Risk stratification of solitary hepatocellular carcinoma ≤ 5 cm without microvascular invasion: prognostic values of MR imaging features based on LI-RADS and clinical parameters

Wang, Leyao; Feng, Bing; Li, Dengfeng; Liang, Meng; Wang, Shuang; Wang, Sicong; Ma, Xiaohong; Zhao, Xinming

doi:10.1007/s00330-023-09484-5

Cited by 8 publications

(5 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies, histological resection of MVI+ or VETC+ HCC was associated with a worse prognosis 5,6,8,9,13 . We obtained similar results; that is, MVI and VETC mode risk stratification based on the constructed nomograms significantly correlated with the recurrence rate after radical HCC resection.…”

Section: Discussionsupporting

confidence: 82%

“…Additionally, serum tumor markers, degree of differentiation of cancer cells, and expression of MVI‐related genes are significantly correlated with RFS 7,8 . However, many patients with MVI‐negative HCC are also at risk of early recurrence after radical resection, 9,10 suggesting that MVI is inadequate for explaining the mechanism of HCC recurrence and metastasis.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Preoperative Gadoxetic Acid‐Enhanced MRI Features for Evaluation of Vessels Encapsulating Tumor Clusters and Microvascular Invasion in Hepatocellular Carcinoma: Creating Nomograms for Risk Assessment

Qu,

Liu,

et al. 2023

Magnetic Resonance Imaging

View full text Add to dashboard Cite

BackgroundVessels encapsulating tumor cluster (VETC) and microvascular invasion (MVI) have a synergistic effect on prognosis assessment and treatment selection of hepatocellular carcinoma (HCC). Preoperative noninvasive evaluation of VETC and MVI is important.PurposeTo explore the diagnosis value of preoperative gadoxetic acid (GA)‐enhanced magnetic resonance imaging (MRI) features for MVI, VETC, and recurrence‐free survival (RFS) in HCC.Study TypeRetrospective.Population240 post‐surgery patients with 274 pathologically confirmed HCC (allocated to training and validation cohorts with a 7:3 ratio) and available tumor marker data from August 2014 to December 2021.Field Strength/Sequence3‐T, T1‐, T2‐, diffusion‐weighted imaging, in/out‐phase imaging, and dynamic contrast‐enhanced imaging.AssessmentThree radiologists subjectively reviewed preoperative MRI, evaluated clinical and conventional imaging features associated with MVI+, VETC+, and MVI+/VETC+ HCC. Regression‐based nomograms were developed for HCC in the training cohort. Based on the nomograms, the RFS prognostic stratification system was further. Follow‐up occurred every 3–6 months.Statistical TestsChi‐squared test or Fisher's exact test, Mann–Whitney U‐test or t‐test, least absolute shrinkage and selection operator–penalized, multivariable logistic regression analyses, receiver operating characteristic analysis, Harrell's concordance index (C‐index), Kaplan–Meier plots. Significance level: P < 0.05.ResultsIn the training group, 44 patients with MVI+ and 74 patients with VETC+ were histologically confirmed. Three nomograms showed good performance in the training (C‐indices: MVI+ vs. VETC+ vs. MVI+/VETC+, 0.892 vs. 0.848 vs. 0.910) and validation (C‐indices: MVI+ vs. VETC+ vs. MVI+/VETC+, 0.839 vs. 0.810 vs. 0.855) cohorts. The median follow‐up duration for the training cohort was 43.6 (95% CI, 35.0–52.2) months and 25.8 (95% CI, 16.1–35.6) months for the validation cohort. Patients with either pathologically confirmed or nomogram‐estimated MVI, VETC, and MVI+/VETC+ suffered higher risk of recurrence.Data ConclusionGA‐enhanced MRI and clinical variables might assist in preoperative estimation of MVI, VETC, and MVI+/VETC+ in HCC.Evidence Level4Technical EfficacyStage 2

show abstract

Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

Preoperative Gadoxetic Acid‐Enhanced MRI Features for Evaluation of Vessels Encapsulating Tumor Clusters and Microvascular Invasion in Hepatocellular Carcinoma: Creating Nomograms for Risk Assessment

Qu,

Liu,

et al. 2023

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“… 35 This may reflect histological differences and tumor heterogeneity, explaining why the presence of mosaic structures serves as a risk factor for poor prognosis in HCC treatment. Previous studies have established mosaic architecture as a risk factor for TACE 23 , 36 and postoperative 17 , 37 , 38 recurrence in HCC patients. In agreement with these findings, our study also observed that HCC patients with mosaic structures had worse postoperative prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Non-smooth tumor margin is defined as a bud-like projection of the tumor margin into the liver parenchyma. 17 Internal artery is a dilated artery traversing the mass in the arterial phase. Peritumoral hypointensity on HBP is characterized by a wedge- or flame-shaped area of hypointensity beyond the tumor edge in the hepatobiliary phase.…”

Section: Methodsmentioning

confidence: 99%

Prediction of Microvascular Invasion and Recurrence After Curative Resection of LI-RADS Category 5 Hepatocellular Carcinoma on Gd-BOPTA Enhanced MRI

