Dataset Information

Preoperative prediction of microvascular invasion of hepatocellular carcinoma with IVIM diffusion-weighted MR imaging and Gd-EOB-DTPA-enhanced MR imaging.

ABSTRACT: Microvascular invasion (MVI) is regarded as one of the independent risk factors for recurrence and poor prognosis of hepatocellular carcinoma (HCC). The presence of MVI in HCCs was evaluated on the basis of pathological reports of surgical specimens and was defined as tumor within a vascular space lined by endothelium that was visible only on microscopy. The aim of the study was to investigate the usefulness of intravoxel incoherent motion (IVIM) diffusion weighted (DW) magnetic resonance (MR) imaging in predicting MVI of HCC. Preoperative IVIM DW imaging and Gd-EOB-DTPA-enhanced MRI (DCE-MRI) of 51 patients were analyzed. Standard apparent diffusion coefficient (ADC), D (the true diffusion coefficient), D* (the pseudodiffusion coefficient) and f (the perfusion fraction), relative enhancement (RE) and radiological features were evaluated and analyzed. Univariate analysis revealed that HCCs with MVI had a higher portion of an irregular tumor shape than HCCs without MVI (p = 0.009), the Standard ADC, D value were significantly lower in HCCs with MVI (p = 0.022, p = 0.007, respectively). Multivariate analysis revealed that an irregular shape (p = 0.012) and D value ? 1.16×10-3mm2/sec (p = 0.048) were independent predictors for MVI. Combining the two factors of an irregular shape and D value, a sensitivity of 94.4% and specificity of 63.6% for predicting MVI was obtained. In conclusion, we found that an irregular shape and D value ? 1.16×10-3mm2/sec may suggest the presence of MVI in HCCs.

SUBMITTER: Zhao W

PROVIDER: S-EPMC5957402 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Preoperative prediction of microvascular invasion of hepatocellular carcinoma with IVIM diffusion-weighted MR imaging and Gd-EOB-DTPA-enhanced MR imaging.

Zhao Wei W Liu Wenguang W Liu Huaping H Yi Xiaoping X Hou Jiale J Pei Yigang Y Liu Hui H Feng Deyun D Liu Liyu L Li Wenzheng W

PloS one 20180517 5

Microvascular invasion (MVI) is regarded as one of the independent risk factors for recurrence and poor prognosis of hepatocellular carcinoma (HCC). The presence of MVI in HCCs was evaluated on the basis of pathological reports of surgical specimens and was defined as tumor within a vascular space lined by endothelium that was visible only on microscopy. The aim of the study was to investigate the usefulness of intravoxel incoherent motion (IVIM) diffusion weighted (DW) magnetic resonance (MR) i ...[more]

PMID: 29771954

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Project description:BackgroundInserting diffusion weighted imaging (DWI) into the time interval between post contrast and hepatobiliary phase (HBP) is time saving and health economic friendly. However, whether DWI would be affected before and after Gd-EOB-DTPA is still unknown. This study aims to validate whether the DWI at both low and high b-values is affected before and after Gd-EOB-DTPA enhancement.MethodsFrom July 2019 to November 2019, seventy-three patients who satisfied the inclusion criteria were enrolled. Those patients were scanned with multiple b-value (b-value of 0, 50, 800, 1,000, and 1,200 s/mm2) DWI using a 3.0 T magnetic resonance (MR) scanner before and after the injection of Gd-EOB-DTPA. The final imaging diagnosis of the malignant liver lesions were made by histopathological analysis. The lesion-liver contrast intensity ratio (CIR) and the apparent diffusion coefficients (ADCs) of hepatic parenchyma and lesions at each b-value was evaluated. The Student's t-test or Mann-Whitney U test was used to compare the CIR and ADC between the MR images before and after contrast agent injection. In addition, the Student's t-test or Mann-Whitney U test was used to compare the ADC values between benign and malignant lesions. Receiver operating characteristics (ROC) curves were used to assess the area under the curve (AUC) of the ADC values in differentiating between benign and malignant lesions.ResultsFor the CIRs comparison, the CIRs showed no statistical significance before and after Gd-EOB-DTPA on b =0 (1.34±1.15 vs. 1.45±1.48, P=0.664), b=50 (1.23±1.13 vs. 1.35±1.34, P=0.982), b=800 (1.19±0.87 vs. 1.19±0.94, P=0.946), b=1,000 (1.21±0.90 vs. 1.32±1.05, P=0.294) and b=1,200 (1.25±1.03 vs. 1.45±1.48, P=0.165) s/mm2. For the ADC value comparison, the ADC also showed no statistical significance before and after Gd-EOB-DTPA on b=50 (4.04±2.82 vs. 3.91±3.00, P=0.151), b=800 (1.68±0.71 vs.1.67±0.76, P=0.163), b=1,000 (1.53±0.69 vs.1.50±0.70, P=0.078) and b=1,200 (1.48±0.66 vs. 1.48±0.70, P=0.294) s/mm2.ConclusionsDWI scanned between the interval of dynamic enhanced imaging and HBP imaging can save overall scanning time without influencing the CIRs, ADCs, and diagnostic capabilities of hepatic lesions at both low and high b-values.

