Differentiation of AFP-negative hepatocellular carcinoma from other intrahepatic malignant lesions by a noninvasive predictive model based on Sonazoid contrast-enhanced ultrasound

ObjectivesThis study aimed to develop and validate a non-invasive predictive model, which was a reliable nomogram to accurately differentiate AFPN-HCC from other intrahepatic malignant lesions.MethodsThis study enrolled 165 patients with malignant focal liver lesions, including AFPN-HCC (n=85) and o...

Full description

Saved in:
Bibliographic Details
Main Authors: Qian Zhang, Zhilong Liu, Ruining Wang, Lele Song, Wenwen Fan, Ping Liang, Liping Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1623670/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849423536270082048
author Qian Zhang
Zhilong Liu
Ruining Wang
Lele Song
Wenwen Fan
Ping Liang
Liping Liu
author_facet Qian Zhang
Zhilong Liu
Ruining Wang
Lele Song
Wenwen Fan
Ping Liang
Liping Liu
author_sort Qian Zhang
collection DOAJ
description ObjectivesThis study aimed to develop and validate a non-invasive predictive model, which was a reliable nomogram to accurately differentiate AFPN-HCC from other intrahepatic malignant lesions.MethodsThis study enrolled 165 patients with malignant focal liver lesions, including AFPN-HCC (n=85) and other intrahepatic malignant lesions (n=80). Data were analyzed to screen for risk factors phase by using LASSO regression as well as univariate and multivariate logistic regression analysis. We constructed a model and developed a nomogram. Then using the area under the curve, Hosmer-Lemeshow test, calibration curves, decision curve analysis, and 1,000 bootstraps to assess and internally validate the model performance. We calculated the optimal threshold, sensitivity, specificity, positive and negative predictive value, and accuracy of the prediction model.ResultsLASSO and multivariate logistic regression analyses indicated that tumor number, necrosis in tumor, arterial phase enhancement pattern, arterial phase perfusion velocity, and Kupffer phase degree of washout were the significant predictors to differentiate AFPN-HCC from OM. The AUC was 0.886, and the AUC of internal validation was 0.865. The optimal critical value of the predicted value was 0.524, with a sensitivity of 82.35%, specificity of 85.00%, positive predicted value of 85.37%, negative predicted value of 81.93%, and an accuracy of 83.64%. The P value of the Hosmer-Lemeshow test was 0.592. The calibration plots showed a high concordance of prediction. The decision curve analysis showed excellent net benefits.ConclusionOur nomogram has excellent discrimination, calibration and clinical utility by combining SCEUS and clinical features, which may help clinicians improve the diagnostic performance for AFPN-HCC, contributing to individualized treatment.
format Article
id doaj-art-8ea252c1bf4049ffbf9295a1f54fdf05
institution Kabale University
issn 2234-943X
language English
publishDate 2025-07-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Oncology
spelling doaj-art-8ea252c1bf4049ffbf9295a1f54fdf052025-08-20T03:30:33ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.16236701623670Differentiation of AFP-negative hepatocellular carcinoma from other intrahepatic malignant lesions by a noninvasive predictive model based on Sonazoid contrast-enhanced ultrasoundQian Zhang0Zhilong Liu1Ruining Wang2Lele Song3Wenwen Fan4Ping Liang5Liping Liu6Department of Interventional Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Interventional Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Interventional Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Interventional Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Interventional Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of Interventional Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaObjectivesThis study aimed to develop and validate a non-invasive predictive model, which was a reliable nomogram to accurately differentiate AFPN-HCC from other intrahepatic malignant lesions.MethodsThis study enrolled 165 patients with malignant focal liver lesions, including AFPN-HCC (n=85) and other intrahepatic malignant lesions (n=80). Data were analyzed to screen for risk factors phase by using LASSO regression as well as univariate and multivariate logistic regression analysis. We constructed a model and developed