Preoperative MR imaging for predicting early recurrence of solitary hepatocellular carcinoma without microvascular invasion. Issue 138 (May 2021)

• Record Type: Journal Article
• Authors: Wei, Yunyun; Pei, Wei; Qin, Yunying; Su, Danke; Liao, Hai
• Is Part Of: European journal of radiology. Issue 138(2021)
• Publication Date: 2021-05
• Subjects: AFP alpha-fetoprotein -- APHE arterial phase hyperenhancement -- ALT alanine aminotransferase -- AST aspartate aminotransferase -- BMI body mass index -- CI confidence interval -- ER early recurrence -- FOV field of view -- Gd-DTPA gadolinium-diethylenetriamine pentaacetic acid -- GLDH glutamic dehydrogenase -- HCC hepatocellular carcinoma -- HR hazard ratio -- LI-RADS Liver Imaging Reporting and Data System -- MRI magnetic resonance imaging -- MVI microvascular invasion -- NRL neutrophil-to-lymphocyte ratio -- RFA radiofrequency ablation -- TACE transcatheter arterial chemoembolization -- TE echo time -- TR repetition time; Hepatocellular carcinoma -- Microvascular invasion -- Magnetic resonance imaging -- Liver Imaging Reporting and Data System; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2021.109663
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: This study explored MRI features in predicting prognosis of HCC without MVI, a subset has rarely been investigated individually. Tumor size, nonsmooth tumor margin, and mosaic architecture were independent risk factors for early recurrence of HCC without MVI. A nomogram for individualized risk estimation of early recurrence provides great diagnostic confidence. Abstract: Objectives: This study aimed to identify preoperative MR imaging features for predicting early recurrence after curative resection of solitary hepatocellular carcinoma (HCC) without microvascular invasion (MVI). Methods: 124 patients with MVI-negative HCC who underwent preoperative dynamic contrast-enhanced 1.5-T MR imaging before surgical resection were included. Liver Imaging Reporting and Data System (LI-RADS v2018) imaging features and three non-LI-RADS MR imaging features for predicting early recurrence (intrahepatic recurrence<2 years) were identified by univariable and multivariable analyses. A nomogram was constructed for individualized risk estimation, and its predictive accuracy and discriminative ability were identified by concordance index (C-index) and calibration curve. Results: In multivariable analysis, tumor size (p = 0.045), nonsmooth tumor margin (p = 0.013), and presence of mosaic architecture (p = 0.035) were independent significant variables associated with early recurrence. These were all incorporated to establish the nomogram. The C-index of the nomogram was 0.743 (95 % CI: 0.697−0.788). Conclusion: At dynamic contrast-enhanced MR imaging, tumor size, nonsmooth tumor margin, and presence of mosaic architecture may be helpful to predict early recurrence of solitary HCC without MVI after curative resection.