New classification of dynamic computed tomography images predictive of malignant characteristics of hepatocellular carcinoma

Kawamura, Yusuke; Ikeda, Kenji; Hirakawa, Miharu; Yatsuji, Hiromi; Sezaki, Hitomi; Hosaka, Tetsuya; Akuta, Norio; Kobayashi, Masahiro; Saitoh, Satoshi; Suzuki, Fumitaka; Suzuki, Yoshiyuki; Arase, Yasuji; Kumada, Hiromitsu

doi:10.1111/j.1872-034x.2010.00703.x

Cited by 68 publications

(77 citation statements)

References 23 publications

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“…These results agree with those from previous studies in which peritumoral parenchymal enhancement or tumorous arterioportal shunt was associated with microvascular invasion (16,17,34). The rim enhancement pattern has been also suggested to indicate rapid progression, poor differentiation, and worse prognosis (22,25,35), possibly by reflecting the absence of a capsule, infiltrative growth, and the presence of microvascular invasion as well as rapid growth with central necrosis.…”

Section: Discussionsupporting

confidence: 83%

Single Hepatocellular Carcinoma: Preoperative MR Imaging to Predict Early Recurrence after Curative Resection

An¹,

Kim

Park³

et al. 2015

Radiology

185

130

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Purpose:To identify magnetic resonance (MR) imaging features that enable prediction of early recurrence (,2 years) after curative resection of hepatocellular carcinoma (HCC) and to derive a preoperative prediction model. Materials and Methods:This retrospective study was approved by the institutional review board. The requirement to obtain written informed consent was waived. A total of 268 patients who underwent hepatic resection for a single HCC from January 2008 to August 2011 were divided into two cohorts: a training cohort, which was used to derive a prediction model (n = 187), and a validation cohort (n = 81). All MR images from the training cohort were reviewed by two radiologists. A prediction model was constructed by using MR imaging features that were independently associated with early recurrence with use of multiple logistic regression analysis. The performance of the prediction model in the validation cohort was evaluated with respect to discrimination (ie, whether the relative ranking of individual predictions of subsequent early recurrence is in the correct order). Results:In the training cohort, four MR imaging features were independently associated with early recurrence: rim enhancement (odds ratio [ Conclusion:The prediction model derived from rim enhancement, peritumoral parenchymal enhancement, satellite nodule, and tumor size can be used preoperatively to estimate the risk of early recurrence after resection of a single HCC.q RSNA, 2015

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Section: Discussionsupporting

confidence: 83%

Single Hepatocellular Carcinoma: Preoperative MR Imaging to Predict Early Recurrence after Curative Resection

An¹,

Kim

Park³

et al. 2015

Radiology

185

130

View full text Add to dashboard Cite

show abstract

“…The diagnosis of HCC was established by histopathology or typical appearance of HCC on two sets of imaging studies (ultrasonography, computed tomography (CT), magnetic resonance imaging, or angiography) and/or based on elevation of tumor markers, such as α ‐fetoprotein (AFP) and DCP. We retrospectively evaluated and classified the vascular patterns of tumors in cases treated with RFA by imaging studies previously reported . Briefly, HCC was classified into four patterns, Type‐1,‐2,‐3, or‐4 according to pattern of enhancement.…”

Section: Methodsmentioning

confidence: 99%

“…In contrast, Type‐3 pattern represents a heterogeneous enhancement pattern with a septum‐like structure, which is associated with not only SN but also SN with extranodular growth type (SNEG) or confluent multinodular type (CMN). Type‐4 represents a heterogeneous enhancement pattern with irregular ring‐like structures, which was also associated with SN, SNEG, and CMN . The status of viral hepatitis infection was evaluated in all patients by the presence of serum anti‐HCV antibody and serum hepatitis B surface antigen.…”

Section: Methodsmentioning

confidence: 99%

Neutrophil‐to‐lymphocyte ratio predicts recurrence after radiofrequency ablation in hepatitis B virus infection

