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Filename: controllers/Detail.php
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Filename: helpers/my_audit_helper.php
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Objective: To investigate the non-invasive prediction of hepatocellular carcinoma (HCC) with vessels encapsulating tumor clusters (VETC) based on qualitative and quantitative imaging features of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI.
Methods: 109 patients with pathologically confirmed HCC who underwent Gd-EOB-DTPA enhanced MRI and immunochemical staining for CD34 were retrospectively evaluated in our institution (the first affiliated hospital of Soochow university). Pre-operative imaging features of Gd-EOB-DTPA-enhanced MRI were qualitatively and quantitatively reviewed by radiologists. Significant variables for differentiating the VETC-positive and VETC-negative HCCs were identified in univariate and multivariate analyses. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cut-off values for quantitative variables. The nomogram based on the coefficient of multivariate analysis was constructed to evaluate the probability of VETC-positive HCCs.
Results: The multivariate analysis showed that the serum AST level >40 U l ( = 0.007), non-rim diffuse and heterogeneous arterial phase hyperenhancement ( = 0.035), tumor-to-liver SI ratio of 1.135 or more on AP images ( = 0.001), and tumor-to-liver SI ratio of 0.585 or less on HBP images ( = 0.002) were significant predictors for predicting VETC-positive HCCs. Combing all four significant variables provided a diagnostic accuracy of 82.6%, sensitivity of 83.9%, specificity of 80.9% for identifying VETC status. The area under the receiver operating characteristics curve value of the logistical regression coefficient-based nomogram was 0.885 (95% confidence intervals, 0.824-0.946).
Conclusion: Qualitative and quantitative imaging features of Gd-EOB-DTPA-enhanced MRI integrating laboratory examination can provide good diagnostic performance.
Advances In Knowledge: VETC is a novel identified microvascular pattern; associations between imaging features and VETC status have not been investigated. Pre-operative diagnosis of VETC status in HCC is essential to help predict the outcome of patients and make a decision for the therapeutic schedule.
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Source |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011268 | PMC |
http://dx.doi.org/10.1259/bjr.20200950 | DOI Listing |
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