Prediction of microvascular invasion in hepatocellular carcinoma with conventional ultrasound, Sonazoid-enhanced ultrasound, and biochemical indicator: a multicenter study
Abstract Purpose To develop and validate a preoperative prediction model based on multimodal ultrasound and biochemical indicator for identifying microvascular invasion (MVI) in patients with a single hepatocellular carcinoma (HCC) ≤ 5 cm. Methods From May 2022 to November 2023, a total of 318 patie...
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SpringerOpen
2024-10-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-024-01743-3 |
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| author | Dan Lu Li-Fan Wang Hong Han Lin-Lin Li Wen-Tao Kong Qian Zhou Bo-Yang Zhou Yi-Kang Sun Hao-Hao Yin Ming-Rui Zhu Xin-Yuan Hu Qing Lu Han-Sheng Xia Xi Wang Chong-Ke Zhao Jian-Hua Zhou Hui-Xiong Xu |
| author_facet | Dan Lu Li-Fan Wang Hong Han Lin-Lin Li Wen-Tao Kong Qian Zhou Bo-Yang Zhou Yi-Kang Sun Hao-Hao Yin Ming-Rui Zhu Xin-Yuan Hu Qing Lu Han-Sheng Xia Xi Wang Chong-Ke Zhao Jian-Hua Zhou Hui-Xiong Xu |
| author_sort | Dan Lu |
| collection | DOAJ |
| description | Abstract Purpose To develop and validate a preoperative prediction model based on multimodal ultrasound and biochemical indicator for identifying microvascular invasion (MVI) in patients with a single hepatocellular carcinoma (HCC) ≤ 5 cm. Methods From May 2022 to November 2023, a total of 318 patients with pathologically confirmed single HCC ≤ 5 cm from three institutions were enrolled. All of them underwent preoperative biochemical, conventional ultrasound (US), and contrast-enhanced ultrasound (CEUS) (Sonazoid, 0.6 mL, bolus injection) examinations. Univariate and multivariate logistic regression analyses on clinical information, biochemical indicator, and US imaging features were performed in the training set to seek independent predictors for MVI-positive. The models were constructed and evaluated using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis in both validation and test sets. Subgroup analyses in patients with different liver background and tumor sizes were conducted to further investigate the model’s performance. Results Logistic regression analyses showed that obscure tumor boundary in B-mode US, intra-tumoral artery in pulsed-wave Doppler US, complete Kupffer-phase agent clearance in Sonazoid-CEUS, and biomedical indicator PIVKA-II were independently correlated with MVI-positive. The combined model comprising all predictors showed the highest AUC, which were 0.937 and 0.893 in the validation and test sets. Good calibration and prominent net benefit were achieved in both sets. No significant difference was found in subgroup analyses. Conclusions The combination of biochemical indicator, conventional US, and Sonazoid-CEUS features could help preoperative MVI prediction in patients with a single HCC ≤ 5 cm. Critical relevance statement Investigation of imaging features in conventional US, Sonazoid-CEUS, and biochemical indicators showed a significant relation with MVI-positivity in patients with a single HCC ≤ 5 cm, allowing the construction of a model for preoperative prediction of MVI status to help treatment decision making. Key Points MVI status is important for patients with a single HCC ≤ 5 cm. The model based on conventional US, Sonazoid-CEUS and PIVKA-II performs best for MVI prediction. The combined model has potential for preoperative prediction of MVI status. Graphical Abstract |
| format | Article |
| id | doaj-art-10aa44d365754c2dac84bf91dc30f221 |
| institution | OA Journals |
| issn | 1869-4101 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | SpringerOpen |
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| series | Insights into Imaging |
| spelling | doaj-art-10aa44d365754c2dac84bf91dc30f2212025-08-20T02:18:24ZengSpringerOpenInsights into Imaging1869-41012024-10-0115111410.1186/s13244-024-01743-3Prediction of microvascular invasion in hepatocellular carcinoma with conventional ultrasound, Sonazoid-enhanced ultrasound, and biochemical indicator: a multicenter studyDan Lu0Li-Fan Wang1Hong Han2Lin-Lin Li3Wen-Tao Kong4Qian Zhou5Bo-Yang Zhou6Yi-Kang Sun7Hao-Hao Yin8Ming-Rui Zhu9Xin-Yuan Hu10Qing Lu11Han-Sheng Xia12Xi Wang13Chong-Ke Zhao14Jian-Hua Zhou15Hui-Xiong Xu16Department of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityDepartment of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong, Provincial Clinical Research Center for CancerDepartment of Ultrasound, Nanjing DrumTower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Ultrasound, Nanjing DrumTower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversitySchool