scholarly journals Value of gadoxetic acid-enhanced MRI for microvascular invasion of small hepatocellular carcinoma: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meng Zhou ◽  
Dan Shan ◽  
Chunhui Zhang ◽  
Jianhua Nie ◽  
Guangyu Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Univariate Analysis ◽  
Microvascular Invasion ◽  
Hepatobiliary Phase ◽  
Phase Imaging ◽  
Imaging Features ◽  
Small Hepatocellular Carcinoma ◽  
Halo Sign ◽  
Rim Enhancement

Abstract Background The objective of this study was to analyze the accuracy of gadolinium–ethoxybenzyl–diethylenetriamine penta–acetic acid enhanced magnetic resonance imaging (Gd–EOB–DTPA–MRI) for predicting microvascular invasion (MVI) in patients with small hepatocellular carcinoma (sHCC) preoperatively. Methods A total of 60 sHCC patients performed with preoperative Gd–EOB–DTPA–MRI in the Harbin Medical University Cancer Hospital from October 2018 to October 2019 were involved in the study. Univariate and multivariate analyses were performed by chi–square test and logistic regression analysis. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of Gd–EOB–DTPA–MRI were performed by receiver operating characteristic (ROC) curves. Results Univariate analysis indicated that alanine aminotransferase (≥ 39.00U/L), poorly differentiated pathology, and imaging features including grim enhancement, capsule enhancement, arterial halo sign and hepatobiliary features (tumor highly uptake, halo sign, spicule sign and brush sign) were associated with the occurrence of MVI (p < 0.05). Multivariate analysis revealed that rim enhancement and hepatobiliary spicule sign were independent predictors of MVI (p < 0.05). The area under the ROC curve was 0.917 (95% confidence interval 0.838–0.996), and the sensitivity was 94.74%. Conclusions The morphologies of hepatobiliary phase imaging, especially the spicule sign, showed high accuracy in diagnosing MVI of sHCC. Rim enhancement played a significant role in diagnosing MVI of sHCC.

scholarly journals Prediction of Microvascular Invasion in Hepatocellular Carcinoma: Preoperative Gd-EOB-DTPA-Dynamic Enhanced MRI and Histopathological Correlation

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Mengqi Huang ◽  
Bing Liao ◽  
Ping Xu ◽  
Huasong Cai ◽  
Kun Huang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prediction Model ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Microvascular Invasion ◽  
Arterial Phase ◽  
Hepatobiliary Phase ◽  
Imaging Features ◽  
Tumor Margin ◽  
Enhanced Mri

Objective. To investigate the imaging features observed in preoperative Gd-EOB-DTPA-dynamic enhanced MRI and correlated with the presence of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients. Methods. 66 HCCs in 60 patients with preoperative Gd-EOB-DTPA-dynamic enhanced MRI were retrospectively analyzed. Features including tumor size, signal homogeneity, tumor capsule, tumor margin, peritumor enhancement during mid-arterial phase, peritumor hypointensity during hepatobiliary phase, signal intensity ratio on DWI and apparent diffusion coefficients (ADC), T1 relaxation times, and the reduction rate between pre- and postcontrast enhancement images were assessed. Correlation between these features and histopathological presence of MVI was analyzed to establish a prediction model. Results. Histopathology confirmed that MVI were observed in 17 of 66 HCCs. Univariate analysis showed tumor size (p=0.003), margin (p=0.013), peritumor enhancement (p=0.001), and hypointensity during hepatobiliary phase (p=0.004) were associated with MVI. A multiple logistic regression model was established, which showed tumor size, margin, and peritumor enhancement were combined predictors for the presence of MVI (α=0.1). R2 of this prediction model was 0.353, and the sensitivity and specificity were 52.9% and 93.0%, respectively. Conclusion. Large tumor size, irregular tumor margin, and peritumor enhancement in preoperative Gd-EOB-DTPA-dynamic enhanced MRI can predict the presence of MVI in HCC.

scholarly journals MRI Features for Predicting Microvascular Invasion of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Liver Cancer ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 94-106
Author(s):  
Seung Baek Hong ◽  
Sang Hyun Choi ◽  
So Yeon Kim ◽  
Ju Hyun Shim ◽  
Seung Soo Lee ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Size ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Microvascular Invasion ◽  
Hepatobiliary Phase ◽  
Phase Imaging ◽  
Arterial Enhancement ◽  
Mri Features ◽  
Peritumoral Enhancement

