Additional nodules detected using EOB-MRI in patients with resectable single hepatocellular carcinoma: An implication for active treatment strategy

Key message: Aggressive treatment (resection/RFA) for additional nodules detected on EOB-MRI in HCC patients results in comparable long-term survival to that of solitary HCC cases.

EOB-MRI improves detection of hepatic nodules compared to CT alone, but optimal treatment for these nodules is uncertain. This study assessed the oncological impact of aggressive treatment for such nodules in hepatocellular carcinoma (HCC) patients.

Data from 522 HCC patients diagnosed via CT from 2008 to 2012 were analyzed. Propensity score-matched (PSM) analysis compared outcomes between patients with solitary HCC and those with additional nodules on EOB-MRI, treated aggressively (resection/RFA). Among 383 patients, 59 had additional nodules on EOB-MRI. Surgical plan was changed in 11.2% of patients. After PSM, long-term outcomes (DFS, OS) were similar between the two groups (Fig. 1 & 2).

This study demonstrated that aggressive treatment (resection/RFA) for additional nodules detected on EOB-MRI yielded long-term survival comparable to solitary HCC.

Fig 1. DFS after propensity score matching
 Fig 2. OS after propensity score matching

DFS, disease-free survival; EOB-MRI, gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging; HCC, hepatocellular carcinoma; MDCT, multidetector computed tomography; OS, overall survival.

References:

  1. Na Reum Kim et al. Additional nodules detected using EOB-MRI in patients with resectable single hepatocellular carcinoma: An implication for active treatment strategy. J Liver Cancer. 2024;24(1):92-101.