of Medicine, Anhui University of Science and TechnologyDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityDepartment of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong, Provincial Clinical Research Center for CancerDepartment of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan UniversityAbstract Purpose To develop and validate a preoperative prediction model based on multimodal ultrasound and biochemical indicator for identifying microvascular invasion (MVI) in patients with a single hepatocellular carcinoma (HCC) ≤ 5 cm. Methods From May 2022 to November 2023, a total of 318 patients with pathologically confirmed single HCC ≤ 5 cm from three institutions were enrolled. All of them underwent preoperative biochemical, conventional ultrasound (US), and contrast-enhanced ultrasound (CEUS) (Sonazoid, 0.6 mL, bolus injection) examinations. Univariate and multivariate logistic regression analyses on clinical information, biochemical indicator, and US imaging features were performed in the training set to seek independent predictors for MVI-positive. The models were constructed and evaluated using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis in both validation and test sets. Subgroup analyses in patients with different liver background and tumor sizes were conducted to further investigate the model’s performance. Results Logistic regression analyses showed that obscure tumor boundary in B-mode US, intra-tumoral artery in pulsed-wave Doppler US, complete Kupffer-phase agent clearance in Sonazoid-CEUS, and biomedical indicator PIVKA-II were independently correlated with MVI-positive. The combined model comprising all predictors showed the highest AUC, which were 0.937 and 0.893 in the validation and test sets. Good calibration and prominent net benefit were achieved in both sets. No significant difference was found in subgroup analyses. Conclusions The combination of biochemical indicator, conventional US, and Sonazoid-CEUS features could help preoperative MVI prediction in patients with a single HCC ≤ 5 cm. Critical relevance statement Investigation of imaging features in conventional US, Sonazoid-CEUS, and biochemical indicators showed a significant relation with MVI-positivity in patients with a single HCC ≤ 5 cm, allowing the construction of a model for preoperative prediction of MVI status to help treatment decision making. Key Points MVI status is important for patients with a single HCC ≤ 5 cm. The model based on conventional US, Sonazoid-CEUS and PIVKA-II performs best for MVI prediction. The combined model has potential for preoperative prediction of MVI status. Graphical Abstracthttps://doi.org/10.1186/s13244-024-01743-3Hepatocellular carcinomaMicrovascular invasionContrast-enhanced ultrasoundSonazoidKupffer-phase |
| spellingShingle | Dan Lu Li-Fan Wang Hong Han Lin-Lin Li Wen-Tao Kong Qian Zhou Bo-Yang Zhou Yi-Kang Sun Hao-Hao Yin Ming-Rui Zhu Xin-Yuan Hu Qing Lu Han-Sheng Xia Xi Wang Chong-Ke Zhao Jian-Hua Zhou Hui-Xiong Xu Prediction of microvascular invasion in hepatocellular carcinoma with conventional ultrasound, Sonazoid-enhanced ultrasound, and biochemical indicator: a multicenter study Insights into Imaging Hepatocellular carcinoma Microvascular invasion Contrast-enhanced ultrasound Sonazoid Kupffer-phase |
| title | Prediction of microvascular invasion in hepatocellular carcinoma with conventional ultrasound, Sonazoid-enhanced ultrasound, and biochemical indicator: a multicenter study |
| title_full | Prediction of microvascular invasion in hepatocellular carcinoma with conventional ultrasound, Sonazoid-enhanced ultrasound, and biochemical indicator: a multicenter study |
| title_fullStr | Prediction of microvascular invasion in hepatocellular carcinoma with conventional ultrasound, Sonazoid-enhanced ultrasound, and biochemical indicator: a multicenter study |
| title_full_unstemmed | Prediction of microvascular invasion in hepatocellular carcinoma with conventional ultrasound, Sonazoid-enhanced ultrasound, and biochemical indicator: a multicenter study |
| title_short | Prediction of microvascular invasion in hepatocellular carcinoma with conventional ultrasound, Sonazoid-enhanced ultrasound, and biochemical indicator: a multicenter study |
| title_sort | prediction of microvascular invasion in hepatocellular carcinoma with conventional ultrasound sonazoid enhanced ultrasound and biochemical indicator a multicenter study |
| topic | Hepatocellular carcinoma Microvascular invasion Contrast-enhanced ultrasound Sonazoid Kupffer-phase |
| url | https://doi.org/10.1186/s13244-024-01743-3 |
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