<b><i>Purpose:</i></b> Microvascular invasion (MVI) is an important prognostic factor in patients with hepatocellular carcinoma (HCC). However, the reported results of magnetic resonance imaging (MRI) features for predicting MVI of HCC are variable and conflicting. Therefore, this meta-analysis aimed to identify the significant MRI features for MVI of HCC and to determine their diagnostic value. <b><i>Methods:</i></b> Original studies reporting the diagnostic performance of MRI for predicting MVI of HCC were identified in MEDLINE and EMBASE up until January 15, 2020. Study quality was assessed using QUADAS-2. A bivariate random-effects model was used to calculate the meta-analytic pooled diagnostic odds ratio (DOR) and 95% confidence interval (CI) for each MRI feature for diagnosing MVI in HCC. The meta-analytic pooled sensitivity and specificity were calculated for the significant MRI features. <b><i>Results:</i></b> Among 235 screened articles, we found 36 studies including 4,274 HCCs. Of the 15 available MRI features, 7 were significantly associated with MVI: larger tumor size (&#x3e;5 cm) (DOR = 5.2, 95% CI [3.0–9.0]), rim arterial enhancement (4.2, 95% CI [1.7–10.6]), arterial peritumoral enhancement (4.4, 95% CI [2.8–6.9]), peritumoral hypointensity on hepatobiliary phase imaging (HBP) (8.2, 95% CI [4.4–15.2]), nonsmooth tumor margin (3.2, 95% CI [2.2–4.4]), multifocality (7.1, 95% CI [2.6–19.5]), and hypointensity on T1-weighted imaging (T1WI) (4.9, 95% CI [2.5–9.6]). Both peritumoral hypointensity on HBP and multifocality showed very high meta-analytic pooled specificities for diagnosing MVI (91.1% [85.4–94.8%] and 93.3% [74.5–98.5%], respectively). <b><i>Conclusions:</i></b> Seven MRI features including larger tumor size, rim arterial enhancement, arterial peritumoral enhancement, peritumoral hypointensity on HBP, nonsmooth margin, multifocality, and hypointensity on T1WI were significant predictors for MVI of HCC. These MRI features predictive of MVI can be useful in the management of HCC.

scholarly journals Importance of Microvascular Invasion Risk and Tumor Size on Recurrence and Survival of Hepatocellular Carcinoma After Anatomical Resection and Non-anatomical Resection

2021 ◽  
Vol 11 ◽  
Author(s):  
Haoyu Hu ◽  
Shuo Qi ◽  
Silue Zeng ◽  
Peng Zhang ◽  
Linyun He ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Predictive Model ◽  
Tumor Size ◽  
Microvascular Invasion ◽  
Low Risk ◽  
Hepatobiliary Phase ◽  
Imaging Features ◽  
Anatomical Resection ◽  
Anatomic Resection

Purpose: To establish a valid prediction model to prognose the occurrence of microvascular invasion (MVI), and to compare the efficacy of anatomic resection (AR) or non-anatomic resection (NAR) for hepatocellular carcinoma (HCC).Methods: Two hundred twenty-eight patients with HCC who underwent surgical treatment were enrolled. Their hematological indicators, MRI imaging features, and outcome data were acquired.Result: In the multivariable analysis, alpha-fetoprotein &gt;15 ng/mL, neutrophil to lymphocyte ratio &gt;3.8, corona enhancement, and peritumoral hypointensity on hepatobiliary phase were associated with MVI. According on these factors, the AUROC of the predictive model in the primary and validation cohorts was 0.884 (95% CI: 0.829, 0.938) and 0.899 (95% CI: 0.821, 0.967), respectively. Patients with high risk of MVI or those with low risk of MVI but tumor size &gt;5 cm in the AR group were associated with a lower rate of recurrence and death than patients in the NAR group; however, when patients are in the state of low-risk MVI with tumor size &gt;5 cm, there is no difference in the rate of recurrence and death between AR and NAR.Conclusion: Our predictive model for HCC with MVI is convenient and accurate. Patients with high-risk of MVI or low-risk of MVI but tumor size &gt;5 cm executing AR is of great necessity.

