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Prediction of microvascular invasion in HCC by a scoring model combining Gd-EOB-DTPA MRI and biochemical indicators

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

This study aimed to establish a reliable diagnostic scoring model for the preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients based on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)–enhanced magnetic resonance imaging (MRI) and biochemical indicators.

Methods

This retrospective study included 129 patients with HCC at our hospital from 2014 to 2020. Based on the intratumoral and peritumoral features on Gd-EOB-DTPA MRI and biochemical indicators, a scoring model was developed for preoperative prediction of MVI, and examined for diagnostic efficacy according to postoperative pathological results. The scoring model was further externally validated in an independent cohort of 63 HCC patients.

Results

Logistic regression analysis was performed to identify five parameters related to MVI, including maximum tumor diameter, peritumoral low intensity in the hepatobiliary phase, incomplete capsule, apparent diffusion coefficient (ADC), and [alkaline phosphatase (ALP) (U/L) + gamma-glutamyl transpeptidase (GGT) (U/L)] / lymphocyte count (× 109/L) ratio (AGLR). Based on these five parameters, a scoring model was developed, and the accuracy, sensitivity, specificity, PPV, and NPV in predicting MVI were 93.6%, 94.7%, 93.2%, 85.7%, and 97.6%, respectively, with a score > 8 set as the threshold.

Conclusion

The scoring model based on Gd-EOB-DTPA MRI and biochemical indicators provides a reliable tool for preoperative prediction of MVI in HCC patients.

Key Points

• The scoring model based on Gd-EOB-DTPA MRI and biochemical indicators is practical for preoperative prediction of MVI in HCC patients.

• AGLR is an independent risk factor for MVI.

• The scoring model could help implement more appropriate interventions, potentially leading to precise and individualized treatments based on the biological characteristics of the tumor.

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Fig. 1
Fig. 2

taken from the connection between the two farthest points of the lesion on the largest level (a). The others showed peritumoral enhancement in arterial phase (the red outline represents peritumoral enhancement, and the black outline represents tumor) (c), peritumoral low intensity in hepatobiliary phase (d), incomplete capsule (e), and intratumoral artery (f), marked with arrows. ADC values of tumors were obtained from the average of three measurements, and ROI was delineated to avoid heterogeneous components such as necrosis or bleeding (g)

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Abbreviations

ADC:

Apparent diffusion coefficient

AGLR:

(ALP [U/L] + GGT [U/L]) / lymphocyte count (× 109/L) ratio

ALP:

Alkaline phosphatase

Gd-EOB-DTPA:

Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid

HBP:

Hepatobiliary phase

HE:

Hematoxylin-eosin

ICC:

Intraclass correlation coefficient

Max-D:

Maximum diameter of the tumor

MVI:

Microvascular invasion

NLR:

Neutrophil-to-lymphocyte ratio

PLR:

Platelet-to-lymphocyte ratio

PTLI:

Peritumoral low intensity

ROC:

Receiver operating characteristic

U/L:

Units per liter

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Funding

This study has received funding by National Natural Science Fund of China (81901710); National Natural Science Fund of China (81671657); and Science and Technology Fund of Tian** (QN20010).

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Authors and Affiliations

  1. Department of Radiology, First Central Clinical College, Tian** Medical University, 22 Qixiangtai Road, He** District, Tian**, 300070, China

    Kun Zhang

  2. Department of Radiology, Tian** Medical Imaging Institute, School of Medicine, Tian** First Central Hospital, Nankai University, Nankai District, No. 24 Fukang Road, Tian**, 300192, China

    Shuang-Shuang **e & Wen Shen

  3. Department of Radiology, Tian** Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tian**, 300060, China

    Wen-Cui Li & Zhao-**ang Ye

  4. Philips Healthcare, The World Profit Centre, No. 16 Tianze Road, Chaoyang District, Bei**g, 100125, China

    Zhi-Wei Shen

Authors
  1. Kun Zhang
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Correspondence to Wen Shen.

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Guarantor

The scientific guarantor of this publication is Dr. Wen Shen from the Department of Radiology, Tian** First Center Hospital.

Conflict of interest

One of the authors (Zhi-Wei Shen) is an employee of Philips Healthcare. The remaining authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Written informed consent was obtained from all subjects in this study.

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Institutional review board approval was obtained.

Methodology

  • • retrospective

  • • diagnostic or prognostic study

  • • multicenter study

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Zhang, K., **e, SS., Li, WC. et al. Prediction of microvascular invasion in HCC by a scoring model combining Gd-EOB-DTPA MRI and biochemical indicators. Eur Radiol 32, 4186–4197 (2022). https://doi.org/10.1007/s00330-021-08502-8

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  • DOI: https://doi.org/10.1007/s00330-021-08502-8

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