Prediction of Microvascular Invasion in Solitary AFP-Negative Hepatocellular Carcinoma ≤ 5 cm Using a Combination of Imaging Features and Quantitative Dual-Layer Spectral-Detector CT Parameters

肝细胞癌 接收机工作特性 医学 逻辑回归 预测值 核医学 曲线下面积 放射科 内科学
作者
Yongjian Zhu,Bing Feng,Wei Cai,Bingzhi Wang,Xuan Meng,Shuang Wang,Xiaohong Ma,Xinming Zhao
出处
期刊:Academic Radiology [Elsevier BV]
卷期号:30: S104-S116 被引量:12
标识
DOI:10.1016/j.acra.2023.02.015
摘要

AFP-negative hepatocellular carcinoma (AFPN-HCC) within 5 cm is a special subgroup of HCC. This study aimed to investigate the value of dual-layer spectral-detector CT (DLCT) and construct a scoring model based on imaging features as well as DLCT for predicting microvascular invasion (MVI) in AFPN-HCC within 5 cm.This retrospective study enrolled 104 HCC patients who underwent multiphase contrast-enhanced DLCT studies preoperatively. Combined radiological features (CR) and combined DLCT quantitative parameter (CDLCT) were constructed to predict MVI. Multivariable logistic regression was applied to identify potential predictors of MVI. Based on the coefficient of the regression model, a scoring model was developed. The predictive efficacy was assessed through ROC analysis.Microvascular invasion (MVI) was found in 28 (26.9%) AFPN-HCC patients. Among single parameters, the effective atomic number in arterial phase demonstrated the best predictive efficiency for MVI with an area under the curve (AUC) of 0.792. CR and CDLCT showed predictive performance with AUCs of 0.848 and 0.849, respectively. A risk score (RS) was calculated using the independent predictors of MVI as follows: RS = 2 × (mosaic architecture) + 2 × (corona enhancement) + 2 × (incomplete tumor capsule) + 2 × (2-trait predictor of venous invasion [TTPVI]) + 3 × (CDLCT > -1.229). Delong's test demonstrated this scoring system could significantly improve the AUC to 0.929 compared with CR (p = 0.016) and CDLCT (p = 0.034).The scoring model combining radiological features with DLCT provides a promising tool for predicting MVI in solitary AFPN-HCC within 5 cm preoperatively.
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