Diagnostic performance of imaging features in the HBP of gadoxetate disodium-enhanced MRI for microvascular invasion in hepatocellular carcinoma: a meta-analysis

2021 ◽  
pp. 028418512110388
Author(s):  
Yuhui Deng ◽  
Dawei Yang ◽  
Hui Xu ◽  
Ahong Ren ◽  
Zhenghan Yang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Microvascular Invasion ◽  
Index Test ◽  
Imaging Features ◽  
Gadoxetate Disodium ◽  
Reference Test ◽  
Tumor Margin ◽  
Meta Regression

Background Microvascular invasion (MVI) is a major risk factor for early recurrence in patients with hepatocellular carcinoma (HCC). Preoperative accurate evaluation of the presence of MVI could enormously benefit its treatment and prognosis. Purpose To evaluate and compare the diagnostic performance of two imaging features (non-smooth tumor margin and peritumor hypointensity) in the hepatobiliary phase (HBP) to preoperatively diagnose the presence of MVI in HCC. Material and Methods Original articles were collected from Medline/PubMed, Web of Science, EMBASE, and the Cochrane Library up to 17 January 2021 linked to gadoxetate disodium–enhanced magnetic resonance imaging (MRI) on 1.5 or 3.0 T. The pooled sensitivity, specificity, and summary area under the receiver operating characteristic curve (AUC) were calculated and meta-regression analyses were performed. Results A total of 14 original articles involving 2193 HCCs were included. The pooled sensitivity and specificity of non-smooth tumor margin and peritumor hypointensity were 73% and 61%, and 43% and 90%, respectively, for the diagnosis of MVI in HCC. The summary AUC of non-smooth tumor margin (0.74) was comparable to that of peritumor hypointensity (0.76) ( z = 0.693, P = 0.488). The meta-regression analysis identified four covariates as possible sources of heterogeneity: average size; time interval between index test and reference test; blindness to index test during reference test; and risk of bias score. Conclusion This meta-analysis showed moderate and comparable accuracy for predicting MVI in HCC using either non-smooth tumor margin or peritumor hypointensity in HBP. Four discovered covariates accounted for the heterogeneity.

Dual energy spectral CT imaging for the evaluation of small hepatocellular carcinoma microvascular invasion

2017 ◽  
Vol 95 ◽  
pp. 222-227 ◽  
Author(s):  
Chuang-bo Yang ◽  
Shuang Zhang ◽  
Yong-jun Jia ◽  
Yong Yu ◽  
Hai-feng Duan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Dual Energy ◽  
Ct Imaging ◽  
Microvascular Invasion ◽  
Small Hepatocellular Carcinoma ◽  
Spectral Ct

scholarly journals Usefulness of Modified CEUS LI-RADS for the Diagnosis of Hepatocellular Carcinoma Using Sonazoid

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 828
Author(s):  
Katsutoshi Sugimoto ◽  
Tatsuya Kakegawa ◽  
Hiroshi Takahashi ◽  
Yusuke Tomita ◽  
Masakazu Abe ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Arterial Phase ◽  
Liver Imaging ◽  
Adrenal Rest Tumor ◽  
Contrast Enhanced ◽  
Rim Enhancement ◽  
Diagnostic Usefulness ◽  
Adrenal Rest ◽  
Sensitivity Specificity

The Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) was introduced for classifying suspected hepatocellular carcinoma (HCC). However, it cannot be applied to Sonazoid. We assessed the diagnostic usefulness of a modified CEUS LI-RADS for HCC and non-HCC malignancies based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Patients with chronic liver disease at risk for HCC were evaluated retrospectively. Nodules ≥1 cm with arterial phase hyperenhancement, no early washout (within 60 s), and contrast defects in the Kupffer phase were classified as LR-5. Nodules showing early washout, contrast defects in the Kupffer phase, and/or rim enhancement were classified as LR-M. A total of 104 nodules in 104 patients (median age: 70.0 years; interquartile range: 54.5–78.0 years; 74 men) were evaluated. The 48 (46.2%) LR-5 lesions included 45 HCCs, 2 high-flow hemangiomas, and 1 adrenal rest tumor. The PPV of LR-5 for HCC was 93.8% (95% confidence interval (CI): 82.8–98.7%). The 22 (21.2%) LR-M lesions included 16 non-HCC malignancies and 6 HCCs. The PPV of LR-M for non-HCC malignancies, including six intrahepatic cholangiocarcinomas, was 100% (95% CI: 69.8–100%). In conclusion, in the modified CEUS LI-RADS for Sonazoid, LR-5 and LR-M are good predictors of HCC and non-HCC malignancies, respectively.

