Risk assessment of hepatocellular carcinoma development for indeterminate hepatic nodules in patients with chronic hepatitis B
- Author:
Haneulsaem SHIN
1
;
Yeon Woo JUNG
;
Beom Kyung KIM
;
Jun Yong PARK
;
Do Young KIM
;
Sang Hoon AHN
;
Kwang Hyub HAN
;
Yeun Yoon KIM
;
Jin Young CHOI
;
Seung Up KIM
Author Information
- Publication Type:Original Article
- Keywords: Radiographic image interpretation, Computer-assisted; Liver neoplasms; Hepatitis B; Risk assessment; Hepatocellular carcinoma
- MeSH: Asian Continental Ancestry Group; Carcinoma, Hepatocellular; Diffusion; Female; Fibrosis; Hepatitis B; Hepatitis B, Chronic; Hepatitis, Chronic; Humans; Incidence; Information Systems; Liver; Liver Cirrhosis; Liver Neoplasms; Magnetic Resonance Imaging; Male; Multivariate Analysis; Radiographic Image Interpretation, Computer-Assisted; Risk Assessment
- From:Clinical and Molecular Hepatology 2019;25(4):390-399
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: A risk prediction model for the development of hepatocellular carcinoma (HCC) from indeterminate nodules detected on computed tomography (CT) (Rad(CT) score) in patients with chronic hepatitis B (CHB)-related cirrhosis was proposed. We validated this model for indeterminate nodules on magnetic resonance imaging (MRI).METHODS: Between 2013 and 2016, Liver Imaging Reporting and Data System (LI-RADS) 2/3 nodules on MRI were detected in 99 patients with CHB. The Rad(CT) score was calculated.RESULTS: The median age of the 72 male and 27 female subjects was 58 years. HCC history and liver cirrhosis were found in 47 (47.5%) and 44 (44.4%) patients, respectively. The median Rad(CT) score was 112. The patients with HCC (n=41, 41.4%) showed significantly higher Rad(CT) scores than those without (median, 119 vs. 107; P=0.013); the Chinese university-HCC and risk estimation for HCC in CHB (REACH-B) scores were similar (both P>0.05). Arterial enhancement, T2 hyperintensity, and diffusion restriction on MRI were not significantly different in the univariate analysis (all P>0.05); only the Rad(CT) score significantly predicted HCC (hazard ratio [HR]=1.018; P=0.007). Multivariate analysis showed HCC history was the only independent HCC predictor (HR=2.374; P=0.012). When the subjects were stratified into three risk groups based on the Rad(CT) score (<60, 60–105, and >105), the cumulative HCC incidence was not significantly different among them (all P>0.05, log-rank test).CONCLUSIONS: HCC history, but not Rad(CT) score, predicted CHB-related HCC development from LI-RADS 2/3 nodules. New risk models optimized for MRI-defined indeterminate nodules are required.
