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Feeding artery: a valuable feature for differentiation of regenerative nodule, dysplastic nodules and small hepatocellular carcinoma in CEUS LI-RADS
Objective To investigate whether the feeding artery (FA) feature can aid in discriminating small hepatocellular carcinoma (HCC) using the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) from precancerous lesions. Methods Between June 2017 and May 2021, a total o...
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| Published in: | European radiology 2024-02, Vol.34 (2), p.745-754 |
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| container_end_page | 754 |
| container_issue | 2 |
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| container_title | European radiology |
| container_volume | 34 |
| creator | Wu, Jiapeng Zhao, Qinxian Wang, Yuling Xiao, Fan Cai, Wenjia Liu, Sisi Du, Zhicheng Yu, Xiaoling Liu, Fangyi Yu, Jie Liang, Ping |
| description | Objective
To investigate whether the feeding artery (FA) feature can aid in discriminating small hepatocellular carcinoma (HCC) using the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) from precancerous lesions.
Methods
Between June 2017 and May 2021, a total of 347 patients with 351 precancerous liver lesions or small HCCs who underwent CEUS were enrolled. Two independent radiologists assigned LI-RADS categories to all lesions and assessed the presence of the FA feature, which was used as an ancillary feature to either upgrade or downgrade the LI-RADS category. The diagnostic performance of CEUS LI-RADS, both with and without the FA feature, was evaluated based on accuracy, sensitivity, specificity, positive predictive value, and negative predictive value.
Results
The FA feature was found to be more prevalent in HCC (85.54%,
p
|
| doi_str_mv | 10.1007/s00330-023-10006-6 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2852630829</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2923538286</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-378ab819fd40a605635d1669228436b07f090c833b577fe882eda0d992b88ecc3</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhiMEoh_wBzggS1w4EHDsxLG5VUsLlVZCovRsTezJ4sqxFzuptP-DH4y3u3yIA6eZ1_PM65HeqnrR0LcNpf27TCnntKaM10VTUYtH1WnTclakbB__1Z9UZznfFUY1bf-0OuF9J5VU6rT6cYVoXdgQSDOm3XsC5B78AoNHMiLMSyo1JmLdOGLCMDuYXQwkjiThBgOmou-RhGgXj2-I3eWthzw7c3zKBIIleQLvyTfcwhwNer94SMRAMi7ECYgLZHV5e0PW1_WXiw83z6onI_iMz4_1vLq9uvy6-lSvP3-8Xl2sa8OZmGveSxhko0bbUhC0E7yzjRCKMdlyMdB-pIoayfnQ9f2IUjK0QK1SbJASjeHn1euD7zbF7wvmWU8u78-DgHHJmsmOCU4lUwV99Q96F5cUynWaKcY7LpkUhWIHyqSYc8JRb5ObIO10Q_U-M33ITJfM9ENmer_08mi9DBPa3yu_QioAPwC5jMIG05-__2P7E7fxohY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2923538286</pqid></control><display><type>article</type><title>Feeding artery: a valuable feature for differentiation of regenerative nodule, dysplastic nodules and small hepatocellular carcinoma in CEUS LI-RADS</title><source>Springer Link</source><creator>Wu, Jiapeng ; Zhao, Qinxian ; Wang, Yuling ; Xiao, Fan ; Cai, Wenjia ; Liu, Sisi ; Du, Zhicheng ; Yu, Xiaoling ; Liu, Fangyi ; Yu, Jie ; Liang, Ping</creator><creatorcontrib>Wu, Jiapeng ; Zhao, Qinxian ; Wang, Yuling ; Xiao, Fan ; Cai, Wenjia ; Liu, Sisi ; Du, Zhicheng ; Yu, Xiaoling ; Liu, Fangyi ; Yu, Jie ; Liang, Ping</creatorcontrib><description>Objective
To investigate whether the feeding artery (FA) feature can aid in discriminating small hepatocellular carcinoma (HCC) using the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) from precancerous lesions.
Methods
Between June 2017 and May 2021, a total of 347 patients with 351 precancerous liver lesions or small HCCs who underwent CEUS were enrolled. Two independent radiologists assigned LI-RADS categories to all lesions and assessed the presence of the FA feature, which was used as an ancillary feature to either upgrade or downgrade the LI-RADS category. The diagnostic performance of CEUS LI-RADS, both with and without the FA feature, was evaluated based on accuracy, sensitivity, specificity, positive predictive value, and negative predictive value.
