Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China.
Medical Imaging Research Center, Anhui Medical University, Hefei, Anhui 230601, China.
Br J Radiol. 2024 Aug 1;97(1160):1467-1475. doi: 10.1093/bjr/tqae116.
Microvascular invasion (MVI) is a recognized biomarker associated with poorer prognosis in patients with hepatocellular carcinoma. Dual-energy computed tomography (DECT) is a highly sensitive technique that can determine the iodine concentration (IC) in tumour and provide an indirect evaluation of internal microcirculatory perfusion. This study aimed to assess whether the combination of DECT with laboratory data can improve preoperative MVI prediction.
This retrospective study enrolled 119 patients who underwent DECT liver angiography at 2 medical centres preoperatively. To compare DECT parameters and laboratory findings between MVI-negative and MVI-positive groups, Mann-Whitney U test was used. Additionally, principal component analysis (PCA) was conducted to determine fundamental components. Mann-Whitney U test was applied to determine whether the principal component (PC) scores varied across MVI groups. Finally, a general linear classifier was used to assess the classification ability of each PC score.
Significant differences were noted (P < .05) in alpha-fetoprotein (AFP) level, normalized arterial phase IC, and normalized portal phase IC between the MVI groups in the primary and validation datasets. The PC1-PC4 accounted for 67.9% of the variance in the primary dataset, with loadings of 24.1%, 16%, 15.4%, and 12.4%, respectively. In both primary and validation datasets, PC3 and PC4 were significantly different across MVI groups, with area under the curve values of 0.8410 and 0.8373, respectively.
The recombination of DECT IC and laboratory features based on varying factor loadings can well predict MVI preoperatively.
Utilizing PCA, the amalgamation of DECT IC and laboratory features, considering diverse factor loadings, showed substantial promise in accurately classifying MVI. There have been limited endeavours to establish such a combination, offering a novel paradigm for comprehending data in related research endeavours.
微血管侵犯（MVI）是与肝细胞癌患者预后不良相关的公认生物标志物。双能 CT（DECT）是一种高度敏感的技术，可确定肿瘤中的碘浓度（IC）并提供对内部微循环灌注的间接评估。本研究旨在评估 DECT 与实验室数据的结合是否可以改善术前 MVI 预测。
本回顾性研究纳入了在 2 家医疗中心行术前 DECT 肝血管造影的 119 例患者。为了比较 MVI 阴性和 MVI 阳性组之间的 DECT 参数和实验室发现，使用了 Mann-Whitney U 检验。此外，进行了主成分分析（PCA）以确定基本成分。应用 Mann-Whitney U 检验来确定主要成分（PC）得分是否在 MVI 组之间有所不同。最后，使用广义线性分类器来评估每个 PC 得分的分类能力。
在主要数据集和验证数据集中，MVI 组之间的 alpha-胎蛋白（AFP）水平、归一化动脉期 IC 和归一化门静脉期 IC 存在显著差异（P<0.05）。PC1-PC4 占主要数据集的 67.9%，负荷分别为 24.1%、16%、15.4%和 12.4%。在主要数据集和验证数据集中，PC3 和 PC4 在 MVI 组之间存在显著差异，曲线下面积分别为 0.8410 和 0.8373。
基于变化的因子负荷，将 DECT IC 和实验室特征重组可以很好地预测术前 MVI。
利用 PCA，将 DECT IC 和实验室特征融合，考虑到不同的因子负荷，在准确分类 MVI 方面显示出很大的潜力。在建立这样的组合方面，已经进行了有限的努力，为理解相关研究工作中的数据提供了新的范例。
