AI Article Synopsis
- The study investigates the preoperative MRI features of hepatocellular carcinoma (HCC) to evaluate their impact on patient prognosis, focusing on targetoid appearances and microvascular invasion (MVI) features based on the LI-RADS system.
- A total of 242 patients with single HCC tumors (≤ 5 cm) were analyzed, revealing that tumors with rim arterial-phase hyperenhancement (APHE) had worse overall and recurrence-free survival compared to other classifications despite similar tumor sizes.
- The findings suggest that categorizing LI-RADS-M tumors based on rim APHE presence could improve predictions for postoperative outcomes in HCC patients.
Article Abstract
Objective: To evaluate the prognostic implications of preoperative magnetic resonance imaging (MRI) features of hepatocellular carcinoma (HCC) with a focus on those with targetoid appearance based on the Liver Imaging Reporting and Data System (LI-RADS), as well as known microvascular invasion (MVI) features.
Materials And Methods: This retrospective study included 242 patients (190 male; mean age, 57.1 years) who underwent surgical resection of a single HCC (≤ 5 cm) as well as preoperative gadoxetic acid-enhanced MRI between January 2012 and March 2015. LI-RADS category was assigned, and the LR-M category was further classified into two groups according to rim arterial-phase hyperenhancement (APHE). The imaging features associated with MVI were also assessed. The overall survival (OS), recurrence-free survival (RFS), and their associated factors were evaluated.
Results: Among the 242 HCCs, 190 (78.5%), 25 (10.3%), and 27 (11.2%) were classified as LR-4/5, LR-M with rim APHE, and LR-M without rim APHE, respectively. LR-M with rim APHE (vs. LR-4/5; hazard ratio [HR] for OS, 5.48 [ = 0.002]; HR for RFS, 2.09 [ = 0.042]) and tumor size (per cm increase; HR for OS, 6.04 [ = 0.009]; HR for RFS, 1.77 [ = 0.014]) but not MVI imaging features ( > 0.05) were independent factors associated with OS and RFS. Compared to the 5-year OS and RFS rates in the LR-4/5 group (93.9% and 66.8%, respectively), the LR-M with rim APHE group had significantly lower rates (68.0% and 45.8%, respectively, both < 0.05), while the LR-M without rim APHE group did not significantly differ in the survival rates (91.3% and 80.2%, respectively, both > 0.05).
Conclusion: Further classification of LR-M according to the presence of rim APHE may help predict the postoperative prognosis of patients with a single HCC.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546127 | PMC |
| http://dx.doi.org/10.3348/kjr.2020.1428 | DOI Listing |
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