A non-smooth tumor margin on preoperative imaging assesses microvascular invasion of hepatocellular carcinoma: A systematic review and meta-analysis

Hu, Hang-Tong; Zheng, Qiao; Huang, Yang; Huang, Xiao Wen; Lai, Zhi Cheng; Liu, JingYa; Xie, Xiaoyan; Feng, Shi Ting; Wang, Wei; Lu, Min‐Shan

doi:10.1038/s41598-017-15491-6

Cited by 63 publications

(66 citation statements)

References 30 publications

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“…Shape-related characteristics were adopted to express the complexity of the lesion shape. Given histological studies, MVI-positive HCC exhibited an aggressive tendency, invading the tumor envelope and extending into the noncancerous substance, thereby causing a higher incidence of irregular tumor margins [ 23 ]. Matrix-based characteristics are second-order statistics applied to express lesions complex characteristics, the variation of hierarchical structure, and the thickness of texture.…”

Section: Discussionmentioning

confidence: 99%

Radiomics Analysis of MR Imaging with Gd-EOB-DTPA for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma: Investigation and Comparison of Different Hepatobiliary Phase Delay Times

Zhang

Duan

et al. 2021

BioMed Research International

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Purpose. To investigate whether the radiomics analysis of MR imaging in the hepatobiliary phase (HBP) can be used to predict microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC). Method. A total of 130 patients with HCC, including 80 MVI-positive patients and 50 MVI-negative patients, who underwent MR imaging with Gd-EOB-DTPA were enrolled. Least absolute shrinkage and selection operator (LASSO) regression was applied to select radiomics parameters derived from MR images obtained in the HBP 5 min, 10 min, and 15 min images. The selected features at each phase were adopted into support vector machine (SVM) classifiers to establish models. Multiple comparisons of the AUCs at each phase were performed by the Delong test. The decision curve analysis (DCA) was used to analyze the classification of MVI-positive and MVI-negative patients. Results. The most predictive features between MVI-positive and MVI-negative patients included 9, 8, and 14 radiomics parameters on HBP 5 min, 10 min, and 15 min images, respectively. A model incorporating the selected features produced an AUC of 0.685, 0.718, and 0.795 on HBP 5 min, 10 min, and 15 min images, respectively. The predictive model for HBP 5 min, 10 min and 15 min showed no significant difference by the Delong test. DCA indicated that the predictive model for HBP 15 min outperformed the models for HBP 5 min and 10 min. Conclusions. Radiomics parameters in the HBP can be used to predict MVI, with the HBP 15 min model having the best differential diagnosis ability.

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Section: Discussionmentioning

confidence: 99%

Radiomics Analysis of MR Imaging with Gd-EOB-DTPA for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma: Investigation and Comparison of Different Hepatobiliary Phase Delay Times

Zhang

Duan

et al. 2021

BioMed Research International

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“…Recently, a non‐smooth tumor margin on preoperative imaging revealed to have great value for MVI assessment according to a systematic review 16 . A treatment strategy for a non‐smooth tumor margin of HCC is required because sectionectomy or larger hepatectomy or adjuvant therapy such as TACE after hepatectomy has been reported to improve survival for patients with HCC and MVI.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, HB‐phase images on Gd‐EOB‐DTPA‐enhanced MRI (EOB‐MRI) predict the MVI of HCC preoperatively. In detail, a non‐smooth tumor margin on HB‐phase images predicts MPVI or intrahepatic metastasis (IM) of HCC 10‐16 . If, on one hand, sectionectomy or larger hepatectomy has been recently reported to decrease the risk of intrahepatic recurrence of HCC and to improve overall survival (OS), on the other hand recurrence‐free survival (RFS) rates and OS rates have not been evaluated in relation to the tumor margin on EOB‐MRI 11 .…”

Section: Introductionmentioning

confidence: 99%

“…In detail, a non-smooth tumor margin on HB-phase images predicts MPVI or intrahepatic metastasis (IM) of HCC. [10][11][12][13][14][15][16] If, on one hand, sectionectomy or larger hepatectomy has been recently reported to decrease the risk of intrahepatic recurrence of HCC and to improve overall survival (OS), on the other hand recurrence-free survival (RFS) rates and OS rates have not been evaluated in relation to the tumor margin on EOB-MRI. 11 We attempted to clarify whether a difference in surgical outcomes, after sectionectomy or larger resection and after segmentectomy or smaller resection, related to the tumor margin on HB-phase EOB-MRI exists.…”

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confidence: 99%

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Hepatocellular carcinoma with a non‐smooth tumor margin on hepatobiliary‐phase gadoxetic acid disodium‐enhanced magnetic resonance imaging. Is sectionectomy the suitable treatment?

