Construction of a nomogram combining CEUS and MRI imaging for preoperative diagnosis of microvascular invasion in hepatocellular carcinoma
Purpose: To use Sonazoid contrast-enhanced ultrasound (S-CEUS) and Gadolinium-Ethoxybenzyl-Diethylenetriamine Penta-Acetic Acid magnetic-resonance imaging (EOB-MRI), exploring a non-invasive preoperative diagnostic strategy for microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods:...
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Elsevier
2024-12-01
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| Series: | European Journal of Radiology Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S235204772400042X |
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| author | Feiqian Wang Kazushi Numata Akihiro Funaoka Takafumi Kumamoto Kazuhisa Takeda Makoto Chuma Akito Nozaki Litao Ruan Shin Maeda |
| author_facet | Feiqian Wang Kazushi Numata Akihiro Funaoka Takafumi Kumamoto Kazuhisa Takeda Makoto Chuma Akito Nozaki Litao Ruan Shin Maeda |
| author_sort | Feiqian Wang |
| collection | DOAJ |
| description | Purpose: To use Sonazoid contrast-enhanced ultrasound (S-CEUS) and Gadolinium-Ethoxybenzyl-Diethylenetriamine Penta-Acetic Acid magnetic-resonance imaging (EOB-MRI), exploring a non-invasive preoperative diagnostic strategy for microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods: 111 newly developed HCC cases were retrospectively collected. Both S-CEUS and EOB-MRI examinations were performed within one month of hepatectomy. The following indicators were investigated: size; vascularity in three phases of S-CEUS; margin, signal intensity, and peritumoral wedge shape in EOB-MRI; tumoral homogeneity, presence and integrity of the tumoral capsule in S-CEUS or EOB-MRI; presence of branching enhancement in S-CEUS; baseline clinical and serological data. The least absolute shrinkage and selection operator regression and multivariate logistic regression analysis were applied to optimize feature selection for the model. A nomogram for MVI was developed and verified by bootstrap resampling. Results: Of the 16 variables we included, wedge and margin in HBP of EOB-MRI, capsule integrity in AP or HBP/PVP images of EOB-MRI/S-CEUS, and branching enhancement in AP of S-CEUS were identified as independent risk factors for MVI and incorporated into construction of the nomogram. The nomogram achieved an excellent diagnostic efficiency with an area under the curve of 0.8434 for full data training set and 0.7925 for bootstrapping validation set for 500 repetitions. In evaluating the nomogram, Hosmer–Lemeshow test for training set exhibited a good model fit with P > 0.05. Decision curve analysis of nomogram model yielded excellent clinical net benefit with a wide range (5–80 % and 85–94 %) of risk threshold. Conclusions: The MVI Nomogram established in this study may provide a strategy for optimizing the preoperative diagnosis of MVI, which in turn may improve the treatment and prognosis of MVI-related HCC. |
| format | Article |
| id | doaj-art-c46c205ceffa423aaaccc8677cb5b38c |
| institution | OA Journals |
| issn | 2352-0477 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
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| series | European Journal of Radiology Open |
| spelling | doaj-art-c46c205ceffa423aaaccc8677cb5b38c2025-08-20T02:37:52ZengElsevierEuropean Journal of Radiology Open2352-04772024-12-011310058710.1016/j.ejro.2024.100587Construction of a nomogram combining CEUS and MRI imaging for preoperative diagnosis of microvascular invasion in hepatocellular carcinomaFeiqian Wang0Kazushi Numata1Akihiro Funaoka2Takafumi Kumamoto3Kazuhisa Takeda4Makoto Chuma5Akito Nozaki6Litao Ruan7Shin Maeda8Ultrasound Department, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 West Yanta Road, Xi’an, Shaanxi 710061, PR China; Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, JapanGastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, Japan; Corresponding author.Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, JapanGastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, JapanGastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, JapanGastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, JapanGastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, JapanUltrasound Department, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 West Yanta Road, Xi’an, Shaanxi 710061, PR ChinaDivision of Gastroenterology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, JapanPurpose: To use Sonazoid contrast-enhanced ultrasound (S-CEUS) and Gadolinium-Ethoxybenzyl-Diethylenetriamine Penta-Acetic Acid magnetic-resonance imaging (EOB-MRI), exploring a non-invasive preoperative diagnostic strategy for microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods: 111 newly developed HCC cases were retrospectively collected. Both S-CEUS and EOB-MRI examinations were performed within one month of hepatectomy. The following indicators were investigated: size; vascularity in three phases of S-CEUS; margin, signal intensity, and peritumoral wedge shape in EOB-MRI; tumoral homogeneity, presence and integrity of the tumoral capsule in S-CEUS or EOB-MRI; presence of branching enhancement in S-CEUS; baseline clinical and serological data. The least absolute shrinkage and selection operator regression and multivariate logistic regression analysis were applied to optimize feature selection for the model. A nomogram for MVI was developed and verified by bootstrap resampling. Results: Of the 16 variables we included, wedge and margin in HBP of EOB-MRI, capsule integrity in AP or HBP/PVP images of EOB-MRI/S-CEUS, and branching enhancement in AP of S-CEUS were identified as independent risk factors for MVI and incorporated into construction of the nomogram. The nomogram achieved an excellent diagnostic efficiency with an area under the curve of 0.8434 for full data training set and 0.7925 for bootstrapping validation set for 500 repetitions. In evaluating the nomogram, Hosmer–Lemeshow test for training set exhibited a good model fit with P > 0.05. Decision curve analysis of nomogram model yielded excellent clinical net benefit with a wide range (5–80 % and 85–94 %) of risk threshold. Conclusions: The MVI Nomogram established in this study may provide a strategy for optimizing the preoperative diagnosis of MVI, which in turn may improve the treatment and prognosis of MVI-related HCC.http://www.sciencedirect.com/science/article/pii/S235204772400042XHepatocellular carcinomaMicrovascular invasionPrediction modelDiagnosisContrast-enhanced ultrasoundMagnetic-resonance imaging |
| spellingShingle | Feiqian Wang Kazushi Numata Akihiro Funaoka Takafumi Kumamoto Kazuhisa Takeda Makoto Chuma Akito Nozaki Litao Ruan Shin Maeda Construction of a nomogram combining CEUS and MRI imaging for preoperative diagnosis of microvascular invasion in hepatocellular carcinoma European Journal of Radiology Open Hepatocellular carcinoma Microvascular invasion Prediction model Diagnosis Contrast-enhanced ultrasound Magnetic-resonance imaging |
| title | Construction of a nomogram combining CEUS and MRI imaging for preoperative diagnosis of microvascular invasion in hepatocellular carcinoma |
| title_full | Construction of a nomogram combining CEUS and MRI imaging for preoperative diagnosis of microvascular invasion in hepatocellular carcinoma |
| title_fullStr | Construction of a nomogram combining CEUS and MRI imaging for preoperative diagnosis of microvascular invasion in hepatocellular carcinoma |
| title_full_unstemmed | Construction of a nomogram combining CEUS and MRI imaging for preoperative diagnosis of microvascular invasion in hepatocellular carcinoma |
| title_short | Construction of a nomogram combining CEUS and MRI imaging for preoperative diagnosis of microvascular invasion in hepatocellular carcinoma |
| title_sort | construction of a nomogram combining ceus and mri imaging for preoperative diagnosis of microvascular invasion in hepatocellular carcinoma |
| topic | Hepatocellular carcinoma Microvascular invasion Prediction model Diagnosis Contrast-enhanced ultrasound Magnetic-resonance imaging |
| url | http://www.sciencedirect.com/science/article/pii/S235204772400042X |
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