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Shimizu et al. Hepatoma Res 2020;6:12 Hepatoma Research
DOI: 10.20517/2394-5079.2019.48

Original Article Open Access

Distinctive magnetic resonance imaging findings
of hepatocellular carcinoma after hepatitis C virus

eradication with direct-acting antivirals

Takao Shimizu 1,2,# , Kaoru Tsuchiya , Masayuki Kurosaki , Yutaka Yasui , Sakura Kirino , Keiya Watakabe ,
1
1,#
1
1
1
Leona Osawa , Mao Okada , Wan Wang , Mayu Higuchi , Kenta Takaura , Shun Kaneko , Nobuharu
1
1
1
1
1
1
Tamaki , Hiroyuki Nakanishi , Jun Itakura , Yuka Takahashi , Tadakazu Hisamatsu , Namiki Izumi 1
1
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2
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1
1 Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo 180-8610, Japan.
2 Department of Gastroenterology and Hepatology, Kyorin University Hospital, Tokyo 180-8610, Japan.
# Authors contributed equally.
Correspondence to: Dr. Namiki Izumi, Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, 1-26-1
Kyonan-cho, Musashino-shi, Tokyo 180-8610, Japan. E-mail: izumi012@musashino.jrc.or.jp
How to cite this article: Shimizu T, Tsuchiya K, Kurosaki M, Yasui Y, Kirino S, Watakabe K, Osawa L, Okada M, Wang W, Higuchi
M, Takaura K, Kaneko S, Tamaki N, Nakanishi H, Itakura J, Takahashi Y, Hisamatsu T, Izumi N. Distinctive magnetic resonance
imaging findings of hepatocellular carcinoma after hepatitis C virus eradication with direct-acting antivirals. Hepatoma Res
2020;6:12. http://dx.doi.org/10.20517/2394-5079.2019.48
Received: 11 Dec 2019 First Decision: 28 Feb 2020 Revised: 12 Mar 2020 Accepted: 17 Mar 2020 Published: 26 Mar 2020
Received: First Decision: Revised: Accepted: Published:
Science Editor: Yuko Kono Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu
Science Editor: Copy Editor: Production Editor: Jing Yu
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).

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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