Imaging features based on Gd-EOB-DTPA-enhanced MRI for predicting vessels encapsulating tumor clusters (VETC) in patients with hepatocellular carcinoma

接收机工作特性 列线图 肝细胞癌 医学 核医学 多元分析 六氯环己烷 磁共振成像 单变量分析 放射科 多元统计 内科学 数学 统计
作者
Yanfen Fan,Yanxia Yu,Mengjie Hu,Ximing Wang,Mingzhan Du,Linxin Guo,Chunhong Hu
出处
期刊:British Journal of Radiology [Wiley]
卷期号:94 (1119): 20200950-20200950 被引量:13
标识
DOI:10.1259/bjr.20200950
摘要

To investigate the non-invasive prediction of hepatocellular carcinoma (HCC) with vessels encapsulating tumor clusters (VETC) based on qualitative and quantitative imaging features of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI.109 patients with pathologically confirmed HCC who underwent Gd-EOB-DTPA enhanced MRI and immunochemical staining for CD34 were retrospectively evaluated in our institution (the first affiliated hospital of Soochow university). Pre-operative imaging features of Gd-EOB-DTPA-enhanced MRI were qualitatively and quantitatively reviewed by radiologists. Significant variables for differentiating the VETC-positive and VETC-negative HCCs were identified in univariate and multivariate analyses. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cut-off values for quantitative variables. The nomogram based on the coefficient of multivariate analysis was constructed to evaluate the probability of VETC-positive HCCs.The multivariate analysis showed that the serum AST level >40 U l-1 (p = 0.007), non-rim diffuse and heterogeneous arterial phase hyperenhancement (p = 0.035), tumor-to-liver SI ratio of 1.135 or more on AP images (p = 0.001), and tumor-to-liver SI ratio of 0.585 or less on HBP images (p = 0.002) were significant predictors for predicting VETC-positive HCCs. Combing all four significant variables provided a diagnostic accuracy of 82.6%, sensitivity of 83.9%, specificity of 80.9% for identifying VETC status. The area under the receiver operating characteristics curve value of the logistical regression coefficient-based nomogram was 0.885 (95% confidence intervals, 0.824-0.946).Qualitative and quantitative imaging features of Gd-EOB-DTPA-enhanced MRI integrating laboratory examination can provide good diagnostic performance.VETC is a novel identified microvascular pattern; associations between imaging features and VETC status have not been investigated. Pre-operative diagnosis of VETC status in HCC is essential to help predict the outcome of patients and make a decision for the therapeutic schedule.
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