We conduct this study to investigate the value of Kupffer phase radiomics signature of Sonazoid-enhanced ultrasound images (SEUS) for the preoperative prediction of hepatocellular carcinoma (HCC) grade. From November 2019 to October 2021, 68 pathologically confirmed HCC nodules from 54 patients were included. Quantitative radiomic features were extracted from grayscale images and arterial and Kupffer phases of SEUS of HCC lesions. Univariate logistic regression and the maximum relevance minimum redundancy (MRMR) method were applied to select radiomic features best corresponding to pathological results. Prediction radiomic signature was calculated using each of the image types. A predictive model was validated using internal leave-one-out cross validation (LOOCV). For discrimination between poorly differentiated HCC (p-HCC) and well-differentiated HCC/moderately differentiated HCC (w/m-HCC), the Kupffer phase radiomic score (KPRS) achieved an excellent area under the curve (AUC = 0.937), significantly higher than the other two radiomic signatures. KPRS was the best radiomic score based on the highest AUC (AUC = 0.878), which is prior to gray and arterial RS for differentiation between w-HCC and m/p-HCC. Univariate and multivariate analysis incorporating all radiomic signatures and serological variables showed that KPRS was the only independent predictor in both predictions of HCC lesions (p-HCC vs. w/m-HCC, log OR 15.869, P < 0.001 , m/p-HCC vs. w-HCC, log OR 12.520, P < 0.05 ). We conclude that radiomics signature based on the Kupffer phase imaging may be useful for identifying the histological grade of HCC. The Kupffer phase radiomic signature may be an independent and effective predictor in discriminating w-HCC and p-HCC.

Objectives This study aimed to investigate the factors influencing the short‐term and long‐term efficacy of sclerotherapy for cystic thyroid nodules. Methods Ninety‐nine cystic thyroid nodules that underwent ultrasound‐guided fine‐needle aspiration biopsy, detection of thyroglobulin in fine needle aspirate (Tg‐FNA), and ultrasound‐guided percutaneous lauromacrogol injection were retrospectively enrolled from July 2018 to July 2021. All nodules were followed up at 3 and 12 months after the procedure. Factors related to lauromacrogol injection efficacy, including initial volume, vascularity, pathological types, and Tg‐FNA level, were analyzed. The nodules were classified as non‐effective (VRR <50%) and effective groups (VRR ≥50%) at 3 months to evaluate short‐term prognosis, and non‐cured (VRR <90%) and cured groups (VRR ≥90%) at 12 months to evaluate long‐term prognosis. Results The volume of cystic thyroid nodules tended to shrink during follow‐up. The resolution rate was 79.80% (79/99) at 3 months and 96.91% (94/97) at 12 months. The cure rate was 80.41% (78/97) at 12 months. Independent factors for the long‐term prognosis included Tg‐FNA level and vascularity (P  < .05). Only Tg‐FNA level was an independent factor for the short‐term prognosis (P  < .05). The area under the receiver operating characteristic curve for assessing the efficacy at 3 months was 0.79 (95% confidence interval [CI]: 0.65–0.89). With a cutoff value of Tg‐FNA 126.92 ng/mL, the specificity was 0.70, and the sensitivity was 0.85. Conclusions Ultrasound‐guided percutaneous lauromacrogol injection is an effective treatment option for cystic thyroid nodules. It is less effective in viscous or vascular predominantly cystic nodules.