Value of preoperative magnetic resonance imaging features in predicting early recurrence of hepatocellular carcinoma after surgical resection
10.3969/j.issn.1000-8179.2020.13.578
- Author:
Wencui LI
1
Author Information
1. Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer
- Publication Type:Journal Article
- Keywords:
Early recurrence;
Hepatocellular carcinoma (HCC);
Imaging features;
Magnetic resonance imaging (MRI)
- From:
Chinese Journal of Clinical Oncology
2020;47(13):670-676
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To assess the value of preoperative clinical data and magnetic resonance (MR) imaging features in predicting early recurrence (recurrence in two years) after surgical resection of hepatocellular carcinoma (HCC). Methods: This retrospective study included 244 patients with HCC who underwent a surgical resection between January 2015 and January 2018 at Tianjin Medical University Cancer Institute and Hospital. The role of preoperative clinical data and MR imaging features on early recurrence after surgical tumor resection were evaluated using univariate and multivariate analyses. All patients were followed up regularly after discharge. The endpoint was considered to be intrahepatic recurrence within 2 years. Results: In the univariate analyses, the maximum diameter of the tumor, tumor capsule, peritumoral parenchyma enhancement, rim enhancement, two-trait predictor of venous invasion (TTPVI), tumor necrosis, satellite nodules, dynamic enhancement pattern, diffusion-weighted imaging (DWI) /T2WI mismatch and other MR imaging features, as well as alpha-fetoprotein (AFP), TNM stage, alanine aminotransferase (ALT), glutamatergic aminotransferase (AST), direct bilirubin (DBIL), γ-glutamyl transferase (γ-GT) and other clinical data were correlated with the early recurrence of HCC. In the multivariate Cox regression analysis, the tumor capsule (HR=0.372, P<0.05), rim enhancement (HR=2.947, P<0.05), TTPVI (HR= 1.993, P=0.004), satellite nodules (HR=2.192, P=0.017) and AFP >400 μg/L (HR=2.234, P<0.05) were independent factors of early recurrence after surgical resection of HCC. According to the results of the multivariate Cox regression analysis, a nomogram can be drawn to intuitively show the risk of recurrence. Conclusions: MRI features like tumor capsule, rim enhancement, TTPVI, satellite nodules, and AFP >400 μg/L were found to be independent factors of the early postoperative recurrence of HCC. This research has established a predictive model for the early recurrence of HCC after surgical resection using a non-invasive method, which can help clinicians to develop individualized treatment protocols and improve patient outcomes.
