Pretreatment non‐hypervascular hypointense nodules on Gd‐EOB‐DTPA‐enhanced MRI as a predictor of hepatocellular carcinoma development after sustained virologic response in HCV infection. Issue 12 (25th April 2021)

• Record Type: Journal Article
• Authors: Toyoda, Hidenori; Yasuda, Satoshi; Shiota, Shohei; Sone, Yasuhiro; Maeda, Atsuyuki; Kaneoka, Yuji; Kumada, Takashi; Tanaka, Junko
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 53:Issue 12(2021)
• Page Start: 1309
• Page End: 1316
• Publication Date: 2021-04-25
• Subjects: gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid‐enhanced magnetic resonance imaging -- hepatitis C virus -- hepatocellular carcinoma -- non‐hypervascular hypointense nodules -- sustained virologic response; Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.16382
• Languages: English
• ISSNs: 0269-2813

Abstract

Summary: Background: Identification of risk factors for the development of hepatocellular carcinoma (HCC) after a sustained virologic response (SVR) in patients with chronic hepatitis C virus (HCV) infection is urgently needed for HCC surveillance. Aims: To evaluate whether the presence of non‐hypervascular hypointense nodules (NHHNs) depicted by gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid‐enhanced magnetic resonance imaging (EOB‐MRI) before direct‐acting antivirals (DAAs) therapy is a risk factor for de novo HCC development after SVR. Methods: The presence of NHHNs was examined with EOB‐MRI before the start of DAA therapy in 383 patients with HCV infection who achieved SVR. The incidence of de novo HCC after SVR was compared between patients with versus without NHHNs. Results: NHHNs were detected before DAA therapy in 32 patients (8.4%). The incidence of de novo HCC after SVR was significantly higher in patients with NHHNs than in those without (1‐, 3‐, 5‐year incidence, 9.8%, 24.2% and 41.6% vs. 0%, 1.2% and 4.4%, P < 0.0001). The presence of NHHNs before DAA therapy (adjusted HR, 10.86; 95% CI, 4.03‐31.64) and cirrhosis (adjusted HR, 7.23; 95% CI, 1.88‐35.85) were independently associated with a higher incidence of HCC after SVR. A higher incidence of de novo HCC after SVR remained after adjustment for age, gender, regular alcohol intake, diabetes, cirrhosis, FIB‐4 index and serum alpha‐foetoprotein with inverse probability of treatment weighting. Conclusions: This study confirmed that the presence of NHHNs before DAA therapy is a strong risk factor for the development of de novo HCC after SVR. Abstract : Patients with non‐hypervascular hypo intense nodules before DAA therapy have 10‐fold higher risk of the development of de novo hepatocellular carcinoma (HCC) after sustained virologic response (SVR) in chronic hepatitis C.