Perfusion parameters of triphasic computed tomography hold preoperative prediction value for microvascular invasion in hepatocellular carcinoma

Abstract

The purpose of this study was to evaluate perfusion parameters of triphasic computed tomography (CT) scans in predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC). All patients were pathologically diagnosed as HCC and underwent triple-phase enhanced CT imaging, which was used to calculate the blood perfusion parameters of hepatic arterial supply perfusion (HAP), portal vein blood supply perfusion (PVP), hepatic artery perfusion Index (HPI), and arterial enhancement fraction (AEF). Receiver operating characteristic (ROC) curve was used to evaluate the performance. The mean values of PVP(Min), AEF(Min), the difference in PVP, HPI and AEF related parameters, the relative PVP(Min) and AEF(Min) in MVI negative group were significantly higher than those in MVI positive group, while for the difference in HPI(Max), the relative HPI(Max) and AEF(Max), the value of MVI positive group significantly higher than that of negative group. The combination of PVP, HPI and AEF had the highest diagnostic efficacy. The two parameters related to HPI had the highest sensitivity, while the combination of PVP related parameters had higher specificity. A combination of perfusion parameters in patients with HCC derived from traditional triphasic CT scans can be used as a preoperative biomarker for predicting MVI.

Dual-energy computed tomography iodine quantification combined with laboratory data for predicting microvascular invasion in hepatocellular carcinoma: a two-centre study

“…They found that the 2 parameters related to HPI (ΔHPI(Max) and relative-HPI(Max)) had the highest sensitivity for predicting MVI at 0.854. 38 These findings are similar to ours, as ICa, ICa/ICaliver, and ΔICa respond to arterial phase blood supply similarly to AEF and HPI. Studies have shown that HCC with cirrhosis leads to a decrease in portal venous pressure (PVP).…”

“… 34 Chan et al identified high albumin bilirubin grading as a key parameter associated with early recurrence and developed a relevant preoperative model to predict the risk of early recurrence after HCC surgical resection. 35 Several recent studies have shown that nomogram models combined with TBIL provide better predictive performance in predicting MVI, 26 , 36 , 38 but the mechanism of interaction between bilirubin levels and MVI remains unclear. We hypothesized that MVI leads to local tissue oedema and limits the local function of the small bile ducts.…”