Gd-EOB-DTPA enhanced MRI is superior in selecting surgical candidates for patients with early-stage hepatocellular carcinoma: An analysis in terms of oncological outcomes

Purpose: To determine the value of preoperative Gd-EOB-DTPA-Enhanced Magnetic Resonance Imaging (MRI) vs the controls (extracellular contrast agent MRI and CT) in selecting surgical candidates for patients with hepatocellular carcinoma in terms of oncological outcomes after hepatectomy. Methods This retrospective study included 542 consecutive patients who underwent radical hepatectomy for HCC. One group underwent preoperative Gd-EOB-DTPA-Enhanced MRI and the other group underwent contrast enhanced CT or extracellular contrast agents MRI. We compared oncologic outcomes including recurrence free survival and overall survival between the three groups. Subgroup analyses were also performed to provide more specific candidates or beneficiaries for preoperative EOB-MRI. Results Totally 244 patients had tumor recurrence, with 55 in the EOB-MRI Group and 106 in the Routine-MRI Group and 83 in the CT Group (P = 0.010), as for early recurrence (< 2 years), 40 (27.03%) ,78(35.78%) and 62(35.22%) patients in each group (P = 0.018). The 1, 2, 3 years RFS were 82.4%, 73.0%, and 68.2% in EOB-MRI Group, 70.2%, 64.3%, and 56.9% in Routine-MRI Group, 76.8%, 64.83%, and 58.9% in CT Group(P = 0.010). The 1, 2, 3 years OS were 89.19%, 83.11%, and 80.41% in EOB-MRI Group, 79.82%, 73.86%, and 67.44% in Routine-MRI Group, and 86.55%, 76.14%, and 69.32% in CT Group (P = 0.016). Subgroup analysis showed that significant difference in RFS was observed in patients with solitary tumor < 3cm. Conclusions Preoperative EOB-MRI is superior to contrast-enhanced CT or extracellular contrast agents MRI in selecting surgical candidates at low risk of recurrence following hepatic resection for HCC.