Macrotrabecular-massive hepatocellular carcinoma: imaging identification and prediction based on gadoxetic acid–enhanced magnetic resonance imaging
Autor: | Xijiao Liu, Ting Duan, Bin Song, Zhenru Wu, Hanyu Jiang, Zhen Zhang, Chunchao Xia, Yujun Shi, Likun Cao, Zheng Ye, Jie Chen, Ronghui Gao |
---|---|
Rok vydání: | 2021 |
Předmět: |
Gadolinium DTPA
medicine.medical_specialty Gadoxetic acid Carcinoma Hepatocellular Contrast Media Logistic regression Sensitivity and Specificity Gastroenterology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Radiology Nuclear Medicine and imaging Retrospective Studies Univariate analysis medicine.diagnostic_test business.industry Liver Neoplasms Magnetic resonance imaging General Medicine Odds ratio Nomogram medicine.disease Magnetic Resonance Imaging digestive system diseases Confidence interval 030220 oncology & carcinogenesis Hepatocellular carcinoma Radiology business medicine.drug |
Zdroj: | European Radiology. 31:7696-7704 |
ISSN: | 1432-1084 0938-7994 |
Popis: | To identify image features of macrotrabecular-massive (MTM) hepatocellular carcinoma (HCC) and to determine its role in predicting MTM-HCC. Patients who underwent preoperative gadoxetic acid-enhanced MRI and with surgery proven HCC were retrospectively included. Imaging features were assessed according to Liver Imaging Reporting and Data System. Quantitative measurements were recorded. Clinical characteristics and imaging findings were compared between MTM-HCCs and non-MTM-HCCs. Predictive factors of MTM-HCC were screened with univariate analyses and then identified with multivariate logistic regression. A regression-based diagnostic model was constructed. ROC analyses were used to determine cutoff values, AUC, and corresponding 95% confidence interval (CI) of findings. The diagnostic performance was validated by 10-fold cross-validation. One hundred and forty-one patients with 37 MTM-HCCs were included. Multivariate analyses identified high platelet count (≥ 163.5 × 103/ul, odds ratio = 3.20; 95% CI: 1.29, 7.96; p = 0.012), low tumor-to-liver ADC ratio (≤ 1.05, odds ratio = 3.05; 95% CI, 1.23 - 7.55; p = 0.016), and necrosis or severe ischemia (odds ratio = 11.61; 95% CI, 3.99 - 33.76, p < 0.001) as independent predictors of MTM-HCC. Necrosis or severe ischemia alone helped identify 86% MTM-HCCs with a specificity of 66%. The average AUCs were 0.81 (95% CI: 0.71, 0.90) for the regression-based diagnostic model, with a sensitivity of 57% and specificity of 92%. Necrosis or severe ischemia was a sensitive imaging feature of MTM-HCC. Noninvasive prediction of this subtype can be achieved with good accuracy and excellent specificity when findings were combined. • The macrotrabecular-massive (MTM) hepatocellular carcinoma (HCC) represents an aggressive subtype of HCC and is associated with poor prognosis. • Imaging features of necrosis or severe ischemia alone helped identify 86% MTM-HCCs with a specificity of 66%. • A regression-based diagnostic model including high platelet count (≥ 163.5 × 10 3 /ul), low tumor-to-liver ADC ratio (≤ 1.05), and necrosis or severe ischemia can provide noninvasive assessment of MTM-HCC with good accuracy and high specificity. |
Databáze: | OpenAIRE |
Externí odkaz: |