Predicting histologic differentiation of solitary hepatocellular carcinoma up to 5 cm on gadoxetate disodium-enhanced MRI

• Published in: Insights into imaging Vol. 14; no. 1; p. 3
• Main Authors: Yang, Ting, Wei, Hong, Wu, Yuanan, Qin, Yun, Chen, Jie, Jiang, Hanyu, Song, Bin
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 08-01-2023; Springer Nature B.V; SpringerOpen
• Subjects: Carcinoma (Hepatocellular); Diagnostic Radiology; Differentiation; Gadolinium ethoxybenzyl DTPA; Heterogeneity; Histologic differentiation; Imaging; Internal Medicine; Interventional Radiology; Liver cancer; Magnetic resonance imaging; Medicine; Medicine & Public Health; Multivariate analysis; Neuroradiology; Original; Original Article; Prediction models; Radiology; Regression analysis; Sensitivity; Training; Tumors; Ultrasound; Carcinoma (Hepatocellular); Magnetic resonance imaging; Histologic differentiation; Gadolinium ethoxybenzyl DTPA
• ISSN: 1869-4101; 1869-4101
• DOI: 10.1186/s13244-022-01354-w

Background
To establish a preoperative score based on gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) and clinical indicators for predicting histologic differentiation of solitary HCC up to 5 cm.
Methods
From July 2015 to January 2022, consecutive patients with surgically proven solitary HCC measuring ≤ 5 cm at preoperative EOB-MRI were retrospectively enrolled. All MR images were independently evaluated by two radiologists who were blinded to all clinical and pathologic information. Univariate and multivariate logistic regression analyses were performed to identify significant clinicoradiological features associated with poorly differentiated (PD) HCC, which were then incorporated into the predictive score. The predictive score was validated in an independent validation set by area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy.
Results
A total of 182 patients were included, 42 (23%) with PD HCC. According to the multivariate analysis, marked hepatobiliary phase hypointensity (odds ratio [OR], 9.98), LR-M category (OR, 5.60), and serum alpha-fetoprotein (AFP) level > 400 ng/mL (OR, 3.58) were incorporated into the predictive model; the predictive score achieved an AUC of 0.802 and 0.830 on the training and validation sets, respectively. The sensitivity, specificity, and accuracy of the predictive score were 66.7%, 85.7%, and 81.3%, respectively, on the training set and 66.7%, 81.0%, and 77.8%, respectively, on the validation set.
Conclusion
The proposed score integrating two EOB-MRI features and AFP level can accurately predict PD HCC in the preoperative setting.
Key points
EOB-MRI features help capture the characteristics of tumor biology and heterogeneity.
EOB-MRI-based HCC differentiation score allowed accurate assessment of poor tumor differentiation preoperatively.
This scoring system might be useful for prompting tailored treatment selection.