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Intraindividual comparison of CT and MRI for predicting vessels encapsulating tumor clusters in hepatocellular carcinoma

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

Abstract

Objectives

To establish and validate scoring models for predicting vessels encapsulating tumor clusters (VETC) in hepatocellular carcinoma (HCC) using computed tomography (CT) and magnetic resonance imaging (MRI), and to intra-individually compare the predictive performance between the two modalities.

Methods

We retrospectively included 324 patients with surgically confirmed HCC who underwent preoperative dynamic CT and MRI with extracellular contrast agent between June 2019 and August 2020. These patients were then divided into a discovery cohort (n = 227) and a validation cohort (n = 97). Imaging features and Liver Imaging Reporting and Data System (LI-RADS) categories of VETC-positive HCCs were evaluated. Logistic regression analyses were conducted on the discovery cohort to identify clinical and imaging predictors associated with VETC-positive cases. Subsequently, separate CT-based and MRI-based scoring models were developed, and their diagnostic performance was compared using generalized estimating equations.

Results

On both CT and MRI, VETC-positive HCCs exhibited a higher frequency of size > 5.0 cm, necrosis or severe ischemia, non-smooth tumor margin, targetoid appearance, intratumor artery, and heterogeneous enhancement with septations or irregular ring-like structure compared to VETC-negative HCCs (all p < 0.05). Regarding LI-RADS categories, VETC-positive HCCs were more frequently categorized as LR-M than VETC-negative cases (all p < 0.05). In the validation cohort, the CT-based model showed similar sensitivity (76.7% vs. 86.7%, p = 0.375), specificity (83.6% vs. 74.6%, p = 0.180), and area under the curve value (0.80 vs. 0.81, p = 0.910) to the MRI-based model in predicting VETC-positive HCCs.

Conclusion

Preoperative CT and MRI demonstrated comparable performance in the identification of VETC-positive HCCs, thus displaying promising predictive capabilities.

Clinical relevance statement

Both computed tomography and magnetic resonance imaging demonstrated promise in preoperatively identifying the vessel-encapsulating tumor cluster pattern in hepatocellular carcinoma, with no statistically significant difference between the two modalities, potentially adding additional prognostic value.

Key Points

  • Computed tomography (CT) and magnetic resonance imaging (MRI) show promise in the preoperative identification of vessels encapsulating tumor clusters-positive hepatocellular carcinoma (HCC).

  • HCC with vessels encapsulating tumor cluster patterns were more frequently LR-M compared to those without.

  • These CT and MRI models showed comparable ability in identifying vessels encapsulating tumor clusters-positive HCC.

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Abbreviations

AFP:

Alpha-fetoprotein

APHE:

Arterial phase hyperenhancement

AUC:

Area under the curve

CT:

Computed tomography

HCC:

Hepatocellular carcinoma

LI-RADS:

Liver Imaging Reporting and Data System

MRI:

Magnetic resonance imaging

OR:

Odds ratio

ROC:

Receiver operating characteristic

VETC:

Vessels encapsulating tumor clusters

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Funding

This study has received funding from the Zhejiang Provincial Natural Science Foundation Committee-Zhejiang Society for Mathematical Medicine Joint Fund Major Project (LSD19H180003) and the National Natural Science Foundation of China (12090020 and 12090025).

Author information

Author notes

  1. Junhan Pan and Huizhen Huang contributed equally to this work..

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Zhejiang University School of Medicine, No.79 Qingchun Road, Hangzhou, 310003, China

    Junhan Pan, Huizhen Huang, Siying Zhang, Yanyan Zhu, Cong Zhang, Yan-Ci Zhao & Feng Chen

  2. Department of Pathology, The First Affiliated Hospital of Zhejiang University School of Medicine, No.79 Qingchun Road, Hangzhou, 310003, China

    Yuhao Zhang & Meng Wang

Authors
  1. Junhan Pan
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Corresponding author

Correspondence to Feng Chen.

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The scientific guarantor of this publication is Feng Chen.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Feng Chen has significant statistical expertise.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

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Methodology

  • Retrospective

  • Diagnostic study

  • Performed at one institution

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Pan, J., Huang, H., Zhang, S. et al. Intraindividual comparison of CT and MRI for predicting vessels encapsulating tumor clusters in hepatocellular carcinoma. Eur Radiol (2024). https://doi.org/10.1007/s00330-024-10944-9

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