Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.
Abdom Radiol (NY). 2023 Jul;48(7):2331-2339. doi: 10.1007/s00261-023-03911-3. Epub 2023 Apr 29.
In hepatocellular carcinoma (HCC), cytokeratin 19(CK19) has been proven to be associated with clinical aggressiveness. Therefore, this study aimed to explore the added value of F-FDG PET/MRI in predicting CK19 status in HCC.
Sixty-six patients who underwent whole-body or abdominal F-FDG PET/MRI after conventional PET/CT for HCC were retrospectively enrolled. The maximal standard uptake value (T-SUVmax) and the mean apparent diffusion coefficient (T-ADCmean) of the tumor (T), as well as those of the normal liver tissues (L) were derived, followed by calculations of the T-SUVmax/L-SUVmax (SUVmax-T/L) and the T-ADCmean/L-ADCmean (ADCmean-T/L) ratios. Combined with the postoperative pathological results, the performance in predicting the CK19 status in HCC was evaluated using receiver operating characteristic analysis (ROC).
The areas under the ROC curve (AUCs) for T-SUVmax, SUVmax-T/L, T-ADCmean, and ADCmean-T/L in predicting the CK19-positive HCC were 0.700, 0.717, 0.717, and 0.735, respectively. In the logistic regression analysis, the T-SUVmax was an independent and significant factor to predict CK19-positive HCC, with an odds ratio of 1.27. In addition, no significant differences were found in the pathological grading, microvascular invasion, liver capsular invasion, Hepatitis B virus (HBV) infection, alpha fetoprotein (AFP) level, and tumor diameter between the CK19-positive and CK19-negative groups, except the recurrent rate.
The radiomic features derived from F-FDG PET/MRI can be used to predict the CK19 status of HCC. T-SUVmax and T-ADCmean were significant indicators, whereas T-SUVmax was an independent predictor.
在肝细胞癌（HCC）中，细胞角蛋白 19（CK19）已被证明与临床侵袭性相关。因此，本研究旨在探讨 F-FDG PET/MRI 在预测 HCC 中 CK19 状态方面的附加价值。
回顾性纳入 66 例在 HCC 常规 PET/CT 后行全身或腹部 F-FDG PET/MRI 的患者。得出肿瘤（T）的最大标准摄取值（T-SUVmax）和平均表观扩散系数（T-ADCmean）以及正常肝组织（L）的 T-SUVmax 和 T-ADCmean，随后计算 T-SUVmax/L-SUVmax（SUVmax-T/L）和 T-ADCmean/L-ADCmean（ADCmean-T/L）比值。结合术后病理结果，采用受试者工作特征曲线（ROC）分析评估 F-FDG PET/MRI 对 HCC 中 CK19 状态的预测性能。
T-SUVmax、SUVmax-T/L、T-ADCmean 和 ADCmean-T/L 预测 CK19 阳性 HCC 的 ROC 曲线下面积（AUCs）分别为 0.700、0.717、0.717 和 0.735。在 logistic 回归分析中，T-SUVmax 是预测 CK19 阳性 HCC 的独立且重要因素，优势比为 1.27。此外，除了复发率外，CK19 阳性组和 CK19 阴性组在病理分级、微血管侵犯、肝包膜侵犯、乙型肝炎病毒（HBV）感染、甲胎蛋白（AFP）水平和肿瘤直径方面无显著差异。
F-FDG PET/MRI 衍生的放射组学特征可用于预测 HCC 的 CK19 状态。T-SUVmax 和 T-ADCmean 是显著指标，而 T-SUVmax 是独立预测因子。