Tajiri

Baba

Kawai

et al. 2016

J of Gastro and Hepatol

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“…If there are evident associations between IRE and prognostic histopathologic features, IRE could be used as an imaging biomarker for prognosis based on the associations. However, to the best of our knowledge, no comprehensive studies of the histopathologic features of IRE-HCCs exist, although some histopathologic findings observed in IRE-HCCs have been sporadically described [13][14][15]. Therefore, the purpose of this study was to examine the histopathologic characteristics of HCCs showing IRE in the arterial phase of gadoxetate-enhanced MRI, and compare them to HCCs without IRE.…”

Section: Introductionmentioning

confidence: 99%

Hepatocellular Carcinoma with Irregular Rim-Like Arterial Phase Hyperenhancement: More Aggressive Pathologic Features

Rhee

An²,

Kim

et al. 2018

Liver Cancer

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Background and Aims: The purpose of our study was to examine the histopathologic characteristics of hepatocellular carcinoma (HCC) with irregular rim-like arterial phase enhancement (IRE), which has been reported to be associated with more aggressive tumor behavior. Methods: We investigated 84 pathologically confirmed HCCs in 84 patients who underwent curative hepatic resection after gadoxetate-enhanced magnetic resonance imaging between January 2008 and February 2013. Two abdominal radiologists independently reviewed these images and classified HCCs into two categories: HCC showing IRE (IRE-HCC) and HCC showing hypoenhancement or diffuse arterial enhancement (non-IRE-HCC). Twenty-two HCCs were classified as IRE-HCCs, and 51 were classified as non-IRE-HCCs concordantly by both reviewers. The remaining 11 HCCs, on whose radiologic classifications the reviewers disagreed, were classified as HCCs with intermediate enhancement patterns. The HCC clinicopathologic characteristics and patient outcomes were then compared. Results: IRE-HCCs showed more frequent microvascular invasion (91 vs. 35%), lower microvascular density (246.5 vs. 426.5/mm²), higher proportions of sinusoid-like microvascular pattern (55 vs. 0%) and macrotrabecular pattern (45 vs. 0%), and larger areas of tumor necrosis (15 vs. 0%) and fibrous stroma (8.3 vs. 2.1%) than non-IRE-HCCs. IRE-HCCs also expressed higher levels of immunomarkers of hypoxia (carbonic anhydrase IX, 64 vs. 8%) and stemness (EpCAM, 50 vs. 20%). p values were < 0.001 for all comparisons except for EpCAM (p = 0.026). HCCs with intermediate enhancement patterns showed mixed/intermediate pathologic features from both IRE- and non-IRE-HCCs. IRE-HCC patients showed poorer 5-year disease-free survival after curative resection than non-IRE-HCC patients (p = 0.005). Conclusions: IRE-HCCs demonstrate aggressive histopathologic features, including more hypoxic and fibrotic tumor microenvironments and increased stemness, compared to non-IRE-HCCs. IRE might therefore serve as a noninvasive imaging biomarker for aggressive HCC.

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New classification of dynamic computed tomography images predictive of malignant characteristics of hepatocellular carcinoma

Abstract: Heterogeneity of dynamic CT images correlates with malignant characteristics of HCC and can be potentially used to predict the malignant potential of HCC before treatment.

Cited by 68 publications

References 23 publications

Single Hepatocellular Carcinoma: Preoperative MR Imaging to Predict Early Recurrence after Curative Resection

Single Hepatocellular Carcinoma: Preoperative MR Imaging to Predict Early Recurrence after Curative Resection

Neutrophil‐to‐lymphocyte ratio predicts recurrence after radiofrequency ablation in hepatitis B virus infection

Hepatocellular Carcinoma with Irregular Rim-Like Arterial Phase Hyperenhancement: More Aggressive Pathologic Features

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