scholarly journals Establishment and Evaluation of a Predictive Model for Early Postoperative Recurrence of Hepatocellular Carcinoma in Patients with Microvascular Invasion

2021 ◽  
Vol Volume 14 ◽  
pp. 2259-2274
Author(s):  
Kai Zhang ◽  
Changcheng Tao ◽  
Fan Wu ◽  
Tana Siqin ◽  
Jianxiong Wu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Model ◽  
Postoperative Recurrence ◽  
Microvascular Invasion

Predictive model for microvascular invasion of hepatocellular carcinoma among candidates for either hepatectomy or liver transplantation.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4079-4079
Author(s):  
Hidetoshi Nitta ◽  
Marc Antoine Allard ◽  
Mylene Sebagh ◽  
Gabriella Pittau ◽  
Oriana Ciacio ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Predictive Model ◽  
Validation Cohort ◽  
Microvascular Invasion ◽  
Roc Curve Analysis ◽  
Training Cohort ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

4079 Background: Microvascular invasion (MVI) is the strongest prognostic factor following surgery of hepatocellular carcinoma (HCC). However, it is usually not available on the preoperative setting. A predictive model of MVI in patients scheduled for hepatic resection (HR) or liver transplantation (LT) would thus help guiding treatment strategy. The aim of this study was to develop a predictive model for MVI of HCC before either HR or LT. Methods: HCC patients who consecutively performed HR or LT from January 1994 to June 2016 at a single institution were subdivided into a training and validation cohort. Risk factors for MVI in the training cohort were used to develop a predictive model for MVI, to be validated in the validation cohort. The outcomes of the HR and LT patients with high or low MVI probability based on the model, were compared using propensity score matching (PSM). Cut-off values for continuous factors were determined based on ROC curve analysis. Results: A total of 910 patients (425 HR, 485 LT) were included in the training (n = 637) and validation (n = 273) cohorts. In the training cohort, multivariate analysis demonstrated that alpha-fetoprotein ≥100ng/ml ( p < 0.0001), largest tumor size ≥40mm ( p = 0.0002), non-boundary HCC type on contrast-enhanced CT ( p = 0.001), neutrophils-to-lymphocytes ratio ≥3.2 ( p = 0.002), aspartate aminotransferase ≥62U/l ( p = 0.02) were independently associated with MVI. Combinations of these 5 factors varied the MVI probability from 15.5% to 91.1%. This predictive model achieved a good c-index of 0.76 in the validation cohort. In PSM (109 HR, 109 LT), there was no difference in survival between HR and LT patients among the high MVI probability (≥50%) patients, (5y-OS; 46.3% vs 42.2%, p = 0.77, 5y-RFS; 54.0% vs 28.8%, p = 0.21). Among the low probability ( < 50%), survival was significantly decreased following HR compared with LT (5y-OS; 54.1% vs 78.8%, p = 0.007, 5y-RFS; 17.3% vs 86.1%, p< 0.0001). Conclusions: This model developed from preoperative data allows reliable prediction of MVI, and may thus help with preoperative decisions about the suitability of HR or LT in patients with 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.

scholarly journals Radiomic Feature-Based Predictive Model for Microvascular Invasion in Patients With Hepatocellular Carcinoma

2020 ◽  
Vol 10 ◽  
Author(s):  
Mu He ◽  
Peng Zhang ◽  
Xiao Ma ◽  
Baochun He ◽  
Chihua Fang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Model ◽  
Microvascular Invasion ◽  
Feature Based

Deep-Learning Based Analysis of Preoperative MRI Predicts Microvascular Invasion and Outcome in Hepatocellular Carcinoma

2021 ◽  
Author(s):  
Bao-Ye sun ◽  
Pei-Yi Gu ◽  
Ruo-Yu Guan ◽  
Cheng Zhou ◽  
Jian-Wei Lu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Deep Learning ◽  
Predictive Model ◽  
Clinical Outcomes ◽  
Area Under The Curve ◽  
Microvascular Invasion ◽  
Dce Mri ◽  
Preoperative Prediction ◽  
Model Combining ◽  
Contrast Enhanced

