フククラ　ヨシヒコ   Yoshihiko Fukukura   福倉　良彦    所属   川崎医科大学  医学部 臨床医学　機能・代謝画像診断学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Magnetic resonance imaging-based risk factors of hepatocellular carcinoma after direct-acting antiviral therapy: A multicenter observational study.
掲載誌名	正式名：Hepatology research : the official journal of the Japan Society of Hepatology 略　 称：Hepatol Res ISSNコード：13866346/13866346
掲載区分	国外
巻・号・頁	54(1),pp.43-53
著者・共著者	Shintaro Ichikawa, Utaroh Motosugi, Yoshiyuki Sawai, Hisashi Ishida, Yasuharu Imai, Kazuto Kozaka, Masakatsu Tsurusaki, Keitaro Sofue, Takamichi Murakami, Nobuyuki Kawai, Masayuki Matsuo, Yoshihiko Fukukura, Seiichi Mawatari, Tatsuya Shimizu, Hiroyuki Morisaka, Taisuke Inoue, Satoshi Goshima
発行年月	2024/01
概要	AIM:To determine risk factors associated with hepatocellular carcinoma (HCC) development following direct-acting antiviral (DAA) therapy.METHODS:We enrolled patients with chronic hepatitis C who underwent direct-acting antiviral therapy and achieved sustained virologic response at 12 weeks between 2012 and 2018. Subsequently, patients were followed up. The primary endpoint was the development of HCC or the date of the last follow up when the absence of HCC was confirmed. Uni- and multivariate Cox proportional hazards models were used to identify factors contributing to HCC development, including gadoxetic acid-enhanced magnetic resonance imaging findings. The cumulative incidence rates of HCC development were calculated using the Kaplan-Meier method, and differences between groups were assessed using the log-rank test.RESULTS:The final study cohort comprised 482 patients (median age 70.5 years; 242 men). The median follow-up period was 36.8 months. Among 482 patients, 96 developed HCC (19.9%). The 1-, 3-, and 5-year cumulative rates of HCC development were 4.9%, 18.6%, and 30.5%, respectively. Multivariate analysis revealed that age, male sex, history of HCC, and hepatobiliary phase hypointense nodules without arterial phase hyperenhancement were independent risk factors significantly associated with HCC development (p < 0.001-0.04). The highest risk group included patients with both a history of HCC and the presence of hepatobiliary phase hypointense nodules without arterial phase hyperenhancement (the 1- and 3-year cumulative HCC development rates were 14.2% and 62.2%, respectively).CONCLUSION:History of HCC and presence of hepatobiliary phase hypointense nodules without arterial phase hyperenhancement were strong risk factors for HCC development following direct-acting antiviral therapy.
DOI	10.1111/hepr.13964
PMID	37676063