% points) of MRI vs. CT (lower 95% confidence interval [CI] > 0.75) in a first step and superiority (complete 95% CI > 1) in a second step. The intent-to-treat population comprised 538 patients. Accuracy of treatment decisions was 73.4% and 70.8% for CT (R1 and R2, respectively) and 75.1% and 70.3% for gadoxetic acid-enhanced dynamic MRI. Non-inferiority but not superiority of gadoxetic acid-enhanced dynamic MRI versus CT was demonstrated (odds ratio 1.01; CI 0.97–1.05). Despite a theoretical disadvantage in wash-out depiction, gadoxetic acid-enhanced dynamic MRI is non-inferior to CT in accuracy of treatment decisions for curative ablation versus palliative strategies. This outcome was not subject to the use of additional MR standard sequences. MDPI 2022-01-27 /pmc/articles/PMC8870455/ /pubmed/35200551 http://dx.doi.org/10.3390/curroncol29020051 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Seidensticker, Max
Steffen, Ingo G.
Bargellini, Irene
Berg, Thomas
Benito, Alberto
Gebauer, Bernhard
Iezzi, Roberto
Loewe, Christian
Karçaaltincaba, Musturay
Pech, Maciej
Sengel, Christian
van Delden, Otto
Vandecaveye, Vincent
Zech, Christoph J.
Ricke, Jens
Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort
title Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort
title_full Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort
title_fullStr Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort
title_full_unstemmed Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort
title_short Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort
title_sort gadoxetic acid-based mri for decision-making in hepatocellular carcinoma employing perfusion criteria only—a post hoc analysis from the soramic trial diagnostic cohort
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870455/
https://www.ncbi.nlm.nih.gov/pubmed/35200551
http://dx.doi.org/10.3390/curroncol29020051
work_keys_str_mv AT seidenstickermax gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT steffeningog gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT bargelliniirene gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT bergthomas gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT benitoalberto gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT gebauerbernhard gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT iezziroberto gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT loewechristian gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT karcaaltincabamusturay gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT pechmaciej gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT sengelchristian gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT vandeldenotto gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT vandecaveyevincent gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT zechchristophj gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort
AT rickejens gadoxeticacidbasedmrifordecisionmakinginhepatocellularcarcinomaemployingperfusioncriteriaonlyaposthocanalysisfromthesoramictrialdiagnosticcohort