Abstract Background & Aims: Preoperative prediction of microvascular invasion (MVI) is critical for treatment strategy making in patients with hepatocellular carcinoma (HCC). We aimed to develop a deep learning (DL) model based on preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict the MVI status and clinical outcomes in patients with HCC. Methods We retrospectively included a total of 321 HCC patients with pathologically confirmed MVI status. Preoperative DCE-MRI of these patients were collected, annotated and further analyzed by DL in this study. A predictive model for MVI integrating DL-predicted MVI status (DL-MVI) and clinical parameters was constructed with multivariate logistic regression. Results Of 321 HCC patients, 136 patients were pathologically MVI absent and 185 patients were MVI present. Recurrence-free survival (RFS) and overall survival (OS) were significantly different between the DL-predicted MVI-absent and MVI-present. Among all clinical variables, only DL-predicted MVI status and AFP were independently associated with MVI: DL-MVI (odds ratio [OR]=35.738; 95% confidence interval [CI]: 14.027-91.056; p<0.001), AFP (OR=4.634, 95% CI: 2.576-8.336; p<0.001). To predict the presence of MVI, DL-MVI combined with AFP achieved an area under the curve (AUC) of 0.824. Conclusions Our predictive model combining DL-MVI and AFP achieved good performance for predicting MVI and clinical outcomes in patients with HCC.

scholarly journals Predictive model for microvascular invasion of hepatocellular carcinoma among candidates for either hepatic resection or liver transplantation

Surgery ◽  
2019 ◽  
Vol 165 (6) ◽  
pp. 1168-1175 ◽  
Author(s):  
Hidetoshi Nitta ◽  
Marc-Antoine Allard ◽  
Mylène Sebagh ◽  
Vincent Karam ◽  
Oriana Ciacio ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Hepatic Resection ◽  
Predictive Model ◽  
Microvascular Invasion

scholarly journals Establishment, validation and evaluation of predictive model for early relapse after R0 resection in hepatocellular carcinoma patients with microvascular invasion

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kai Zhang ◽  
Changcheng Tao ◽  
Tana Siqin ◽  
Jianxiong Wu ◽  
Weiqi Rong
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Model ◽  
Validation Cohort ◽  
Medical Science ◽  
Microvascular Invasion ◽  
R0 Resection ◽  
Tumor Diameter ◽  
Early Relapse ◽  
Staging Systems ◽  
The Status

Abstract Backgrounds This is the first study to build and evaluate a predictive model for early relapse after R0 resection in hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI). Methods The consecutive HCC patients with MVI who underwent hepatectomy in Cancer Hospital of Chinese Academy of Medical Science from Jan 2014 to June 2019 were retrospectively enrolled and randomly allocated into a derivation (N = 286) and validation cohort (N = 120) in a ratio of 7:3. Cox regression and Logistic regression analyses were performed and a predictive model for postoperative early-relapse were developed. Results A total of 406 HCC patients with MVI were included in our work. Preoperative blood alpha-fetoprotein (AFP) level, hepatitis B e antigen (HBeAg) status, MVI classification, largest tumor diameter, the status of serosal invasion, number of tumors, and the status of satellite nodules were incorporated to construct a model. The concordance index (C-index) was 0.737 and 0.736 in the derivation and validation cohort, respectively. The calibration curves showed a good agreement between actual observation and nomogram prediction. The C-index of the nomogram was obviously higher than those of the two traditional HCC staging systems. Conclusion We have developed and validated a prediction model for postoperative early-relapse in HCC patient with MVI after R0 resection.

scholarly journals Radiomics Analysis of MR Imaging with Gd-EOB-DTPA for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma: Investigation and Comparison of Different Hepatobiliary Phase Delay Times

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Shuai Zhang ◽  
Guizhi Xu ◽  
Chongfeng Duan ◽  
Xiaoming Zhou ◽  
Xin Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Mr Imaging ◽  
Predictive Model ◽  
Microvascular Invasion ◽  
Support Vector ◽  
Hepatobiliary Phase ◽  
Lasso Regression ◽  
Preoperative Prediction ◽  
Significant Difference ◽  
Selection Operator

Purpose. To investigate whether the radiomics analysis of MR imaging in the hepatobiliary phase (HBP) can be used to predict microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC). Method. A total of 130 patients with HCC, including 80 MVI-positive patients and 50 MVI-negative patients, who underwent MR imaging with Gd-EOB-DTPA were enrolled. Least absolute shrinkage and selection operator (LASSO) regression was applied to select radiomics parameters derived from MR images obtained in the HBP 5 min, 10 min, and 15 min images. The selected features at each phase were adopted into support vector machine (SVM) classifiers to establish models. Multiple comparisons of the AUCs at each phase were performed by the Delong test. The decision curve analysis (DCA) was used to analyze the classification of MVI-positive and MVI-negative patients. Results. The most predictive features between MVI-positive and MVI-negative patients included 9, 8, and 14 radiomics parameters on HBP 5 min, 10 min, and 15 min images, respectively. A model incorporating the selected features produced an AUC of 0.685, 0.718, and 0.795 on HBP 5 min, 10 min, and 15 min images, respectively. The predictive model for HBP 5 min, 10 min and 15 min showed no significant difference by the Delong test. DCA indicated that the predictive model for HBP 15 min outperformed the models for HBP 5 min and 10 min. Conclusions. Radiomics parameters in the HBP can be used to predict MVI, with the HBP 15 min model having the best differential diagnosis ability.