Results
The FA feature was found to be more prevalent in HCC (85.54%,
p
< 0.001) than in regenerative nodules (RNs, 29.73%), low-grade dysplastic nodules (LGDNs, 33.33%), and high-grade dysplastic nodules (HGDNs, 55.26%). Furthermore, the presence of arterial phase hyperenhancement (APHE), washout (WO), and FA in liver nodules was associated with a higher expression of GPC-3 and Ki-67 compared to the group without these features (
p
< 0.001). After adjusting, the sensitivity and accuracy of LR-5 for HCC improved from 68.67% (95%CI: 62.46%, 74.30%) to 77.51% (95%CI: 71.72%, 82.44%) and from 69.23% (95%CI: 64.11%, 74.02%) to 73.79% (95%CI: 68.86%, 78.31%), respectively.
Conclusion
The FA feature is a valuable feature for distinguishing small HCC and precancerous lesions and could be added as a possible ancillary feature in CEUS LI-RADS which was backed up by biomarkers.
Clinical relevance statement
The presence of a feeding artery is a valuable imaging feature in the differentiation of HCC and precancerous lesions. Incorporating this characteristic in the CEUS LI-RADS can enhance the diagnostic ability.
Key Points
• Feeding artery is more frequent in HCC than in regenerative nodules, low-grade dysplastic nodules, and high-grade dysplastic nodules.
• Feeding artery feature is a valuable ancillary feature for CEUS LI-RADS to differentiate regenerative nodules, low-grade dysplastic nodules, high-grade dysplastic nodules, and HCC.
• The existence of feeding artery, arterial phase hyperenhancement, and washout is associated with more GPC-3 positive expression and higher Ki-67 expression than the group without these features.</description><identifier>ISSN: 1432-1084</identifier><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-023-10006-6</identifier><identifier>PMID: 37589899</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Biomarkers ; Data systems ; Diagnostic Radiology ; Diagnostic systems ; Differentiation ; Feeding ; Hepatocellular carcinoma ; Imaging ; Internal Medicine ; Interventional Radiology ; Lesions ; Liver ; Liver cancer ; Medical imaging ; Medicine ; Medicine & Public Health ; Neuroradiology ; Nodules ; Radiology ; Ultrasound ; Veins & arteries</subject><ispartof>European radiology, 2024-02, Vol.34 (2), p.745-754</ispartof><rights>The Author(s), under exclusive licence to European Society of Radiology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to European Society of Radiology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-378ab819fd40a605635d1669228436b07f090c833b577fe882eda0d992b88ecc3</cites><orcidid>0000-0001-8933-6392</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37589899$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Jiapeng</creatorcontrib><creatorcontrib>Zhao, Qinxian</creatorcontrib><creatorcontrib>Wang, Yuling</creatorcontrib><creatorcontrib>Xiao, Fan</creatorcontrib><creatorcontrib>Cai, Wenjia</creatorcontrib><creatorcontrib>Liu, Sisi</creatorcontrib><creatorcontrib>Du, Zhicheng</creatorcontrib><creatorcontrib>Yu, Xiaoling</creatorcontrib><creatorcontrib>Liu, Fangyi</creatorcontrib><creatorcontrib>Yu, Jie</creatorcontrib><creatorcontrib>Liang, Ping</creatorcontrib><title>Feeding artery: a valuable feature for differentiation of regenerative nodule, dysplastic nodules and small hepatocellular carcinoma in CEUS LI-RADS</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objective
To investigate whether the feeding artery (FA) feature can aid in discriminating small hepatocellular carcinoma (HCC) using the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) from precancerous lesions.
Methods
Between June 2017 and May 2021, a total of 347 patients with 351 precancerous liver lesions or small HCCs who underwent CEUS were enrolled. Two independent radiologists assigned LI-RADS categories to all lesions and assessed the presence of the FA feature, which was used as an ancillary feature to either upgrade or downgrade the LI-RADS category. The diagnostic performance of CEUS LI-RADS, both with and without the FA feature, was evaluated based on accuracy, sensitivity, specificity, positive predictive value, and negative predictive value.
