Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma Using Quantitative Image Analysis. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Microvascular invasion (MVI) is a significant risk factor for early recurrence after resection or transplantation for hepatocellular carcinoma (HCC). Knowledge of MVI status would help guide treatment recommendations, but is generally identified after operation. This study aims to predict MVI preoperatively using quantitative image analysis. STUDY DESIGN: One hundred and twenty patients from 2 institutions underwent resection of HCC from 2003 to 2015 were included. The largest tumor from preoperative CT was subjected to quantitative image analysis, which uses an automated computer algorithm to capture regional variation in CT enhancement patterns. Quantitative imaging features by automatic analysis, qualitative radiographic descriptors by 2 radiologists, and preoperative clinical variables were included in multivariate analysis to predict histologic MVI. RESULTS: Histologic MVI was identified in 19 (37%) patients with tumors ≤5 cm and 34 (49%) patients with tumors >5 cm. Among patients with tumors ≤5 cm, none of the clinical findings or radiographic descriptors were associated with MVI; however, quantitative features based on angle co-occurrence matrix predicted MVI with an area under curve of 0.80, positive predictive value of 63%, and negative predictive value of 85%. In patients with tumors >5 cm, higher α-fetoprotein level, larger tumor size, and viral hepatitis history were associated with MVI, and radiographic descriptors were not. However, a multivariate model combining α-fetoprotein, tumor size, hepatitis status, and quantitative feature based on local binary pattern predicted MVI with area under curve of 0.88, positive predictive value of 72%, and negative predictive value of 96%. CONCLUSIONS: This study reveals the potential importance of quantitative image analysis as a predictor of MVI.

publication date

  • September 21, 2017

Research

keywords

  • Carcinoma, Hepatocellular
  • Image Processing, Computer-Assisted
  • Liver Neoplasms
  • Microvessels
  • Tomography, X-Ray Computed
  • Vascular Neoplasms

Identity

PubMed Central ID

  • PMC5705269

Scopus Document Identifier

  • 85031325330

Digital Object Identifier (DOI)

  • 10.1016/j.jamcollsurg.2017.09.003

PubMed ID

  • 28941728

Additional Document Info

volume

  • 225

issue

  • 6