We conduct this study to investigate the value of Kupffer phase radiomics signature of Sonazoid-enhanced ultrasound images (SEUS) for the preoperative prediction of hepatocellular carcinoma (HCC) grade. From November 2019 to October 2021, 68 pathologically confirmed HCC nodules from 54 patients were included. Quantitative radiomic features were extracted from grayscale images and arterial and Kupffer phases of SEUS of HCC lesions. Univariate logistic regression and the maximum relevance minimum redundancy (MRMR) method were applied to select radiomic features best corresponding to pathological results. Prediction radiomic signature was calculated using each of the image types. A predictive model was validated using internal leave-one-out cross validation (LOOCV). For discrimination between poorly differentiated HCC (p-HCC) and well-differentiated HCC/moderately differentiated HCC (w/m-HCC), the Kupffer phase radiomic score (KPRS) achieved an excellent area under the curve (AUC = 0.937), significantly higher than the other two radiomic signatures. KPRS was the best radiomic score based on the highest AUC (AUC = 0.878), which is prior to gray and arterial RS for differentiation between w-HCC and m/p-HCC. Univariate and multivariate analysis incorporating all radiomic signatures and serological variables showed that KPRS was the only independent predictor in both predictions of HCC lesions (p-HCC vs. w/m-HCC, log OR 15.869, P < 0.001 , m/p-HCC vs. w-HCC, log OR 12.520, P < 0.05 ). We conclude that radiomics signature based on the Kupffer phase imaging may be useful for identifying the histological grade of HCC. The Kupffer phase radiomic signature may be an independent and effective predictor in discriminating w-HCC and p-HCC.
Aim To evaluate the role of Sonazoid enhanced ultrasound assistant laparoscopic radiofrequency ablation in treating liver malignancy. Methods Consecutive patients are recruited. Rates of complication and postoperative length of stay are compared between the study and control groups. Progression‐free survival (PFS) of colorectal liver metastasis (CRLM) after ablation are compared. Complete ablation rates are compared and optimal tumor size is calculated by ROC curve analysis. Risk factors of incomplete ablation are determined by logistic regression analysis. Results Totally 73 patients with 153 lesions were included. No significant differences in the rate of complication were found between the study and control groups. PFS of CRLM in laparoscopic, intraoperative CEUS, and laparoscopic CEUS groups are all longer than their control groups. Complete ablation rates of laparoscopic, intraoperative CEUS, and laparoscopic CEUS groups are all higher than in their control groups with statistical significance. A tumor size of 2.15 cm is determined to be the optimal cut‐off with the area under the ROC curve of 0.854, 95% CI (0.764, 0.944), p = 0.001. In logistic regression analysis, tumor size [OR 20.425, 95% CI (3.136, 133.045), p = 0.002] and location of segments VII and VIII [OR 9.433, 95% CI (1.364, 65.223), p = 0.023] are calculated to be the risk factors of incomplete ablation, meanwhile, intraoperative CEUS shows to be a protective factor in univariate analysis [OR 0.110, 95% CI (0.013, 0.915), p = 0.041]. Conclusion Sonazoid‐enhanced ultrasound assistant laparoscopic radiofrequency ablation is safe and effective to treat liver malignancy. We should pay attention to the ablation planning of larger tumors and tumors in special locations.
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