Results
The FA feature was found to be more prevalent in HCC (85.54%,
p
< 0.001) than in regenerative nodules (RNs, 29.73%), low-grade dysplastic nodules (LGDNs, 33.33%), and high-grade dysplastic nodules (HGDNs, 55.26%). Furthermore, the presence of arterial phase hyperenhancement (APHE), washout (WO), and FA in liver nodules was associated with a higher expression of GPC-3 and Ki-67 compared to the group without these features (
p
< 0.001). After adjusting, the sensitivity and accuracy of LR-5 for HCC improved from 68.67% (95%CI: 62.46%, 74.30%) to 77.51% (95%CI: 71.72%, 82.44%) and from 69.23% (95%CI: 64.11%, 74.02%) to 73.79% (95%CI: 68.86%, 78.31%), respectively.
Conclusion
The FA feature is a valuable feature for distinguishing small HCC and precancerous lesions and could be added as a possible ancillary feature in CEUS LI-RADS which was backed up by biomarkers.
Clinical relevance statement
The presence of a feeding artery is a valuable imaging feature in the differentiation of HCC and precancerous lesions. Incorporating this characteristic in the CEUS LI-RADS can enhance the diagnostic ability.
Key Points
• Feeding artery is more frequent in HCC than in regenerative nodules, low-grade dysplastic nodules, and high-grade dysplastic nodules.
• Feeding artery feature is a valuable ancillary feature for CEUS LI-RADS to differentiate regenerative nodules, low-grade dysplastic nodules, high-grade dysplastic nodules, and HCC.
• The existence of feeding artery, arterial phase hyperenhancement, and washout is associated with more GPC-3 positive expression and higher Ki-67 expression than the group without these features.</description><subject>Biomarkers</subject><subject>Data systems</subject><subject>Diagnostic Radiology</subject><subject>Diagnostic systems</subject><subject>Differentiation</subject><subject>Feeding</subject><subject>Hepatocellular carcinoma</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Lesions</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Nodules</subject><subject>Radiology</subject><subject>Ultrasound</subject><subject>Veins & arteries</subject><issn>1432-1084</issn><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kU1v1DAQhiMEoh_wBzggS1w4EHDsxLG5VUsLlVZCovRsTezJ4sqxFzuptP-DH4y3u3yIA6eZ1_PM65HeqnrR0LcNpf27TCnntKaM10VTUYtH1WnTclakbB__1Z9UZznfFUY1bf-0OuF9J5VU6rT6cYVoXdgQSDOm3XsC5B78AoNHMiLMSyo1JmLdOGLCMDuYXQwkjiThBgOmou-RhGgXj2-I3eWthzw7c3zKBIIleQLvyTfcwhwNer94SMRAMi7ECYgLZHV5e0PW1_WXiw83z6onI_iMz4_1vLq9uvy6-lSvP3-8Xl2sa8OZmGveSxhko0bbUhC0E7yzjRCKMdlyMdB-pIoayfnQ9f2IUjK0QK1SbJASjeHn1euD7zbF7wvmWU8u78-DgHHJmsmOCU4lUwV99Q96F5cUynWaKcY7LpkUhWIHyqSYc8JRb5ObIO10Q_U-M33ITJfM9ENmer_08mi9DBPa3yu_QioAPwC5jMIG05-__2P7E7fxohY</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Wu, Jiapeng</creator><creator>Zhao, Qinxian</creator><creator>Wang, Yuling</creator><creator>Xiao, Fan</creator><creator>Cai, Wenjia</creator><creator>Liu, Sisi</creator><creator>Du, Zhicheng</creator><creator>Yu, Xiaoling</creator><creator>Liu, Fangyi</creator><creator>Yu, Jie</creator><creator>Liang, Ping</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8933-6392</orcidid></search><sort><creationdate>20240201</creationdate><title>Feeding artery: a valuable feature for differentiation of regenerative nodule, dysplastic nodules and small hepatocellular carcinoma in CEUS LI-RADS</title><author>Wu, Jiapeng ; Zhao, Qinxian ; Wang, Yuling ; Xiao, Fan ; Cai, Wenjia ; Liu, Sisi ; Du, Zhicheng ; Yu, Xiaoling ; Liu, Fangyi ; Yu, Jie ; Liang, Ping</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-378ab819fd40a605635d1669228436b07f090c833b577fe882eda0d992b88ecc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Biomarkers</topic><topic>Data systems</topic><topic>Diagnostic Radiology</topic><topic>Diagnostic systems</topic><topic>Differentiation</topic><topic>Feeding</topic><topic>Hepatocellular