Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No.58, Zhongshan Road 2, Guangzhou, 510080, P.R. China.
Department of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
BMC Cancer. 2024 Nov 19;24(1):1425. doi: 10.1186/s12885-024-13185-7.
Non-hypervascular hypointense nodules (NHHNs) can transform into hypervascular hepatocellular carcinoma (HCC) during the long-term follow-up. However, the risk factors for NHHN hypervascular transformation in chronic hepatitis B virus (HBV)-infected populations are unknown. This study assessed the predictive value of gadoxetic acid-enhanced magnetic resonance imaging (MRI) for HCC development in patients with chronic HBV infection.
A total of 86 patients with HBV infection who underwent gadoxetic acid-enhanced MRI at the First Affiliated Hospital of Sun Yat-sen University between January 2011 and July 2019 and were followed up for 2 years were retrospectively reviewed. Imaging features, including cirrhosis, steatosis, and NHHNs, were collected. Radiomics features were extracted from the entire liver. The HCC development predictive models were built based on each patient's clinical data, MRI features, and radiomic features. We then collected the qualitative and quantitative features of each NHHN and investigated the risk factors of hypervascular transformation.
Thirteen patients developed HCC within two years. The risk factors for HCC development in patients with chronic HBV infection included older age, cirrhosis, and NHHNs. The MRI, radiomics, and integrated models developed all had an area under the curve (AUC) above 0.8. The potential risk factors for hypervascular transformation of NHHNs were the diameter of the NHHN (OR = 1.69, 95% CI:1.23, 2.32, P = 0.001) and the signal intensity (SI) ratio of the NHHN to the liver in the hepatobiliary phase (HBP SI ratio*10, OR = 0.36, 95% CI:0.11, 0.85, P = 0.044). The AUC of the hypervascular transformation model was 0.846 (95% CI:0.719, 0.972).
In chronic HBV infection population, patients with older age, cirrhosis and NHHNs are more likely to develop HCC within two years. Models based on these factors or radiomic features can effectively predict HCC development. The diameter of the NHHNs and the signal intensity ratio of NHHN to the liver in the hepatobiliary phase are potential risk factors for the hypervascular transformation of NHHNs.
非富血供低信号结节（NHHN）在长期随访中可转变为富血供肝细胞癌（HCC）。然而，在慢性乙型肝炎病毒（HBV）感染人群中，NHHN 富血供转变的危险因素尚不清楚。本研究评估了钆塞酸增强磁共振成像（MRI）对慢性 HBV 感染患者 HCC 发展的预测价值。
回顾性分析 2011 年 1 月至 2019 年 7 月中山大学附属第一医院接受钆塞酸增强 MRI 检查并随访 2 年的 86 例 HBV 感染患者的资料。收集患者的影像学特征，包括肝硬化、脂肪变性和 NHHN；提取全肝的放射组学特征。基于每位患者的临床数据、MRI 特征和放射组学特征构建 HCC 发生预测模型。然后收集每个 NHHN 的定性和定量特征，探讨富血供转变的危险因素。
两年内有 13 例患者发生 HCC。慢性 HBV 感染患者 HCC 发生的危险因素包括年龄较大、肝硬化和 NHHN。MRI、放射组学和综合模型的 AUC 均大于 0.8。NHHN 富血供转变的潜在危险因素是 NHHN 的直径（OR=1.69，95%CI：1.23，2.32，P=0.001）和肝胆期 NHHN 与肝脏的信号强度比（HBP SI 比*10，OR=0.36，95%CI：0.11，0.85，P=0.044）。富血供转变模型的 AUC 为 0.846（95%CI：0.719，0.972）。
在慢性 HBV 感染人群中，年龄较大、肝硬化和 NHHN 的患者在两年内更有可能发生 HCC。基于这些因素或放射组学特征的模型可以有效地预测 HCC 的发生。NHHN 的直径和肝胆期 NHHN 与肝脏的信号强度比是 NHHN 富血供转变的潜在危险因素。
