Prediction for Aggressiveness and Postoperative Recurrence of Hepatocellular Carcinoma Using Gadoxetic Acid-Enhanced Magnetic Resonance Imaging

Lu, Mengtian; Qu, Qi; Xu, Lei; Zhang, Jiyun; Liu, Mao-tong; Jiang, Junkang; Shen, Wei; Zhang, Tao; Zhang, Xueqin

doi:10.1016/j.acra.2022.12.018

Cited by 10 publications

(1 citation statement)

References 43 publications

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“…A total of 4300 samples were involved (2002 samples in Ki-67 models, 2298 samples in CK-19 models) in the 34 included studies. Among the included studies, 18 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) focused on Ki-67 and 16 (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) focused on CK-19. The samples of the included studies came from different hospitals, with six studies from multiple centers and the rest from single centers (33,37,42,44,48,53).…”

Section: Study Characteristicsmentioning

confidence: 99%

Diagnostic value of radiomics in predicting Ki-67 and cytokeratin 19 expression in hepatocellular carcinoma: a systematic review and meta-analysis

Zhou,

Chen,

et al. 2024

Front. Oncol.

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BackgroundRadiomics have been increasingly used in the clinical management of hepatocellular carcinoma (HCC), such as markers prediction. Ki-67 and cytokeratin 19 (CK-19) are important prognostic markers of HCC. Radiomics has been introduced by many researchers in the prediction of these markers expression, but its diagnostic value remains controversial. Therefore, this review aims to assess the diagnostic value of radiomics in predicting Ki-67 and CK-19 expression in HCC.MethodsOriginal studies were systematically searched in PubMed, EMBASE, Cochrane Library, and Web of Science from inception to May 2023. All included studies were evaluated by the radiomics quality score. The C-index was used as the effect size of the performance of radiomics in predicting Ki-67and CK-19 expression, and the positive cutoff values of Ki-67 label index (LI) were determined by subgroup analysis and meta-regression.ResultsWe identified 34 eligible studies for Ki-67 (18 studies) and CK-19 (16 studies). The most common radiomics source was magnetic resonance imaging (MRI; 25/34). The pooled C-index of MRI-based models in predicting Ki-67 was 0.89 (95% CI:0.86–0.92) in the training set, and 0.87 (95% CI: 0.82–0.92) in the validation set. The pooled C-index of MRI-based models in predicting CK-19 was 0.86 (95% CI:0.81–0.90) in the training set, and 0.79 (95% CI: 0.73–0.84) in the validation set. Subgroup analysis suggested Ki-67 LI cutoff was a significant source of heterogeneity (I2 = 0.0% P>0.05), and meta-regression showed that the C-index increased as Ki-67 LI increased.ConclusionRadiomics shows promising diagnostic value in predicting positive Ki-67 or CK-19 expression. But lacks standardized guidelines, which makes the model and variables selection dependent on researcher experience, leading to study heterogeneity. Therefore, standardized guidelines are warranted for future research.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023427953.

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Section: Study Characteristicsmentioning

confidence: 99%

Diagnostic value of radiomics in predicting Ki-67 and cytokeratin 19 expression in hepatocellular carcinoma: a systematic review and meta-analysis

Zhou,

Chen,

et al. 2024

Front. Oncol.

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Diagnostic Model for Proliferative HCC Using LI‐RADS: Assessing Therapeutic Outcomes in Hepatectomy and TKI‐ICI Combination

Lu,

Yan,

et al. 2024

Magnetic Resonance Imaging

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BackgroundProliferative hepatocellular carcinoma (HCC), aggressive with poor prognosis, and lacks reliable MRI diagnosis.PurposeTo develop a diagnostic model for proliferative HCC using liver imaging reporting and data system (LI‐RADS) and assess its prognostic value.Study TypeRetrospective.Population241 HCC patients underwent hepatectomy (90 proliferative HCCs: 151 nonproliferative HCCs), divided into the training (N = 167) and validation (N = 74) sets. 57 HCC patients received combination therapy with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs).Field Strength/Sequence3.0 T, T1‐ and T2‐weighted, diffusion‐weighted, in‐ and out‐phase, T1 high resolution isotropic volume excitation and dynamic gadoxetic acid‐enhanced imaging.AssessmentLI‐RADS v2018 and other MRI features (intratumoral artery, substantial hypoenhancing component, hepatobiliary phase peritumoral hypointensity, and irregular tumor margin) were assessed. A diagnostic model for proliferative HCC was established, stratifying patients into high‐ and low‐risk groups. Follow‐up occurred every 3–6 months, and recurrence‐free survival (RFS), progression‐free survival (PFS) and overall survival (OS) in different groups were compared.Statistical TestsFisher's test or chi‐square test, t‐test or Mann–Whitney test, logistic regression, Harrell's concordance index (C‐index), Kaplan–Meier curves, and Cox proportional hazards. Significance level: P < 0.05.ResultsThe diagnostic model, incorporating corona enhancement, rim arterial phase hyperenhancement, infiltrative appearance, intratumoral artery, and substantial hypoenhancing component, achieved a C‐index of 0.823 (training set) and 0.804 (validation set). Median follow‐up was 32.5 months (interquartile range [IQR], 25.1 months) for postsurgery patients, and 16.8 months (IQR: 13.2 months) for combination‐treated patients. 99 patients experienced recurrence, and 30 demonstrated tumor nonresponse. Differences were significant in RFS and OS rates between high‐risk and low‐risk groups post‐surgery (40.3% vs. 65.8%, 62.3% vs. 90.1%, at 5 years). In combination‐treated patients, PFS rates differed significantly (80.6% vs. 7.7% at 2 years).Data ConclusionThe MR‐based model could pre‐treatment identify proliferative HCC and assist in prognosis evaluation.Level of Evidence4.Technical EfficacyStage 2.

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A Step Closer to Personalized Treatment of Hepatocellular Carcinoma

Bahsoun¹,

Hussain²

2023

Academic Radiology

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Prediction for Aggressiveness and Postoperative Recurrence of Hepatocellular Carcinoma Using Gadoxetic Acid-Enhanced Magnetic Resonance Imaging

Cited by 10 publications

References 43 publications

Diagnostic value of radiomics in predicting Ki-67 and cytokeratin 19 expression in hepatocellular carcinoma: a systematic review and meta-analysis

Diagnostic value of radiomics in predicting Ki-67 and cytokeratin 19 expression in hepatocellular carcinoma: a systematic review and meta-analysis

Diagnostic Model for Proliferative HCC Using LI‐RADS: Assessing Therapeutic Outcomes in Hepatectomy and TKI‐ICI Combination

A Step Closer to Personalized Treatment of Hepatocellular Carcinoma

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