Microvascular invasion in hepatocellular carcinoma: is it predictable with quantitative computed tomography parameters?

Abstract Objective: To investigate whether quantitative computed tomography (CT) measurements can predict microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Materials and Methods: This was a retrospective analysis of 200 cases of surgically proven HCCs in 125 consecutive patients evaluated between March 2010 and November 2017. We quantitatively measured regions of interest in lesions and adjacent areas of the liver on unenhanced CT scans, as well as in the arterial, portal venous, and equilibrium phases on contrast-enhanced CT scans. Enhancement profiles were analyzed and compared with histopathological references of MVI. Univariate and multivariate logistic regression analyses were used in order to evaluate CT parameters as potential predictors of MVI. Results: Of the 200 HCCs, 77 (38.5%) showed evidence of MVI on histopathological analysis. There was no statistical difference between HCCs with MVI and those without, in terms of the percentage attenuation ratio in the portal venous phase (114.7 vs. 115.8) and equilibrium phase (126.7 vs. 128.2), as well as in terms of the relative washout ratio, also in the portal venous and equilibrium phases (15.0 vs. 8.2 and 31.4 vs. 26.3, respectively). Conclusion: Quantitative dynamic CT parameters measured in the preoperative period do not appear to correlate with MVI in HCC.

研究目的：探讨定量计算机断层扫描（computed tomography，CT）测量值能否预测肝细胞癌（hepatocellular carcinoma，HCC）的微血管侵犯（microvascular invasion，MVI）。材料与方法：本研究为回顾性分析，纳入2010年3月至2017年11月期间收治的125例经手术病理证实为肝细胞癌的连续患者，共计200个病灶。对平扫CT及增强CT动脉期、门静脉期、平衡期图像中病灶及肝脏邻近区域的感兴趣区进行定量测量。分析强化特征，并与微血管侵犯的组织病理学参考标准进行对比。采用单因素及多因素logistic回归分析，评估CT参数作为微血管侵犯潜在预测因子的可行性。结果：200个肝细胞癌病灶中，77个（38.5%）经组织病理学分析证实存在微血管侵犯。有无微血管侵犯的肝细胞癌病灶在门静脉期衰减百分比（114.7 vs 115.8）、平衡期衰减百分比（126.7 vs 128.2），以及门静脉期和平衡期的相对廓清率（分别为15.0 vs 8.2、31.4 vs 26.3）方面，均无统计学差异。结论：术前测量的定量动态CT参数似乎与肝细胞癌的微血管侵犯无相关性。