Zhang,

Li,

Xia

et al. 2024

JHC

View full text Add to dashboard Cite

Objective This study aims to investigate the predictive value of Gadobenate dimeglumine (Gd-BOPTA) enhanced MRI features on microvascular invasion (MVI) and recurrence in patients with Liver Imaging Reporting and Data System (LI-RADS) category 5 hepatocellular carcinoma (HCC). Methods A total of 132 patients with LI-RADS category 5 HCC who underwent curative resection and Gd-BOPTA enhanced MRI at our hospital between January 2016 and December 2018 were retrospectively analyzed. Qualitative evaluation based on LI-RADS v2018 imaging features was performed. Logistic regression analyses were conducted to assess the predictive significance of these features for MVI, and the Cox proportional hazards model was used to identify postoperative risk factors of recurrence. The recurrence-free survival (RFS) was analyzed by using the Kaplan–Meier curve and Log rank test. Results Multivariate logistic regression analysis identified that corona enhancement (odds ratio [OR] = 3.217; p < 0.001), internal arteries (OR = 4.147; p = 0.004), and peritumoral hypointensity on hepatobiliary phase (HBP) (OR = 5.165; p < 0.001) were significantly associated with MVI. Among the 132 patients with LR-5 HCC, 62 patients experienced postoperative recurrence. Multivariate Cox regression analysis showed that mosaic architecture (hazard ratio [HR] = 1.982; p = 0.014), corona enhancement (HR = 1.783; p = 0.039), and peritumoral hypointensity on HBP (HR = 2.130; p = 0.009) were risk factors for poor RFS. Conclusion MRI features based on Gd-BOPTA can be noninvasively and effectively predict MVI and recurrence of LR-5 HCC patients.

show abstract

“…7,9 A number of previous studies have demonstrated that LI-RADS imaging features can be used to assess the recurrence of HCC. 10,11 Meanwhile, AFP has long been used to assess HCC invasiveness. [12][13][14] However, currently, no one has combined these features to predict the occurrence of NTR.…”

Section: Introductionmentioning

confidence: 99%

Prediction of Non-Transplantable Recurrence After Liver Resection for Solitary Hepatocellular Carcinoma

Zhang,

Tao,

Yang

et al. 2024

JHC

View full text Add to dashboard Cite

Purpose Using a combination model of preoperative imaging and clinical factors to predict non-transplantable recurrence (NTR) after liver resection and assist solitary hepatocellular carcinoma (HCC) patients in the selection of early treatment options. Patients and Methods A retrospective analysis was conducted on 253 solitary HCC patients who underwent radical resection and had preoperative MRI. NTR patients were defined as those exceeding the University of California, San Francisco (UCSF) criteria at the time of recurrence. Cox regression analysis was employed to identify preoperative factors associated with NTR based on clinical and tumor imaging characteristics. A risk scoring model (NTRScore) was developed and validated. Results Among the 253 patients, 86 (33.9%) experienced recurrence, and among those with recurrence, 34 patients (39.5%) developed NTR. In multivariate analysis, factors associated with NTR included alpha-fetoprotein (AFP) [>10 ng/mL] [HR: 3.42, 95% confidence interval (CI): 1.54–7.63, P: 0.003], arterial phase hyperenhancement (APHE) [HR: 2.23, 95% CI: 1.03–4.81, P: 0.041], washout[HR: 0.35, 95% CI: 0.15–0.84, P: 0.019], and capsule [HR: 0.44, 95% CI: 0.22–0.88, P: 0.021]. The β-coefficients of these variables were utilized to develop the weighted NTRScore(c-index 0.72, 95% CI: 0.65–0.79). The NTR occurrence increased across the three categories (low: 5.6%, medium: 13.6%, high: 35.1%, p < 0.001), and the Kaplan-Meier curves of recurrence-free survival(RFS) and overall survival(OS) show significant differences (p = 0.004 and p<0.001). Furthermore, the higher NTR categories may be associated with an increased risk of extrahepatic recurrence. Conclusion The NTRScore demonstrated strong discriminatory ability and may serve as a clinically useful tool to assist in risk stratification and potential to guide treatment and optimal surveillance for patients of solitary hepatocellular carcinoma within UCSF criteria.

show abstract

Risk stratification of solitary hepatocellular carcinoma ≤ 5 cm without microvascular invasion: prognostic values of MR imaging features based on LI-RADS and clinical parameters

Cited by 8 publications

References 40 publications

Preoperative Gadoxetic Acid‐Enhanced MRI Features for Evaluation of Vessels Encapsulating Tumor Clusters and Microvascular Invasion in Hepatocellular Carcinoma: Creating Nomograms for Risk Assessment

Preoperative Gadoxetic Acid‐Enhanced MRI Features for Evaluation of Vessels Encapsulating Tumor Clusters and Microvascular Invasion in Hepatocellular Carcinoma: Creating Nomograms for Risk Assessment

Prediction of Microvascular Invasion and Recurrence After Curative Resection of LI-RADS Category 5 Hepatocellular Carcinoma on Gd-BOPTA Enhanced MRI

Prediction of Non-Transplantable Recurrence After Liver Resection for Solitary Hepatocellular Carcinoma

Contact Info

Product

Resources

About