<p>Evaluation of Multiple Prognostic Factors of Hepatocellular Carcinoma with Intra-Voxel Incoherent Motions Imaging by Extracting the Histogram Metrics</p>

Abstract

To predict multiple prognostic factors of HCC including histopathologic grade, the expression of Ki67 as well as capsule formation with intravoxel incoherent motions imaging by extracting the histogram metrics. Patients and Methods: A total of 52 patients with HCC were recruited with the MR examinations undertaken at a 3T scanner. Histogram metrics were extracted from IVIMderived parametric maps. Independent student t-test was performed to explore the differences in metrics across different subtypes of prognostic factors. Spearman correlation test was utilized to evaluate the correlations between the IVIM metrics and prognostic factors. ROC analysis was applied to evaluate the diagnostic performance. Results: According to the independent student t-test, there were 18, 4, and 8 IVIM-derived histogram metrics showing the capability for differentiating the subtypes of histopathologic grade, Ki67, and capsule formation, respectively, with P-values of less than 0.05. Besides, there existed a lot of significant correlations between IVIM metrics and prognostic factors. Finally, by integrating different histogram metrics showing significant differences between various subgroups together via establishing logistic regression based diagnostic models, greatest diagnostic power was obtained for grading HCC (AUC=0.917), diagnosing patients with highly expressed Ki67 (AUC=0.861) and diagnosing patients with capsule formation (AUC=0.839). Conclusion: Multiple prognostic factors including histopathologic grade, Ki67 expression status, and capsule formation can be accurately predicted with assistance of histogram metrics sourced from a single IVIM scan.

The Role of Non-Gaussian Models of Diffusion Weighted MRI in Hepatocellular Carcinoma: A Systematic Review

“…Finally, it is worth noting that the application of the recently introduced radiomics approach to non-Gaussian DWI models could be a useful tool for HCC diagnosis, grading, response to treatment, and prognosis [94,95]. In this context, four of the selected studies [41,42,53,56] investigated first-order features arising from histograms, but any of the selected studies investigated more complex radiomic features.…”

“…Among the 33 studies, 11 investigated IVIM for HCC diagnosis, namely for HCC detection respect to normal liver parenchyma or other types of hepatic lesions (either benign or malignant), and seven evaluated the power of IVIM parameters for HCC histological grading. Among the 15 remaining studies, six assessed the usefulness of IVIM for the response of HCC to therapy [40,42,48,66,69,73], five evaluated if IVIM could be associated with prognostic factors [51,52,56,58,67], and four explored IVIM model for multiple aims [37,41,53,64] (two investigated response to therapy and survival [53,64], one on grading and prognostic factors [41], and the remaining one on diagnosis and grading [37]).…”

“…However, differently from Sokmen et al, they included patients with G2 (according to Edmondson-Steiner grade) in the high-grade group. Shi et al [41] aimed to predict histologic grade by using histogram-based IVIM parameters. They found that many of them were able to distinguish between low-and high-grade HCC patients and correlated with the histopathologic grade.…”

“…Shi et al [41] found that several histogram-based IVIM parameters (D mean, f 70th percentile, D 40th percentile, and D* 75th percentile) were able to predict the expression of Ki67 and capsule formation of HCC. Zhang et al [52] aimed to evaluate IVIM parameters to predict tumor recurrence after hepatectomy in patients with HBV related HCC and found that D was a valuable biomarker for the preoperative prediction of recurrence after hepatectomy in HCC patients.…”

Gene Polymorphism of MUC15, MMP14, BRAF, and COL1A1 Is Associated with Capsule Formation in Hepatocellular Carcinoma

“…Multiple tumors with no capsule in HCC patients are associated with poor survival after TACE [40,41], while improved survival was observed in patients who received sorafenib or chemotherapy such as capecitabine [41][42][43][44]. Capsule formation related SNPs as a prognostic marker for a preferable treatment decision deserved further investigation in future studies.…”