Distinctive magnetic resonance imaging findings of hepatocellular carcinoma after hepatitis C virus eradication with direct-acting antivirals

Abstract

Aim: The aim of the present study was to evaluate the characteristics of the magnetic resonance imaging features of hepatocellular carcinoma (HCC) that developed early after the eradication of hepatitis C virus (HCV) by direct-acting antiviral (DAA) treatment.

Methods: This study included 26 patients who achieved sustained viral response with DAA and developed HCC thereafter within one year (DAA-SVR HCC). The radiologic characteristics of these patients were evaluated by contrast-enhanced magnetic resonance imaging, including diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI). For comparison, 80 HCC patients with positive HCV RNA (HCV-positive HCC) were included. Among 42 patients where tumor biopsy was available, histological grade and radiologic findings were compared.

Results: The rates of high intensity on DWI and T2WI were significantly higher in DAA-SVR HCC compared to HCV-positive HCC (DWI: 100% vs. 67.5%, P < 0.001; T2WI: 92.6% vs. 67.5%, P = 0.01). HCC with high intensity on DWI or T2WI was more likely to have moderately or poorly differentiated HCC compared to well-differentiated HCC (DWI: 69.7% vs. 30.3%, P = 0.02; T2WI: 66.7% vs. 27.3%, P = 0.03).

Conclusion: High intensity on DWI and hyperintensity on T2WI were distinctive features of HCC that developed within one year after the end of DAA treatment.

Keywords

Hepatocellular carcinoma / direct-acting antivirals / sustained viral response / contrast enhanced magnetic resonance imaging

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