Pre-operative enhanced magnetic resonance imaging combined with clinical features predict early recurrence of hepatocellular carcinoma after radical resection

Jian-Ping Chen; Ri-Hui Yang; Tian-Hui Zhang; Li-An Liao; Yu-Ting Guan; Hai-Yang Dai

doi:10.4251/wjgo.v16.i4.1192

Pre-operative enhanced magnetic resonance imaging combined with clinical features predict early recurrence of hepatocellular carcinoma after radical resection

World J Gastrointest Oncol. 2024 Apr 15;16(4):1192-1203. doi: 10.4251/wjgo.v16.i4.1192.

Authors

Jian-Ping Chen¹, Ri-Hui Yang², Tian-Hui Zhang², Li-An Liao², Yu-Ting Guan², Hai-Yang Dai³

Affiliations

¹ Department of Intervention, Meizhou People's Hospital, Meizhou 514031, Guangdong Province, China.
² Department of Medical Imaging, Meizhou People's Hospital, Meizhou 514031, Guangdong Province, China.
³ Department of Medical Imaging, Huizhou Municipal Central Hospital, Huizhou 516001, Guangdong Province, China. d.ocean@163.com.

Abstract

Background: Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma (HCC) has great significance for patient prognosis.

Aim: To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) combined with clinical features in predicting early recurrence of HCC after resection.

Methods: A total of 161 patients with pathologically confirmed HCC were enrolled. The patients were divided into early recurrence and non-early recurrence group based on the follow-up results. The clinical, laboratory, pathological results and Gd-EOB-DTPA enhanced MRI imaging features were analyzed.

Results: Of 161 patients, 73 had early recurrence and 88 were had non-early recurrence. Univariate analysis showed that patient age, gender, serum alpha-fetoprotein level, the Barcelona Clinic Liver Cancer stage, China liver cancer (CNLC) stage, microvascular invasion (MVI), pathological satellite focus, tumor size, tumor number, tumor boundary, tumor capsule, intratumoral necrosis, portal vein tumor thrombus, large vessel invasion, nonperipheral washout, peritumoral enhancement, hepatobiliary phase (HBP)/tumor signal intensity (SI)/peritumoral SI, HBP peritumoral low signal and peritumoral delay enhancement were significantly associated with early recurrence of HCC after operation. Multivariate logistic regression analysis showed that patient age, MVI, CNLC stage, tumor boundary and large vessel invasion were independent predictive factors. External data validation indicated that the area under the curve of the combined predictors was 0.861, suggesting that multivariate logistic regression was a reasonable predictive model for early recurrence of HCC.

Conclusion: Gd-EOB-DTPA enhanced MRI combined with clinical features would help predicting the early recurrence of HCC after operation.

Keywords: Enhanced magnetic resonance imaging; Hepatobiliary phase; Hepatocellular carcinoma; Microvascular invasion; Recurrence.