MR features based on LI-RADS identify cytokeratin 19 status of hepatocellular carcinomas

Objective: To retrospectively evaluate the value of MR features based on Liver Imaging Reporting and Data System (LI-RADS ver. 2017) for identifying the status of cytokeratin (CK) 19 expression of HCC before surgery. Methods: A total of 201 patients with 207 HCCs who underwent MR imaging were reviewed retrospectively. MR features based on LI-RADS ver. 2017 as well as clinical data were compared between CK19-positive (n=51) and CK19-negative (n=156) HCCs groups. Potential predictive parameters were identified by univariate and multivariate logistic regression analysis and diagnostic odds ratios (ORs) were recorded. Results: MR features including targetoid appearance (p=0.001) was more frequently observed while nonperipheral "washout" (p < 0.0001) and non-rim arterial phase hyper-enhancement (p < 0.0001) were found less frequently in CK19-positive HCCs compared to CK19-negative HCCs. At multivariate analysis, serum alphafetoprotein (AFP)> 20 ng/ml (OR=5.9) and targetoid appearance (OR=4.2) and non-peripheral "washout" (OR=0.2) were significant independent predictors of CK19-positive HCCs. Conclusion: Targetoid appearance and absence non-peripheral "washout" combined with elevated AFP were useful for differentiating CK19-positive HCCs from CK19-negative HCC.