A multivariate model based on gadoxetic acid-enhanced MRI using Li-RADS v2018 and other imaging features for preoperative prediction of dual‑phenotype hepatocellular carcinoma

• Published in: Radiologia medica 2023-11, Vol.128 (11), p.1333-1346
• Main Authors: Liu, Mao-Tong, Zhang, Ji-Yun, Xu, Lei, Qu, Qi, LU, Meng-Tian, Jiang, Ji-Feng, Zhao, Xian-Ce, Zhang, Xue-Qin, Zhang, Tao
• Format: Article
• Language: English
• Subjects: Abdominal Radiology; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - surgery; Confidence intervals; Contrast Media; Data systems; Diagnostic Radiology; Diagnostic systems; Gadolinium DTPA; Humans; Image analysis; Imaging; Interventional Radiology; Liver cancer; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - surgery; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Medical imaging; Medicine; Medicine & Public Health; Multivariate analysis; Neuroradiology; Phenotype; Radiology; Regression analysis; Regression models; Retrospective Studies; Sensitivity and Specificity; Statistical analysis; Surgery; Ultrasound
• ISSN: 1826-6983; 0033-8362; 1826-6983
• DOI: 10.1007/s11547-023-01715-5

Objective To investigate the diagnostic value of liver imaging reporting and data system (LI-RADS) v2018 and other imaging features in dual-phenotype hepatocellular carcinoma (DPHCC), establish a prediagnostic model based on gadoxetic acid-enhanced MRI, and explore the prognostic significance after surgery of the DPHCC. Materials and methods Preoperative enhanced MRI findings and the clinical and pathological data of patients with surgically confirmed HCC were analysed retrospectively. Image analysis was based on LI-RADS v2018 and other image features. Univariate analysis was used to screen for predictive factors of DPHCC, and multivariate logistic regression analysis was used to determine the predictive factors. A regression diagnostic model was established. Receiver operating characteristic (ROC) curve analysis was used to determine the critical value, area under curve (AUC), and the corresponding 95% confidence interval (95% CI). The diagnostic performance was verified by fivefold cross-validation. Cox regression analysis was used to determine the prognostic factors associated with early recurrence after surgical resection. Results In total, 158 patients were included, of whom 79 had DPHCC and 79 had non-DPHCC. Multivariate analysis showed that rim arterial phase hyperenhancement (Rim APHE) and targetoid restriction were independent risk factors for DPHCC ( P