Department of Interventional Therapy, Beijing Shijitan Hospital, Affiliated Hospital of Capital Medical University, Beijing, 100038, People's Republic of China.
Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
Abdom Radiol (NY). 2021 Aug;46(8):3748-3757. doi: 10.1007/s00261-020-02891-y. Epub 2021 Jan 1.
To investigate the prognostic value of baseline magnetic resonance imaging (MRI) texture analysis of hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA).
MRI was performed on 102 patients with HCC before receiving TACE combined with MWA in this retrospective study. The best 10 texture features were screened as a feature group for each MRI sequence by MaZda software using mutual information coefficient (MI), nonlinear discriminant analysis (NDA) and other methods. The optimal feature group with the lowest misdiagnosis rate was achieved on one MRI sequence between two groups dichotomized by 3-year survival, which was used to optimize the significant texture features with the optimal cutoff values. The Cox proportional hazards model was generated for the significant texture features and clinical variables to determine the independent predictors of overall survival (OS). The predictive performance of the model was further evaluated by the area under the ROC curve (AUC). Kaplan-Meier and log-rank tests were performed for disease-free survival (DFS) and Local recurrence-free survival (LRFS).
The optimal feature group with the lowest misdiagnosis rate of 8.82% was obtained on T2WI using MI combined with NDA feature analysis. For Cox proportional hazards regression models, the independent prognostic factors associated with OS were albumin (P = 0.047), BCLC stage (P = 0.001), Correlat (P = 0.01) and SumEntrp (P = 0.015), and the prediction efficiency of multivariate model is AUC = 0.876, 95%CI = 0.803-0.949. Kaplan-Meier analyses further demonstrated that BCLC (P < 0.001), Correlat (P = 0.023) and SumEntrp (P < 0.001) were associated with DFS, and BCLC (P = 0.007) related to LRFS.
MR imaging texture features may be used to predict the prognosis of HCC treated with TACE combined with MWA.
探讨经导管动脉化疗栓塞（TACE）联合微波消融（MWA）治疗肝细胞癌（HCC）患者基线磁共振成像（MRI）纹理分析的预后价值。
本回顾性研究共纳入 102 例接受 TACE 联合 MWA 治疗的 HCC 患者，对其进行 MRI 检查。使用互信息系数（MI）、非线性判别分析（NDA）等方法，MaZda 软件筛选出每个 MRI 序列中最佳的 10 个纹理特征。在两组间按 3 年生存率进行二分类，选择误诊率最低的最佳特征组，利用最优截断值对有意义的纹理特征进行优化。采用 Cox 比例风险模型确定与总生存期（OS）相关的独立预测因子，基于显著纹理特征和临床变量。进一步通过受试者工作特征曲线（ROC）下面积（AUC）评估模型的预测性能。Kaplan-Meier 和对数秩检验用于评估无病生存期（DFS）和局部无复发生存期（LRFS）。
采用 MI 联合 NDA 特征分析，在 T2WI 上获得误诊率最低的最佳特征组为 8.82%。对于 Cox 比例风险回归模型，与 OS 相关的独立预后因素为白蛋白（P=0.047）、BCLC 分期（P=0.001）、Correlat（P=0.01）和 SumEntrp（P=0.015），多变量模型的预测效率 AUC=0.876，95%CI=0.803-0.949。Kaplan-Meier 分析进一步表明，BCLC（P<0.001）、Correlat（P=0.023）和 SumEntrp（P<0.001）与 DFS 相关，BCLC（P=0.007）与 LRFS 相关。
MR 成像纹理特征可用于预测 TACE 联合 MWA 治疗 HCC 的预后。
