Role of baseline volumetric functional MRI in predicting histopathologic grade and patients’ survival in hepatocellular carcinoma

Ameli, Sanaz; Shaghaghi, Mohammadreza; Ghasabeh, Mounes Aliyari; Pandey, Pallavi; Hazhirkarzar, Bita; Ghadimi, Maryam; Habibabadi, Roya Rezvani; Khoshpouri, Pegah; Pandey, Ankur; Anders, Robert A.; Kamel, Ihab R.

doi:10.1007/s00330-020-06742-8

Cited by 20 publications

(17 citation statements)

References 32 publications

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“…These results are consistent with the aforementioned results that first attempt incomplete ablation might not influence the OS of patients, despite the poor PFS. Regarding the Child-Pugh class, it has been reported that the therapeutic outcomes of patients with HCC are associated with liver function by several previous studies ( 23 , 24 ) and the present study has shown a similar result. High AFP level represents a more aggressive nature of the tumor and has been associated with a poor therapeutic outcome in patients with HCC ( 25 , 26 ); the results of the present study have confirmed this finding.…”

Section: Discussionsupporting

confidence: 89%

Initial Incomplete Thermal Ablation Is Associated With a High Risk of Tumor Progression in Patients With Hepatocellular Carcinoma

et al. 2021

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PurposeTo investigate whether incomplete thermal ablation is associated with a high risk of tumor progression in patients with hepatocellular carcinoma (HCC), and to compare the efficacy of repeated thermal ablation and transarterial chemoembolization (TACE) for residual tumor after incomplete ablation.MethodsThis retrospective study included 284 patients with unresectable HCC who underwent thermal ablation from June 2014 to September 2020. The response of the initially attempted ablation was classified into complete (n=236) and incomplete (n=48). The progression-free survival (PFS) and overall survival (OS) were compared between patients with complete and incomplete responses, before and after a one-to-one propensity score-matching (PSM), and between patients in whom repeated ablation or TACE was performed after a first attempt incomplete ablation.ResultsAfter PSM of the 284 patients, 46 pairs of patients were matched. The PFS was significantly higher in the complete response group than in the incomplete response group (P<0.001). No difference in OS was noted between two groups (P=0.181). After a first attempt incomplete ablation, 29 and 19 patients underwent repeated ablation and TACE, respectively. There were no significant differences in PFS (P=0.424) and OS (P=0.178) between patients who underwent repeated ablation and TACE. In multivariate Cox regression analysis, incomplete response (P<0.001) and Child-Pugh class B (P=0.017) were independent risk factors for tumor progression, while higher AFP level (P=0.011) and Child-Pugh class B (P=0.026) were independent risk factors for poor OS.ConclusionAlthough patients with incomplete ablation are associated with tumor progression compared with those with complete ablation, their OS is not affected by incomplete ablation. When patients present with residual tumors, TACE may be an alternative if repeated ablation is infeasible.

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Section: Discussionsupporting

confidence: 89%

Initial Incomplete Thermal Ablation Is Associated With a High Risk of Tumor Progression in Patients With Hepatocellular Carcinoma

et al. 2021

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“…According to Edmondson's 4-grade classification method [ 17 ], the tumors were divided into I, II, III, and IV grades, with I–II, II–III, and III–IV grades in between. Our study used the classification of Ameli [ 3 ] for reference, and classified i, i–ii, and ii as low-grade tumors. Grade ii–iii, iii, iii–iv, and iv were classified as high-grade tumors.…”

Section: Methodsmentioning

confidence: 99%

“…Liver biopsy is the only method for pathological grading of liver cancer before treatment. However, because of the invasion, sampling error, tumor planting, and bleeding, the wide application of preoperative biopsy is limited [ 2 , 3 ]. Using non-invasive imaging technique to safely and accurately assess the pathological grade of HCC before operation will help clinicians to develop the best treatment methods for patients, improve the prognosis of patients, and also help to evaluate the indications of liver transplantation to wisely utilize scarce liver sources.…”

Section: Introductionmentioning

confidence: 99%

Clinical and imaging features preoperative evaluation of histological grade and microvascular infiltration of hepatocellular carcinoma

et al. 2022

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Background To predict the histological grade and microvascular invasion (MVI) in patients with HCC. Methods A retrospective analysis was conducted on 175 patients who underwent MRI enhancement scanning (from September 2016.9 to October 2020). They were divided into MVI positive, MVI negative, Grade-high and Grade-low groups. Results The AFP of 175 HCC patients distributed in MVI positive and negative groups, Grade-low and Grade-high groups were statistically significant (P = 0.002 and 0.03, respectively). Multiple HCC lesions were more common in MVI positive and Grade-high groups. Correspondingly, more single lesions were found in MVI negative and Grade-low groups (P = 0.005 and 0.019, respectively). Capsule on MRI was more common in MVI negative and Grade-high groups, and the difference was statistically significant (P = 0.02 and 0.011, respectively). There were statistical differences in the distribution of three MRI signs: artistic rim enhancement, artistic peripheral enhancement, and tumor margin between MVI positive and MVI negative groups (P = 0.001, < 0.001, and < 0.001, respectively). Tumor hypointensity on HBP was significantly different between MVI positive and negative groups (P < 0.001). Conclusions Our research shows that preoperative enhanced imaging can be used to predict MVI and tumor differentiation grade of HCC. The prognosis of MVI-negative group was better than that of MVI-positive group.

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“…Hepatocellular carcinoma (HCC) is an aggressive tumor which remains the second-most frequent cause of cancer death worldwide [1][2][3]. According to the different statuses of patients with HCC, several guidelines [4][5][6][7] recommend various treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

Current updates in machine learning in the prediction of therapeutic outcome of hepatocellular carcinoma: what should we know?

et al. 2021

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With the development of machine learning (ML) algorithms, a growing number of predictive models have been established for predicting the therapeutic outcome of patients with hepatocellular carcinoma (HCC) after various treatment modalities. By using the different combinations of clinical and radiological variables, ML algorithms can simulate human learning to detect hidden patterns within the data and play a critical role in artificial intelligence techniques. Compared to traditional statistical methods, ML methods have greater predictive effects. ML algorithms are widely applied in nearly all steps of model establishment, such as imaging feature extraction, predictive factor classification, and model development. Therefore, this review presents the literature pertaining to ML algorithms and aims to summarize the strengths and limitations of ML, as well as its potential value in prognostic prediction, after various treatment modalities for HCC.

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Role of baseline volumetric functional MRI in predicting histopathologic grade and patients’ survival in hepatocellular carcinoma

Cited by 20 publications

References 32 publications

Initial Incomplete Thermal Ablation Is Associated With a High Risk of Tumor Progression in Patients With Hepatocellular Carcinoma

Initial Incomplete Thermal Ablation Is Associated With a High Risk of Tumor Progression in Patients With Hepatocellular Carcinoma

Clinical and imaging features preoperative evaluation of histological grade and microvascular infiltration of hepatocellular carcinoma

Current updates in machine learning in the prediction of therapeutic outcome of hepatocellular carcinoma: what should we know?

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