scholarly journals Predictive Value of Plasma Long Noncoding RNA Associated With Microvascular Invasion in Hepatic Carcinoma for Preeclampsia

2020 ◽  
Vol 33 (8) ◽  
pp. 791-791
Author(s):  
Ying Li ◽  
Ning Yang ◽  
Xiao-yi Zou ◽  
Yuan-bing Li ◽  
Xin Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Predictive Value ◽  
Long Noncoding Rna ◽  
Plasma Levels ◽  
Noncoding Rna ◽  
Characteristic Curve ◽  
Univariate Analysis ◽  
Microvascular Invasion ◽  
Hepatic Carcinoma ◽  
Urine Protein

Abstract Background To investigate plasma levels of long noncoding RNA associated with microvascular invasion in hepatic carcinoma (LncRNA MVIH) in patients with preeclampsia (PE) and to explore its predictive value for PE either alone or in combination with other indicators. Methods Plasma samples were obtained from patients in a prospective pregnancy cohort at 7–16 weeks of gestation. Patients were divided into PE and control groups according to pregnancy outcomes. Real-time polymerase chain reaction was used to detect plasma levels of LncRNA MVIH. A univariate analysis was conducted on all indicators. Logistic regression analysis was performed on indexes with statistical differences. The receiver operating characteristic curve was used to evaluate the predict value of each independent risk factor and regression model. Results Before 16 weeks of pregnancy, body mass index, systolic blood pressure, diastolic blood pressure, mean arterial pressure, white blood cell (WBC), hemoglobin, alanine aminotransferase (ALT), uric acid (UA), and urine protein were positively correlated with PE while LncRNA MVIH was negatively correlated with PE. Independent markers with predictive value were LncRNA MVIH, UA, WBC, ALT, and urine protein, with the area under curve (AUC) in predicting PE of 0.763, 0.741, 0.663, 0.666, and 0.601, respectively. After combining these indexes, the AUC increased to 0.890 with sensitivity, specificity, and accuracy of 86.4%, 83.1%, and 84.7% respectively. Conclusions Plasma levels of LncRNA MVIH are negatively correlated with PE and have a predictive value for PE. The combination of LncRNA MVIH, UA, WBC, ALT, and urine protein has a greater predictive value.

scholarly journals Prognostic Factors for Tumor Recurrence after a 12-Year, Single-Center Experience of Liver Transplantations in Patients with Hepatocellular Carcinoma

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Matteo Cescon ◽  
Matteo Ravaioli ◽  
Gian Luca Grazi ◽  
Giorgio Ercolani ◽  
Alessandro Cucchetti ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Microvascular Invasion ◽  
Proportional Hazard ◽  
Single Center ◽  
Tumor Treatment ◽  
Factors Affecting ◽  
Single Center Experience ◽  
Liver Transplantations

Background. Factors affecting outcomes after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) have been extensively studied, but some of them have only recently been discovered or reassessed.Methods. We analyzed classical and more recently emerging variables with a hypothetical impact on recurrence-free survival (RFS) in a single-center series of 283 patients transplanted for HCC between 1997 and 2009.Results. Five-year patient survival and RFS were 75% and 86%, respectively. Thirty-four (12%) patients had HCC recurrence. Elevated preoperative alpha-fetoprotein (AFP) levels, preoperative treatments of HCC, unfulfilled Milan and up-to-seven criteria at final histology, poor tumor differentiation, and tumor microvascular invasion negatively affected RFS by univariate analysis. Milan and up-to-seven criteria applied preoperatively, and the use of m-TOR inhibitors did not reach statistical significance. Cox's proportional hazard model showed that only elevated AFP levels (Odds ; 95% –5.80; ), preoperative tumor treatments (Odds ; 95% –16.42; ), and microvascular invasion (Odds ; 95% –12.41; ) were predictors of lower RFS.Conclusions. Biological aggressiveness and preoperative tumor treatment, rather than traditional and expanded dimensional criteria, conditioned the outcomes in patients transplanted for HCC.

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