Universal Liver Imaging Lexicon: Imaging Atlas for Research and                     Clinical Practice

Fowler, Kathryn J.; Bashir, Mustafa R.; Fetzer, David T.; Kitao, Azusa; Lee, Jeong Min; Jiang, Hanyu; Kielar, Ania Z.; Ronot, Maxime; Kamaya, Aya; Marks, Robert M.; Elsayes, Khaled M.; Tang, An; Sirlin, Claude B.; Chernyak, Victoria

doi:10.1148/rg.220066

Cited by 11 publications

(1 citation statement)

References 30 publications

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“…However, most of them were highly dependent on the radiologists’ experiences with unsatisfactory intra- and inter-observer agreement. Therefore, efforts are required to enhance the repeatability and reproducibility of these subjectively interpreted findings, perhaps through more streamlined terminology, standardized training, and artificial intelligence techniques [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic MRI features to predict postresection survivals for very early to intermediate stage hepatocellular carcinoma

Jiang,

Qin,

Wei

et al. 2023

Eur Radiol

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Objectives Contrast-enhanced MRI can provide individualized prognostic information for hepatocellular carcinoma (HCC). We aimed to investigate the value of MRI features to predict early (≤ 2 years)/late (> 2 years) recurrence-free survival (E-RFS and L-RFS, respectively) and overall survival (OS). Materials and methods Consecutive adult patients at a tertiary academic center who received curative-intent liver resection for very early to intermediate stage HCC and underwent preoperative contrast-enhanced MRI were retrospectively enrolled from March 2011 to April 2021. Three masked radiologists independently assessed 54 MRI features. Uni- and multivariable Cox regression analyses were conducted to investigate the associations of imaging features with E-RFS, L-RFS, and OS. Results This study included 600 patients (median age, 53 years; 526 men). During a median follow-up of 55.3 months, 51% of patients experienced recurrence (early recurrence: 66%; late recurrence: 34%), and 17% died. Tumor size, multiple tumors, rim arterial phase hyperenhancement, iron sparing in solid mass, tumor growth pattern, and gastroesophageal varices were associated with E-RFS and OS (largest p = .02). Nonperipheral washout (p = .006), markedly low apparent diffusion coefficient value (p = .02), intratumoral arteries (p = .01), and width of the main portal vein (p = .03) were associated with E-RFS but not with L-RFS or OS, while the VICT2 trait was specifically associated with OS (p = .02). Multiple tumors (p = .048) and radiologically-evident cirrhosis (p < .001) were the only predictors for L-RFS. Conclusion Twelve visually-assessed MRI features predicted postoperative E-RFS (≤ 2 years), L-RFS (> 2 years), and OS for very early to intermediate-stage HCCs. Clinical relevance statement The prognostic MRI features may help inform personalized surgical planning, neoadjuvant/adjuvant therapies, and postoperative surveillance, thus may be included in future prognostic models. Key Points • Tumor size, multiple tumors, rim arterial phase hyperenhancement, iron sparing, tumor growth pattern, and gastroesophageal varices predicted both recurrence-free survival within 2 years and overall survival. • Nonperipheral washout, markedly low apparent diffusion coefficient value, intratumoral arteries, and width of the main portal vein specifically predicted recurrence-free survival within 2 years, while the VICT2 trait specifically predicted overall survival. • Multiple tumors and radiologically-evident cirrhosis were the only predictors for recurrence-free survival beyond 2 years. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%