scholarly journals Prediction of Microvascular Invasion in Hepatocellular Carcinoma via Deep Learning: A Multi-Center and Prospective Validation Study

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2368
Author(s):  
Jingwei Wei ◽  
Hanyu Jiang ◽  
Mengsu Zeng ◽  
Meiyun Wang ◽  
Meng Niu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Deep Learning ◽  
High Risk ◽  
External Validation ◽  
Progression Free Survival ◽  
Risk Groups ◽  
Postoperative Recurrence ◽  
Microvascular Invasion ◽  
Operating Characteristics ◽  
Enhanced Computed Tomography

Microvascular invasion (MVI) is a critical risk factor for postoperative recurrence of hepatocellular carcinoma (HCC). Preknowledge of MVI would assist tailored surgery planning in HCC management. In this multicenter study, we aimed to explore the validity of deep learning (DL) in MVI prediction using two imaging modalities—contrast-enhanced computed tomography (CE-CT) and gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI). A total of 750 HCCs were enrolled from five Chinese tertiary hospitals. Retrospective CE-CT (n = 306, collected between March, 2013 and July, 2019) and EOB-MRI (n = 329, collected between March, 2012 and March, 2019) data were used to train two DL models, respectively. Prospective external validation (n = 115, collected between July, 2015 and February, 2018) was performed to assess the developed models. Furthermore, DL-based attention maps were utilized to visualize high-risk MVI regions. Our findings revealed that the EOB-MRI-based DL model achieved superior prediction outcome to the CE-CT-based DL model (area under receiver operating characteristics curve (AUC): 0.812 vs. 0.736, p = 0.038; sensitivity: 70.4% vs. 57.4%, p = 0.015; specificity: 80.3% vs. 86.9%, p = 0.052). DL attention maps could visualize peritumoral high-risk areas with genuine histopathologic confirmation. Both DL models could stratify high and low-risk groups regarding progression free survival and overall survival (p < 0.05). Thus, DL can be an efficient tool for MVI prediction, and EOB-MRI was proven to be the modality with advantage for MVI assessment than CE-CT.

scholarly journals A Nomogram Based on Combining Clinical Features and Contrast Enhanced Ultrasound LI-RADS Improves Prediction of Microvascular Invasion in Hepatocellular Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Hang Zhou ◽  
Jiawei Sun ◽  
Tao Jiang ◽  
Jiaqi Wu ◽  
Qunying Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Model ◽  
Clinical Features ◽  
Diagnostic Performance ◽  
Clinical Information ◽  
Microvascular Invasion ◽  
Liver Imaging ◽  
Contrast Enhanced Ultrasound ◽  
Training Cohort ◽  
Contrast Enhanced

PurposesTo establish a predictive model incorporating clinical features and contrast enhanced ultrasound liver imaging and reporting and data system (CEUS LI-RADS) for estimation of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients.MethodsIn the retrospective study, 127 HCC patients from two hospitals were allocated as training cohort (n=98) and test cohorts (n=29) based on cutoff time-point, June 2020. Multivariate regression analysis was performed to identify independent indicators for developing predictive nomogram models. The area under receiver operating characteristic (AUC) curve was also determined to establish the diagnostic performance of different predictive models. Corresponding sensitivities and specificities of different models at the cutoff nomogram value were compared.ResultsIn the training cohort, clinical information (larger tumor size, higher AFP level) and CEUS LR-M were significantly correlated with the presence of MVI (all p&lt;0.05). By incorporating clinical information and CEUS LR-M, the predictive model (LR-M+Clin) achieved a desirable diagnostic performance (AUC=0.80 and 0.84) in both cohorts at nomogram cutoff score value of 89. The sensitivity of LR-M+Clin when predicting MVI in HCC patients was higher than that of the clinical model alone (86.7% vs. 46.7%, p=0.027), while specificities were 78.6% and 85.7% (p=0.06), respectively, in the test cohort. In addition, LR-M+Clin exhibited similar AUC and specificity, but a significantly higher sensitivity (86.7%) than those of LR-M alone and LR-5(No)+Clin (both sensitivities=73.3%, both p=0.048).ConclusionThe predictive model incorporating CEUS LR-M and clinical features was able to predict the MVI status of HCC and is a potential reliable preoperative tool for informing treatment.

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