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Prognostic MRI features to predict postresection survivals for very early to intermediate stage hepatocellular carcinoma.

Publication ,  Journal Article
Jiang, H; Qin, Y; Wei, H; Zheng, T; Yang, T; Wu, Y; Ding, C; Chernyak, V; Ronot, M; Fowler, KJ; Chen, W; Bashir, MR; Song, B
Published in: Eur Radiol
October 23, 2023

OBJECTIVES: Contrast-enhanced MRI can provide individualized prognostic information for hepatocellular carcinoma (HCC). We aimed to investigate the value of MRI features to predict early (≤ 2 years)/late (> 2 years) recurrence-free survival (E-RFS and L-RFS, respectively) and overall survival (OS). MATERIALS AND METHODS: Consecutive adult patients at a tertiary academic center who received curative-intent liver resection for very early to intermediate stage HCC and underwent preoperative contrast-enhanced MRI were retrospectively enrolled from March 2011 to April 2021. Three masked radiologists independently assessed 54 MRI features. Uni- and multivariable Cox regression analyses were conducted to investigate the associations of imaging features with E-RFS, L-RFS, and OS. RESULTS: This study included 600 patients (median age, 53 years; 526 men). During a median follow-up of 55.3 months, 51% of patients experienced recurrence (early recurrence: 66%; late recurrence: 34%), and 17% died. Tumor size, multiple tumors, rim arterial phase hyperenhancement, iron sparing in solid mass, tumor growth pattern, and gastroesophageal varices were associated with E-RFS and OS (largest p = .02). Nonperipheral washout (p = .006), markedly low apparent diffusion coefficient value (p = .02), intratumoral arteries (p = .01), and width of the main portal vein (p = .03) were associated with E-RFS but not with L-RFS or OS, while the VICT2 trait was specifically associated with OS (p = .02). Multiple tumors (p = .048) and radiologically-evident cirrhosis (p < .001) were the only predictors for L-RFS. CONCLUSION: Twelve visually-assessed MRI features predicted postoperative E-RFS (≤ 2 years), L-RFS (> 2 years), and OS for very early to intermediate-stage HCCs. CLINICAL RELEVANCE STATEMENT: The prognostic MRI features may help inform personalized surgical planning, neoadjuvant/adjuvant therapies, and postoperative surveillance, thus may be included in future prognostic models. KEY POINTS: • Tumor size, multiple tumors, rim arterial phase hyperenhancement, iron sparing, tumor growth pattern, and gastroesophageal varices predicted both recurrence-free survival within 2 years and overall survival. • Nonperipheral washout, markedly low apparent diffusion coefficient value, intratumoral arteries, and width of the main portal vein specifically predicted recurrence-free survival within 2 years, while the VICT2 trait specifically predicted overall survival. • Multiple tumors and radiologically-evident cirrhosis were the only predictors for recurrence-free survival beyond 2 years.

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Published In

Eur Radiol

DOI

EISSN

1432-1084

Publication Date

October 23, 2023

Location

Germany

Related Subject Headings

  • Nuclear Medicine & Medical Imaging
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Jiang, H., Qin, Y., Wei, H., Zheng, T., Yang, T., Wu, Y., … Song, B. (2023). Prognostic MRI features to predict postresection survivals for very early to intermediate stage hepatocellular carcinoma. Eur Radiol. https://doi.org/10.1007/s00330-023-10279-x
Jiang, Hanyu, Yun Qin, Hong Wei, Tianying Zheng, Ting Yang, Yuanan Wu, Chengyu Ding, et al. “Prognostic MRI features to predict postresection survivals for very early to intermediate stage hepatocellular carcinoma.Eur Radiol, October 23, 2023. https://doi.org/10.1007/s00330-023-10279-x.
Jiang, Hanyu, et al. “Prognostic MRI features to predict postresection survivals for very early to intermediate stage hepatocellular carcinoma.Eur Radiol, Oct. 2023. Pubmed, doi:10.1007/s00330-023-10279-x.
Jiang H, Qin Y, Wei H, Zheng T, Yang T, Wu Y, Ding C, Chernyak V, Ronot M, Fowler KJ, Chen W, Bashir MR, Song B. Prognostic MRI features to predict postresection survivals for very early to intermediate stage hepatocellular carcinoma. Eur Radiol. 2023 Oct 23;
Journal cover image

Published In

Eur Radiol

DOI

EISSN

1432-1084

Publication Date

October 23, 2023

Location

Germany

Related Subject Headings

  • Nuclear Medicine & Medical Imaging
  • 3202 Clinical sciences
  • 1103 Clinical Sciences