carcinoma</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Lesions</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Nodules</topic><topic>Radiology</topic><topic>Ultrasound</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Jiapeng</creatorcontrib><creatorcontrib>Zhao, Qinxian</creatorcontrib><creatorcontrib>Wang, Yuling</creatorcontrib><creatorcontrib>Xiao, Fan</creatorcontrib><creatorcontrib>Cai, Wenjia</creatorcontrib><creatorcontrib>Liu, Sisi</creatorcontrib><creatorcontrib>Du, Zhicheng</creatorcontrib><creatorcontrib>Yu, Xiaoling</creatorcontrib><creatorcontrib>Liu, Fangyi</creatorcontrib><creatorcontrib>Yu, Jie</creatorcontrib><creatorcontrib>Liang, Ping</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Jiapeng</au><au>Zhao, Qinxian</au><au>Wang, Yuling</au><au>Xiao, Fan</au><au>Cai, Wenjia</au><au>Liu, Sisi</au><au>Du, Zhicheng</au><au>Yu, Xiaoling</au><au>Liu, Fangyi</au><au>Yu, Jie</au><au>Liang, Ping</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feeding artery: a valuable feature for differentiation of regenerative nodule, dysplastic nodules and small hepatocellular carcinoma in CEUS LI-RADS</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>34</volume><issue>2</issue><spage>745</spage><epage>754</epage><pages>745-754</pages><issn>1432-1084</issn><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objective
To investigate whether the feeding artery (FA) feature can aid in discriminating small hepatocellular carcinoma (HCC) using the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) from precancerous lesions.
Methods
Between June 2017 and May 2021, a total of 347 patients with 351 precancerous liver lesions or small HCCs who underwent CEUS were enrolled. Two independent radiologists assigned LI-RADS categories to all lesions and assessed the presence of the FA feature, which was used as an ancillary feature to either upgrade or downgrade the LI-RADS category. The diagnostic performance of CEUS LI-RADS, both with and without the FA feature, was evaluated based on accuracy, sensitivity, specificity, positive predictive value, and negative predictive value.
Results
The FA feature was found to be more prevalent in HCC (85.54%,
p
< 0.001) than in regenerative nodules (RNs, 29.73%), low-grade dysplastic nodules (LGDNs, 33.33%), and high-grade dysplastic nodules (HGDNs, 55.26%). Furthermore, the presence of arterial phase hyperenhancement (APHE), washout (WO), and FA in liver nodules was associated with a higher expression of GPC-3 and Ki-67 compared to the group without these features (
p
< 0.001). After adjusting, the sensitivity and accuracy of LR-5 for HCC improved from 68.67% (95%CI: 62.46%, 74.30%) to 77.51% (95%CI: 71.72%, 82.44%) and from 69.23% (95%CI: 64.11%, 74.02%) to 73.79% (95%CI: 68.86%, 78.31%), respectively.
Conclusion
The FA feature is a valuable feature for distinguishing small HCC and precancerous lesions and could be added as a possible ancillary feature in CEUS LI-RADS which was backed up by biomarkers.
Clinical relevance statement
The presence of a feeding artery is a valuable imaging feature in the differentiation of HCC and precancerous lesions. Incorporating this characteristic in the CEUS LI-RADS can enhance the diagnostic ability.
Key Points
• Feeding artery is more frequent in HCC than in regenerative nodules, low-grade dysplastic nodules, and high-grade dysplastic nodules.
• Feeding artery feature is a valuable ancillary feature for CEUS LI-RADS to differentiate regenerative nodules, low-grade dysplastic nodules, high-grade dysplastic nodules, and HCC.
• The existence of feeding artery, arterial phase hyperenhancement, and washout is associated with more GPC-3 positive expression and higher Ki-67 expression than the group without these features.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37589899</pmid><doi>10.1007/s00330-023-10006-6</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8933-6392</orcidid></addata></record> |
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| subjects | Biomarkers Data systems Diagnostic Radiology Diagnostic systems Differentiation Feeding Hepatocellular carcinoma Imaging Internal Medicine Interventional Radiology Lesions Liver Liver cancer Medical imaging Medicine Medicine & Public Health Neuroradiology Nodules Radiology Ultrasound Veins & arteries |
| title | Feeding artery: a valuable feature for differentiation of regenerative nodule, dysplastic nodules and small hepatocellular carcinoma in CEUS LI-RADS |
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