The Iron Content of Hepatocellular Carcinoma Associated Nodules: Study of Histopathology and MR Imaging

LIU Dan, SONG Bin, HUANG Zi-xing. et al

Abstract

To explore the clinical value of MRI imaging of measuring the iron content for hepatocellular carcinoma (HCC) associated nodules. Methods 55 male Wistar rats were randomly allocated into a treatment and a control group, which were administered with diethyl nitrosamine (DEN) and the sterilized tap water. According to the macro pathology differences, the treatment groups were divided into three groups: cirrhotic nodules group, cirrhotic nodules with HCC group, and HCC group; According to the micro pathology differences, the treatment groups were divided into four groups: regenerative nodules (RN) group, low grade dysplastic nodules (LGDN) group, high grade dysplastic nodules (HGDN) group, and HCC group. After 13 weeks, the rats were scanned by MRI T2WI and T2*WI. The next day all rats were sacrificed for histological tests and tissue iron level determination. The correlations were statically analyzed between the values of T2, T2* and the grades of iron stain, the quantification of tissue iron. Results With macro pathology observation, the values of T2, T2* among control group (normal rats), cirrhotic nodules group, cirrhotic nodules with HCC group, HCC group were increased, while the quantification of tissue iron were decreased. Significant differences were found for T2, T2*and quantification of tissue iron in three groups (P<0.05). Low-grade negative correlations could be found between T2, T2* and quantification of tissue iron in whole samples (r1=-0.364, P1=0.000; r2=-0.245, P2=0.018). With micro pathology observation, there were significant differences among the control (normal rats), RN, LGDN, HGDN, and HCC groups for the grades of iron stain both in the essence and the interstitial (P<0.05). After comparison each two groups, significant differences were found among some groups for the grades of iron stain both in the essence and the interstitial (P<0.05). Generally the grades of iron stain for HCCs were lower than non-HCC both in the essence and the interstitial. Conclusion Negative correlation between T2, T2* and iron content demonstrats that T2 and T2* could roughly estimate the iron content in the cirrhotic nodules. T2 and T2* measurements could contribute to differential diagnosis of HCC nodules.

 

Keywords: DNE, Cirrhotic nodule, HCC, MRI 

 

Full Text:

PDF


References


SUH CH. KIM KW, KIM GY. et at. The diagnostic value of Gd-EOB-DTPA-MRI for the diagnosis of focal nodular hyperplasia; a systematic review and meta-analysis. Eur Radiol .2015.25(4): 950-960.

CHOI JY, LEE JM, SIRLIN СВ. CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part I . Development, growth, and spread; key pathologic and imaging aspects. Radiology,2014,272(3);635-654.

TURLIN B, DEUGNIER Y. Evaluation and interpretation of iron in the liver. Semin Diagn Pathol, 1998,15(4) :237-245.

HOLMSTROM P. GAFVELS М, ERIKSSON LC, et al. Expression of iron regulatory genes in a rat model of hepatocellular carcinoma. Liver Int,2006,26(8) ;976-985.

ZHANG JB, KRINSKY GA. Iron-containing nodules of cirrhosis. NMR Biome, 2004 ,17(7): 459-464.

HUHJ, KIM KW. KIM J. et al. Pathology-MRI correlation of hepatocarcinogenesis: recent update. J Pathol Transl Med.2015,49(3) :218-229.

KEARNEY SL, NEMETH E. NEUFELD EJ, et al. Urinary hepcidin in congenital chronic anemias. Pediatr Blood Cancer, 2007,48(1):57-63.

YVES D, BRUNO T. Pathology of hepatic iron overload. World J Gastroenterol,2007,13(35):4755-4760.

MURAKAMI T, KURODA C, MARUKAWA T, et al. Regenerating nodules in hepatic cirrhosis: MR findings with pathologic correlation. AJR, 1990,155(6); 1227-1231.

GANDON Y, OLIVIE D. GUYADER D, et al. Non- invasive assessment of hepatic iron stores by MRI. Lancet, 2004,363(9406):357-362.

