Deng Yuhui, Yang Dawei, Tan Xianzheng, Xu Hui, Xu Lixue, Ren Ahong, Liu Peng, Yang Zhenghan
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, West District, Beijing, 100050, China.
Medical Imaging Division, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Zhongshan Road 82, Xiangfang District, Harbin, 150036, China.
BMC Med Imaging. 2024 Jan 27;24(1):29. doi: 10.1186/s12880-024-01206-7.
PURPOSE: To develop a nomogram for preoperative assessment of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) based on the radiological features of enhanced CT and to verify two imaging techniques (CT and MRI) in an external centre. METHOD: A total of 346 patients were retrospectively included (training, n = 185, CT images; external testing 1, n = 90, CT images; external testing 2, n = 71, MRI images), including 229 MVI-negative patients and 117 MVI-positive patients. The radiological features and clinical information of enhanced CT images were analysed, and the independent variables associated with MVI in HCC were determined by logistic regression analysis. Then, a nomogram prediction model was constructed. External validation was performed on CT (n = 90) and MRI (n = 71) images from another centre. RESULTS: Among the 23 radiological and clinical features, size, arterial peritumoral enhancement (APE), tumour margin and alpha-fetoprotein (AFP) were independent influencing factors for MVI in HCC. The nomogram integrating these risk factors had a good predictive effect, with AUC, specificity and sensitivity values of 0.834 (95% CI: 0.774-0.895), 75.0% and 83.5%, respectively. The AUC values of external verification based on CT and MRI image data were 0.794 (95% CI: 0.700-0.888) and 0.883 (95% CI: 0.807-0.959), respectively. No statistical difference in AUC values among training set and testing sets was found. CONCLUSION: The proposed nomogram prediction model for MVI in HCC has high accuracy, can be used with different imaging techniques, and has good clinical applicability.
目的:基于增强CT的影像学特征开发一种用于肝细胞癌(HCC)微血管侵犯(MVI)术前评估的列线图,并在外部中心验证两种成像技术(CT和MRI)。 方法:回顾性纳入346例患者(训练组,n = 185,CT图像;外部测试1组,n = 90,CT图像;外部测试2组,n = 71,MRI图像),包括229例MVI阴性患者和117例MVI阳性患者。分析增强CT图像的影像学特征和临床信息,通过逻辑回归分析确定与HCC中MVI相关的独立变量。然后,构建列线图预测模型。对来自另一个中心的CT(n = 90)和MRI(n = 71)图像进行外部验证。 结果:在23项影像学和临床特征中,大小、动脉期瘤周强化(APE)、肿瘤边缘和甲胎蛋白(AFP)是HCC中MVI的独立影响因素。整合这些危险因素的列线图具有良好的预测效果,AUC、特异性和敏感性值分别为0.834(95%CI:0.774 - 0.895)、75.0%和83.5%。基于CT和MRI图像数据的外部验证AUC值分别为0.794(95%CI:0.700 - 0.888)和0.883(95%CI:0.807 - 0.959)。训练集和测试集的AUC值无统计学差异。 结论:所提出的HCC中MVI列线图预测模型具有较高准确性,可用于不同成像技术,具有良好的临床适用性。
Cancer Manag Res. 2020-6-2