Wang Weilang, Zhang Shuhang, Zhong Binyan, Cai Wu, Gao Lei, Li Binrong, Yao Dandan, Zhao Yuan, Sun Ziying, Zhou Shuwei, Zhang Teng, Chen Xunjun, Ju Shenghong, Wang Yuan-Cheng
Zhongda Hospital Southeast University, Nanjing, China.
First Affiliated Hospital of Soochow University, Suzhou, China.
Abdom Radiol (NY). 2025 May;50(5):2110-2120. doi: 10.1007/s00261-024-04676-z. Epub 2024 Nov 15.
This study aims to analyze the magnetic resonance imaging (MRI) change patterns of viable hepatocellular carcinomas (HCCs) following the initial transarterial chemoembolization (TACE).
A retrospective analysis of HCC patients' initial TACE from February 2015 to October 2022 across three centers and a clinical trial (NCT03113955) was conducted. The viability of residual HCCs at one and six months after TACE was evaluated using the LI-RADS Treatment Response Algorithm (LR-TRA) v2024. The radiological and radiomics features of post-TACE viable tumors between baseline and one-month, and between one- and six- months were compared using Wilcoxon signed-rank test and McNemar's test.
A total of 160 viable tumors were included in the study. Viable tumors at one month after TACE exhibited higher T1WI intensity (P =.024), lower T2WI intensity (P =.005), fewer washout features (P <.001), smaller size (P <.001), and higher ADC values (P <.001) compared to baseline HCC imaging.A significant reduction in DWI intensity (P =.002) and ADC values (P <.001) were observed in viable tumors at one month compared to those at six months. There were 82 (45.1%) radiomics features that changed significantly between the baseline and one-month. Only three radiomics features showed statistically significant difference of viable tumors between one- and six-month.
Compared to the baseline, viable HCCs after TACE demonstrated significant changes of imaging characteristics in a series of radiological and radiomics features at one- and six-month follow-ups.
Clinically diagnosing of viable HCCs using radiological methods is challenging. A comprehensive analysis of these imaging characteristics can facilitate the accurate identification of viable tumors.
本研究旨在分析初次经动脉化疗栓塞术（TACE）后存活肝细胞癌（HCC）的磁共振成像（MRI）变化模式。
对2015年2月至2022年10月期间三个中心的HCC患者初次TACE进行回顾性分析，并开展一项临床试验（NCT03113955）。使用LI-RADS治疗反应算法（LR-TRA）v2024评估TACE术后1个月和6个月时残留HCC的存活情况。采用Wilcoxon符号秩检验和McNemar检验比较基线与1个月之间、1个月与6个月之间TACE术后存活肿瘤的放射学和放射组学特征。
本研究共纳入160个存活肿瘤。与基线HCC成像相比，TACE术后1个月时的存活肿瘤表现出更高的T1WI信号强度（P = 0.024）、更低的T2WI信号强度（P = 0.005）、更少的廓清特征（P < 0.001）、更小的尺寸（P < 0.001）以及更高的表观扩散系数（ADC）值（P < 0.001）。与6个月时的存活肿瘤相比，1个月时的存活肿瘤在扩散加权成像（DWI）信号强度（P = 0.002）和ADC值（P < 0.001）方面均有显著降低。基线与1个月之间有82个（45.1%）放射组学特征发生了显著变化。1个月与6个月之间仅有3个放射组学特征在存活肿瘤中表现出统计学显著差异。
与基线相比，TACE术后存活的HCC在1个月和6个月随访时，在一系列放射学和放射组学特征方面表现出显著的影像学特征变化。
临床上使用放射学方法诊断存活HCC具有挑战性。对这些影像学特征进行综合分析有助于准确识别存活肿瘤。