WESTWOOD MA, ANDERSON LJ, FIRMIN DN, etui. A single breath-hold multi echo T2, cardiovascular magnetic resonance technique for diagnosis of myocardial iron overload. J Magn Reson Imaging,2003,18(5) ;33-39.

HANKINS JS, MC CARVILLE MB, LOEFFLER RB.et al. R2, magnetic resonance imaging of the liver in patients with iron overload. Blood,2009,113(20);4853-4855.

ST PIERRE TG, CLARK PR, CHUA-ANUSORN W. Single spin-echo proton transverse relaxometry of iron loaded- liver. NMR Biomed,2004 ,17(7);446-448.

TEDASHI T, MASUMI K, YASUNI N, et al. Iron- accumulating adenomatous hyperplastic nodule with malignant foci in the cirrhotic liver. Cancer, 1999, 65 ( 9): 1994-2000.

ARGYROPOULOU MI, ASTRAKAS L. MRI evaluation of tissue iron burden in patients with beta-thalassaemia major. Pediatr Radiol,2007,37( 12): 1191-1200.

WOOD JC, ENRIQUEZ C, GHUGRE N, et al. MRI R2 and R2, mapping accurately estimates hepatic iron concentration in transfusion-dependent thalassemia and sickle cell disease patients. Blood,2005,106(4) ; 1460-1465.

HAACKEEM, MI AO Y, LIU M, et al. Correlation of putative iron content as represented by changes in R2, and phase with age in deep gray matter of healthy adults. J Magn Reson Imaging.2010,32(3);561-576.

GUO Z. LI J, PEI GX, et al. Pelvic reconstruction with a combined hemipelvic prostheses after resection of primary malignant tumor. Surg Oncol.2010,19(2) ;95-105.

JI T, GUO W. TANG ХD. et al. Reconstruction of type II + III pelvic resection with a modular hemipelvic endoprosthesis; a finite element analysis study. Orthop Surg. 2010,2(4):272-277.

TANG X. GUO W, JI T, et al. Reconstruction with modular hemipelvic prosthesis for the resection of solitary periacetabular metastasis. Arch Orthop Trauma Surg.2011. 131(12):1609-1615.

JI T, GUO W. YANG RL. et al. Modular hemipelvic endoprosthesis reconstruction experience in 100 patients with mid-term follow-up results. Eur J Surg Oncol, 2013,39 (1);53-60.

ZHOU Y. DUAN H, LIU Y. et al. Outcome after pelvic sarcoma resection and reconstruction with a modular hemipelvic prostheses. Int Orthop.2011, 35(12): 1839-1846.

ZHOU Y, MIN L. LIU Y. et al. Finite element analysis of the pelvis after modular hemipelvic endoprosthesis reconstruction. Int Orthop,2013,37(4) :653-658.

WANG В. XIE X, YIN J. et al. Reconstruction with modular hemipelvic endoprosthesis after pelvic tumor resection: a report of 50 consecutive cases. PLoS One. 2015. 10(5): e0127263. doi: 10. 1371/journal, pone. 0127263. eCollection 2015.

ANGELINI A, DRAGO G, TROVARELLI G, et al. Infection after surgical resection for pelvic hone tumors: an analysis of 270 patients from one institution. Clin Orthop Relat Res,2014 ,472(1); 349-359.

WITTE D, BERND U BRUNS J, et al. Limb-salvage reconstruction with MUTARS hemipelvic endoprosthesis: a prospective multicenter study. Eur J Surg Oncol, 2009, 35 (12);1318-1325.

MCCOLLUM DE, GRAY WJ. Dislocation after total hip arthroplasty. Causes and prevention. Clin Orthop Relat Res, 1990(261):159-170.

KLEEMANN RU, HELLER MO, STOECKLE U, et al. THA loading arising from increased femoral anteversion and offset may lead to critical cement stresses. J Orthop Res, 2003,21(5):767-774.


Refbacks

  • There are currently no refbacks.