Multi-scale and multi-parametric radiomics of gadoxetate disodium-enhanced MRI predicts microvascular invasion and outcome in patients with solitary hepatocellular carcinoma ≤ 5 cm.
Multi-scale and multi-parametric radiomics of gadoxetate disodium-enhanced MRI predicts microvascular invasion and outcome in patients with solitary hepatocellular carcinoma ≤ 5 cm.
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DOI：
10.1007/s00330-020-07601-2
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发表时间：
2021-07
影响因子：
5.9
通讯作者：
Zeng MS
中科院分区：
文献类型：
--
作者：
Chong HH;Yang L;Sheng RF;Yu YL;Wu DJ;Rao SX;Yang C;Zeng MS
建立基于放射组学的单发肝细胞癌（HCC）患者术前微血管侵犯（MVI）和无复发生存（RFS）预测的影像学图。2012年3月至2019年9月，回顾性纳入356例术前行加多赛特二钠增强MRI的病理证实的≤5 cm的孤立性HCC患者。根据浸润血管的数量和分布，MVI分为M0、M1、M2。从整个肿瘤区域、肿瘤周围≤10 mm区域以及随机选择的肝组织的DWI、动脉、门静脉和肝胆期图像中提取放射组学特征。多变量分析确定了MVI和RFS的独立预测因子，并使用nomogram可视化最终预测模型。甲胎蛋白、总胆红素和放射组学值升高、肿瘤周围增强、囊膜增强不完全或缺失是MVI的独立危险因素。验证队列（n = 106）的随机森林和logistic回归分析的MVI模态图auc分别为0.920 （95% CI: 0.861 ~ 0.979）和0.879 （95% CI: 0.820 ~ 0.938）。mvi阳性（M2和M1）和mvi阴性（M0）患者的中位RFS分别为30.5（11.9和40.9）和96.9个月（p < 0.001）， 5年RFS率为68.4%。在RFS验证队列中，年龄、组织学MVI、碱性磷酸酶和丙氨酸转氨酶独立预测复发，AUC为0.654 （95% CI: 0.538-0.769, n = 99）。术前使用随机森林的MVI图预测MVI，而不是组织学上的MVI，在MVI分层和RFS预测方面取得了相当的准确性。术前使用随机森林的基于放射组学的nomogram是一种潜在的MVI生物标志物，对于≤5 cm的孤立性HCC， RFS预测也具有潜力。•放射组学评分是MVI的主要独立预测因子，而MVI是术后复发的主要独立危险因素。•使用随机森林或逻辑回归分析的基于放射组学的nomogram预测HCC患者术前MVI的效果是目前为止最好的。•作为浸润性组织学MVI的极好替代品，术前使用随机森林（MVI- rf）的MVI图预测MVI在MVI分层和结果方面具有相当的准确性，加强了对HCC血管浸润和进展的放射学理解。在线版本包含补充材料，可在10.1007/s00330-020-07601-2获得。
To develop radiomics-based nomograms for preoperative microvascular invasion (MVI) and recurrence-free survival (RFS) prediction in patients with solitary hepatocellular carcinoma (HCC) ≤ 5 cm. Between March 2012 and September 2019, 356 patients with pathologically confirmed solitary HCC ≤ 5 cm who underwent preoperative gadoxetate disodium–enhanced MRI were retrospectively enrolled. MVI was graded as M0, M1, or M2 according to the number and distribution of invaded vessels. Radiomics features were extracted from DWI, arterial, portal venous, and hepatobiliary phase images in regions of the entire tumor, peritumoral area ≤ 10 mm, and randomly selected liver tissue. Multivariate analysis identified the independent predictors for MVI and RFS, with nomogram visualized the ultimately predictive models. Elevated alpha-fetoprotein, total bilirubin and radiomics values, peritumoral enhancement, and incomplete or absent capsule enhancement were independent risk factors for MVI. The AUCs of MVI nomogram reached 0.920 (95% CI: 0.861–0.979) using random forest and 0.879 (95% CI: 0.820–0.938) using logistic regression analysis in validation cohort (n = 106). With the 5-year RFS rate of 68.4%, the median RFS of MVI-positive (M2 and M1) and MVI-negative (M0) patients were 30.5 (11.9 and 40.9) and > 96.9 months (p < 0.001), respectively. Age, histologic MVI, alkaline phosphatase, and alanine aminotransferase independently predicted recurrence, yielding AUC of 0.654 (95% CI: 0.538–0.769, n = 99) in RFS validation cohort. Instead of histologic MVI, the preoperatively predicted MVI by MVI nomogram using random forest achieved comparable accuracy in MVI stratification and RFS prediction. Preoperative radiomics-based nomogram using random forest is a potential biomarker of MVI and RFS prediction for solitary HCC ≤ 5 cm. • The radiomics score was the predominant independent predictor of MVI which was the primary independent risk factor for postoperative recurrence. • The radiomics-based nomogram using either random forest or logistic regression analysis has obtained the best preoperative prediction of MVI in HCC patients so far. • As an excellent substitute for the invasive histologic MVI, the preoperatively predicted MVI by MVI nomogram using random forest (MVI-RF) achieved comparable accuracy in MVI stratification and outcome, reinforcing the radiologic understanding of HCC angioinvasion and progression. The online version contains supplementary material available at 10.1007/s00330-020-07601-2.
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影响因子：
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Kuang, Ming
DOI：
10.1002/hep.27877
发表时间：
2015-09
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
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通讯作者：
Kuo MD