a nomogram. Then using the area under the curve, Hosmer-Lemeshow test, calibration curves, decision curve analysis, and 1,000 bootstraps to assess and internally validate the model performance. We calculated the optimal threshold, sensitivity, specificity, positive and negative predictive value, and accuracy of the prediction model.ResultsLASSO and multivariate logistic regression analyses indicated that tumor number, necrosis in tumor, arterial phase enhancement pattern, arterial phase perfusion velocity, and Kupffer phase degree of washout were the significant predictors to differentiate AFPN-HCC from OM. The AUC was 0.886, and the AUC of internal validation was 0.865. The optimal critical value of the predicted value was 0.524, with a sensitivity of 82.35%, specificity of 85.00%, positive predicted value of 85.37%, negative predicted value of 81.93%, and an accuracy of 83.64%. The P value of the Hosmer-Lemeshow test was 0.592. The calibration plots showed a high concordance of prediction. The decision curve analysis showed excellent net benefits.ConclusionOur nomogram has excellent discrimination, calibration and clinical utility by combining SCEUS and clinical features, which may help clinicians improve the diagnostic performance for AFPN-HCC, contributing to individualized treatment.https://www.frontiersin.org/articles/10.3389/fonc.2025.1623670/fullAFP-negativehepatocellular carcinomacontrast-enhanced ultrasoundSonazoidnomogram
spellingShingle Qian Zhang
Zhilong Liu
Ruining Wang
Lele Song
Wenwen Fan
Ping Liang
Liping Liu
Differentiation of AFP-negative hepatocellular carcinoma from other intrahepatic malignant lesions by a noninvasive predictive model based on Sonazoid contrast-enhanced ultrasound
Frontiers in Oncology
AFP-negative
hepatocellular carcinoma
contrast-enhanced ultrasound
Sonazoid
nomogram
title Differentiation of AFP-negative hepatocellular carcinoma from other intrahepatic malignant lesions by a noninvasive predictive model based on Sonazoid contrast-enhanced ultrasound
title_full Differentiation of AFP-negative hepatocellular carcinoma from other intrahepatic malignant lesions by a noninvasive predictive model based on Sonazoid contrast-enhanced ultrasound
title_fullStr Differentiation of AFP-negative hepatocellular carcinoma from other intrahepatic malignant lesions by a noninvasive predictive model based on Sonazoid contrast-enhanced ultrasound
title_full_unstemmed Differentiation of AFP-negative hepatocellular carcinoma from other intrahepatic malignant lesions by a noninvasive predictive model based on Sonazoid contrast-enhanced ultrasound
title_short Differentiation of AFP-negative hepatocellular carcinoma from other intrahepatic malignant lesions by a noninvasive predictive model based on Sonazoid contrast-enhanced ultrasound
title_sort differentiation of afp negative hepatocellular carcinoma from other intrahepatic malignant lesions by a noninvasive predictive model based on sonazoid contrast enhanced ultrasound
topic AFP-negative
hepatocellular carcinoma
contrast-enhanced ultrasound
Sonazoid
nomogram
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1623670/full
work_keys_str_mv AT qianzhang differentiationofafpnegativehepatocellularcarcinomafromotherintrahepaticmalignantlesionsbyanoninvasivepredictivemodelbasedonsonazoidcontrastenhancedultrasound
AT zhilongliu differentiationofafpnegativehepatocellularcarcinomafromotherintrahepaticmalignantlesionsbyanoninvasivepredictivemodelbasedonsonazoidcontrastenhancedultrasound
AT ruiningwang differentiationofafpnegativehepatocellularcarcinomafromotherintrahepaticmalignantlesionsbyanoninvasivepredictivemodelbasedonsonazoidcontrastenhancedultrasound
AT lelesong differentiationofafpnegativehepatocellularcarcinomafromotherintrahepaticmalignantlesionsbyanoninvasivepredictivemodelbasedonsonazoidcontrastenhancedultrasound
AT wenwenfan differentiationofafpnegativehepatocellularcarcinomafromotherintrahepaticmalignantlesionsbyanoninvasivepredictivemodelbasedonsonazoidcontrastenhancedultrasound
AT pingliang differentiationofafpnegativehepatocellularcarcinomafromotherintrahepaticmalignantlesionsbyanoninvasivepredictivemodelbasedonsonazoidcontrastenhancedultrasound
AT lipingliu differentiationofafpnegativehepatocellularcarcinomafromotherintrahepaticmalignantlesionsbyanoninvasivepredictivemodelbasedonsonazoidcontrastenhancedultrasound