Project description:PurposeThe aim was to investigate the association between microvascular invasion (MVI) and the peritumoral imaging features of gadolinium ethoxybenzyl DTPA-enhanced magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI) in hepatocellular carcinoma (HCC).MethodsUp until Feb 24, 2022, the PubMed, Embase, and Cochrane Library databases were carefully searched for relevant material. The software packages utilized for this meta-analysis were Review Manager 5.4.1, Meta-DiSc 1.4, and Stata16.0. Summary results are presented as sensitivity (SEN), specificity (SPE), diagnostic odds ratios (DORs), area under the receiver operating characteristic curve (AUC), and 95% confidence interval (CI). The sources of heterogeneity were investigated using subgroup analysis.ResultsAn aggregate of nineteen articles were remembered for this meta-analysis: peritumoral enhancement on the arterial phase (AP) was described in 13 of these studies and peritumoral hypointensity on the hepatobiliary phase (HBP) in all 19 studies. The SEN, SPE, DOR, and AUC of the 13 investigations on peritumoral enhancement on AP were 0.59 (95% CI, 0.41-0.58), 0.80 (95% CI, 0.75-0.85), 4 (95% CI, 3-6), and 0.73 (95% CI, 0.69-0.77), respectively. The SEN, SPE, DOR, and AUC of 19 studies on peritumoral hypointensity on HBP were 0.55 (95% CI, 0.45-0.64), 0.87 (95% CI, 0.81-0.91), 8 (95% CI, 5-12), and 0.80 (95% CI, 0.76-0.83), respectively. The subgroup analysis of two imaging features identified ten and seven potential factors for heterogeneity, respectively.ConclusionThe results of peritumoral enhancement on the AP and peritumoral hypointensity on HBP showed high SPE but low SEN. This indicates that the peritumoral imaging features on Gd-EOB-DTPA-enhanced MRI can be used as a noninvasive, excluded diagnosis for predicting hepatic MVI in HCC preoperatively. Moreover, the results of this analysis should be updated when additional data become available. Additionally, in the future, how to improve its SEN will be a new research direction.

Project description:BackgroundNuclear protein Ki-67 indicates the status of cell proliferation and has been regarded as an attractive biomarker for the prognosis of HCC. The aim of this study is to investigate which radiomics model derived from different sequences and phases of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI was superior to predict Ki-67 expression in hepatocellular carcinoma (HCC), then further to validate the optimal model for preoperative prediction of Ki-67 expression in HCC.MethodsThis retrospective study included 151 (training cohort: n = 103; validation cohort: n = 48) pathologically confirmed HCC patients. Radiomics features were extracted from the artery phase (AP), portal venous phase (PVP), hepatobiliary phase (HBP), and T2-weighted (T2W) images. A logistic regression with the least absolute shrinkage and selection operator (LASSO) regularization was used to select features to build a radiomics score (Rad-score). A final combined model including the optimal Rad-score and clinical risk factors was established. Receiver operating characteristic (ROC) curve analysis, Delong test and calibration curve were used to assess the predictive performance of the combined model. Decision cure analysis (DCA) was used to evaluate the clinical utility.ResultsThe AP radiomics model with higher decision curve indicating added more net benefit, gave a better predictive performance than the HBP and T2W radiomic models. The combined model (AUC = 0.922 vs. 0.863) including AP Rad-score and serum AFP levels improved the predictive performance more than the AP radiomics model (AUC = 0.873 vs. 0.813) in the training and validation cohort. Calibration curve of the combined model showed a good agreement between the predicted and the actual probability. DCA of the validation cohort revealed that at a range threshold probability of 30-60%, the combined model added more net benefit compared with the AP radiomics model.ConclusionsA combined model including AP Rad-score and serum AFP levels based on enhanced MRI can preoperatively predict Ki-67 expression in HCC.

Dataset Information

Preoperative prediction of microvascular invasion of hepatocellular carcinoma with IVIM diffusion-weighted MR imaging and Gd-EOB-DTPA-enhanced MR imaging.

Publications

Preoperative prediction of microvascular invasion of hepatocellular carcinoma with IVIM diffusion-weighted MR imaging and Gd-EOB-DTPA-enhanced MR imaging.

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