Prediction of progression of hepatic metastases from uveal melanoma using gadoxetic acid-enhanced magnetic resonance imaging

MRI is the preferred method for evaluating hepatic metastases from uveal melanoma. This study was aimed to predict the progression of hepatic metastases from uveal melanoma using gadoxetic acid-enhanced MRI findings. This retrospective study included patients (≥18 years) with uveal melanoma who underwent gadoxetic acid-enhanced liver MRI for evaluation of hepatic metastasis between 2010 and 2023 at two tertiary referral centers. Radiologists retrospectively evaluated the baseline MRI findings of the included patients and assessed tumor responses on follow-up studies according to the Response Evaluation Criteria in Solid Tumors version 1.1. Independent prognostic factors for the time to progression of hepatic metastases were identified using Cox proportional regression analysis. A nomogram based on the multivariable analysis was created and internally validated. A total of 65 patients (mean age, 61.5 ± 14.0 years; 36 men and 29 women) were included. Multivariable analysis revealed that the size of the largest tumor [hazard ratio (HR): 1.028, P = 0.005], precontrast T1 hypointensity (HR: 3.033, P = 0.016), mild to moderate T2 hyperintensity (HR: 3.680, P = 0.001), and hepatobiliary phase hypointensity (HR: 3.370, P = 0.020) were significantly associated with shorter time to progressions of hepatic metastases from uveal melanoma. An internally validated nomogram developed using these MRI findings demonstrated excellent agreement between the predicted probabilities and actual rates of tumor progression, as shown by the calibration plots, with a Harrell's c-index of 0.807. Gadoxetic acid-enhanced MRI findings may be useful in predicting the progression of hepatic metastases from uveal melanoma.