Details

Autor(en) / Beteiligte

• Zhang, Zhaohe
• Yu, Jie
• Liu, Sisi
• Dong, Linan
• Liu, Tiefang
• Wang, Haiyi
• Han, Zhiyu
• Zhang, Xiaojing
• Liang, Ping

Titel

Multiparametric liver MRI for predicting early recurrence of hepatocellular carcinoma after microwave ablation

Ist Teil von

• Cancer imaging, 2022-08, Vol.22 (1), p.1-42, Article 42

Ort / Verlag

London: BioMed Central Ltd

Erscheinungsjahr

2022

Quelle

Springer Nature - Complete Springer Journals

Beschreibungen/Notizen

• Background High early recurrence (ER) of hepatocellular carcinoma (HCC) after microwave ablation (MWA) represents a sign of aggressive behavior and severely worsens prognosis. The aim of this study was to estimate the outcome of HCC following MWA and develop a response algorithmic strategy based on multiparametric MRI and clinical variables. Methods In this retrospective study, we reviewed the records of 339 patients (mean age, 62 [+ or -] 12 years; 106 men) treated with percutaneous MWA for HCC between January 2014 and December 2017 that were evaluated by multiparametric MRI. These patients were randomly split into a development and an internal validation group (3:1). Logistic regression analysis was used to screen imaging features. Multivariate Cox regression analysis was then performed to determine predictors of ER (within 2 years) of MWA. The response algorithmic strategy to predict ER was developed and validated using these data sets. ER rates were also evaluated by Kaplan-Meier analysis. Results Based on logistic regression analyses, we established an image response algorithm integrating ill-defined margins, lack of capsule enhancement, pre-ablative ADC, [DELA]ADC, and EADC to calculate recurrence scores and define the risk of ER. In a multivariate Cox regression model, the independent risk factors of ER (p < 0.05) were minimal ablative margin (MAM) (HR 0.57; 95% CI 0.35 - 0.95; p < 0.001), the recurrence score (HR: 9.25; 95% CI 4.25 - 16.56; p = 0.021), and tumor size (HR 6.21; 95% CI 1.25 - 10.82; p = 0.014). Combining MAM and tumor size, the recurrence score calculated by the response algorithmic strategy provided predictive accuracy of 93.5%, with sensitivity of 92.3% and specificity of 83.1%. Kaplan-Meier estimates of the rates of ER in the low-risk and high-risk groups were 6.8% (95% CI 4.0 - 9.6) and 30.5% (95% CI 23.6 - 37.4), respectively. Conclusion A response algorithmic strategy based on multiparametric MRI and clinical variables was useful for predicting the ER of HCC after MWA. Keywords: Hepatocellular carcinoma, Minimal ablative margin, Multiparametric liver MRI, Microwave ablation, Early recurrence