Romanzi

Ariizumi

Kotera

et al. 2020

J Hepato Biliary Pancreat

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Background/Purpose: Anatomical sectionectomy or larger resection is known to be effective in patients with hepatocellular carcinoma (HCC) with microvascular invasion. A non-smooth tumor margin on hepatobiliary-phase gadoxetic acid disodium-enhanced magnetic resonance imaging (EOB-MRI) can predict microvascular invasion of HCC. We evaluated the usefulness of EOB-MRI for operative planning. Methods: We evaluated 224 patients with single HCC who underwent hepatectomy between 2010 and 2013. The tumor margin was determined preoperatively. The hepatic resection was determined based on tumor location, liver function, 3D CT simulation and functional liver reserve. To control for confounding variable distributions, propensity score match was applied to compare the outcomes. Multivariate analysis was conducted to identify independent predictors of 5-year recurrence-free survival (RFS) and overall survival (OS). Results: Of 113 patients with a non-smooth tumor margin, 40 patients (35%) showed microscopic portal invasion. The 5-year RFS and OS rates were significantly higher after sectionectomy or larger hepatectomy (hemihepatectomy) than after segmentectomy or smaller hepatectomy (non-anatomical resection). Of 111 patients with a smooth tumor margin, eight patients (7%) showed microscopic portal invasion. The 5-year RFS and OS rates did not differ significantly between patients who underwent sectionectomy and those who underwent segmentectomy. Conclusions: Our preliminary results appear to recommend that HCC with a nonsmooth margin on HB-phase images is treated with anatomical sectionectomy or larger hepatectomy.

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“…Wu et al [31] reported that irregular tumor margin was alone independent predictive factor for MVI among previously proposed predicting factors such as fluorine-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) results and serum tumor markers. Hu et al [32] demonstrated in a meta-analysis that CT is superior to MRI in evaluating an irregular tumor margin for MVI assessment. Banerjee et al [33] showed new features of contrast CT that can also accurately predict histological MVI in HCC surgical candidates.…”

Section: Prediction Of MVI Using Contrast Ctmentioning

confidence: 99%

The prediction of microvascular invasion of hepatocellular carcinoma using multiple imaging modalities

Tamai¹

2018

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To implement an adequate treatment strategy for solitary hepatocellular carcinoma (HCC), the prediction of microvascular invasion (MVI) is crucial. Metastatic recurrences after curative treatments can result from occult metastasis derived from invisible MVI. For predicting MVI, poorly differentiated or non-singular nodular HCC with a high risk of MVI should be evaluated by common imaging modalities such as ultrasound, contrast enhanced computed tomography (CECT), or magnetic resonance imaging (MRI). Summarizing these predictabilities in previous reports, the accuracies for predicting MVI were 78% in contrast enhanced ultrasonography (CEUS), 76%-89% in CECT, and 62%-77% in MRI. Those for predicting poor differentiation were 69%-92% in CEUS, 52%-90% in CECT, and 71%-75% in MRI. Those for predicting non-singular nodular type were 92%-95% in CEUS, 81%-89% in MRI, and 91%-93% in the combination of MRI and CECT. Among common imaging modalities, MRI can provide tissue characterization of the HCC using signal intensity. Gadolinium-ethoxybenzyl diethylenetriamine penta-acetic acid-enhanced MRI including diffusion imaging is the most informative imaging modality to predict MVI. Combination of MRI with other imaging modalities or tumor markers may provide a more accurate predicting for MVI. HCC with a high risk of MVI should be treated as advanced HCC even after curative treatment.

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A non-smooth tumor margin on preoperative imaging assesses microvascular invasion of hepatocellular carcinoma: A systematic review and meta-analysis

Cited by 63 publications

References 30 publications

Radiomics Analysis of MR Imaging with Gd-EOB-DTPA for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma: Investigation and Comparison of Different Hepatobiliary Phase Delay Times

Radiomics Analysis of MR Imaging with Gd-EOB-DTPA for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma: Investigation and Comparison of Different Hepatobiliary Phase Delay Times

Hepatocellular carcinoma with a non‐smooth tumor margin on hepatobiliary‐phase gadoxetic acid disodium‐enhanced magnetic resonance imaging. Is sectionectomy the suitable treatment?

The prediction of microvascular invasion of hepatocellular carcinoma using multiple imaging modalities

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