Non-radiomics Imaging (US-CEUS) Features and Clinical Text Features: Correlation with Microvascular Invasion and Tumor Grading in Hepatocellular Carcinoma

Overview

Journal Abdom Radiol (NY)

Publisher Springer

Specialties Gastroenterology
Radiology

Date 2024 Nov 28

PMID 39607454

Authors

Qi Yang

Jianhua Zhou

BaoMing Luo

Rongqin Zheng

Jintang Liao

Lina Tang

Wen Cheng

Xiang Jing

Wenjia Cai

Zhigang Cheng

Fangyi Liu

Zhiyu Han

Xiaoling Yu

Jie Yu

Ping Liang

Affiliations

Soon will be listed here.

Abstract

Objectives: To predict microvascular invasion (MVI) status and tumor grading of hepatocellular carcinoma (HCC) by evaluating preoperative non-radiomics ultrasound and contrast-enhanced ultrasound (US-CEUS) features and determine the influences of MVI/tumor grading on the category of CEUS LI-RADS for HCC.

Methods: A total of 506 HCC patients who underwent preoperative US-CEUS examinations from 8 hospitals between July 2020 and June 2023 were enrolled. According to the MVI status, all the patients were classified, and HCC differentiation was assessed by using Edmondson-Steiner (ES) grading: MVI-negative (M0) and low-grade ES (GI/II) (MN-L, n = 297) and MVI-positive (M1/M2) and/or high-grade ES (GIII/IV) (MP-H, n = 209). Stratified analysis was performed based on fibrosis stage and tumor size.

Results: The results proved that MN-L HCC was more frequently classified into the LR-5 category (p = 0.034), while MP-H HCC was more frequently classified into the LR-TIV (p = 0.010). The heterogeneously arterial phase hyperenhancement (APHE) is significantly correlated with MVI(+)/high grade-ES (p = 0.003). Compared with MN-L HCC, the onset of washout was earlier, washout rate was higher, and tumor-invasion border was larger (all p < 0.01) in MP-H HCC. In addition, fibrosis stage and tumor size significantly influenced the onset of washout and washout rate of HCC (all p < 0.01). The tumor-invasion border was only positively correlated with tumor size (p < 0.001) rather than fibrosis stage (p > 0.05).

Conclusions: MVI status and tumor grading influence the classification of LR-5 and LR-TIV. Heterogeneous APHE, higher washout rate, earlier onset of washout (≤65 s), larger tumor-invasion border (≥3 mm) and higher alpha fetoprotein level indicate the presence of MVI and/or high-grade ES.

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