Hepatocellular carcinoma: preoperative gadoxetic acid–enhanced MR imaging can predict early recurrence after curative resection using image features and texture analysis
To investigate whether pre-operative gadoxetic acid–enhanced MRI can predict early recurrence after curative resection of single HCC using image features and texture analysis.
Materials and methods
179 patients with single HCC and who underwent pre-operative MRI were included. Two reviewers analyzed MR findings, including the tumor margin, peritumoral enhancement, peritumoral hypointensity on the hepatobiliary phase (HBP), diffusion restriction, capsule, tumoral fat, washout, portal-vein thrombus, signal intensity on HBP, and satellite nodule. Texture analysis on the HBP was also quantified. A multivariate analysis was used to identify predictive factors for early recurrence, microvascular invasion (MVI), and the tumor grade.
For early recurrence, satellite nodule, peritumoral hypointensity, absence of capsule, and GLCM ASM were predictors (P < 0.05). For MVI, satellite nodule, peritumoral hypointensity, washout, and sphericity were predictors (P < 0.05). Satellite nodules, peritumoral hypointensity, diffusion restriction, and iso to high signal intensity on HBP were predictor for higher tumor grade (P < 0.05). Satellite nodules and peritumoral hypointensity were important showed common predictors for early recurrence, MVI, and grade (P < 0.05). The sensitivity and specificity for satellite nodule were 47.36% and 96.25%. When added texture variables to MRI findings, the diagnostic performance for predicting early recurrence is improved from 0.7 (SD 0.604–0.790) to 0.83 (SD 0.787–0.894).
MR finding, including satellite nodule and peritumoral hypointensity on the HBP, as well as the texture parameters are useful to predict not only early recurrence, but also MVI and higher grade.
KeywordsHepatocellular carcinoma Gadoxetic acid–enhanced MRI Texture analysis Recurrence Microvascular invasion
We also thank Bonnie Hami, M.A. (USA) for her editorial assistance in the preparation of this manuscript.
Compliance with ethical standards
Conflict of interest
All authors confirm that no disclosure of potential conflicts of interest.
This retrospective study was approved by our institutional review board, and the requirement to obtain written, informed consent was waived.
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