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MR Elastography-Based Shear Strain Mapping for Assessment of Microvascular Invasion in Hepatocellular Carcinoma

  • Hepatobiliary-Pancreas
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Abstract

Objectives

To evaluate the potential of MR elastography (MRE)–based shear strain mapping to noninvasively predict the presence of microvascular invasion (MVI) in hepatocellular carcinoma (HCC).

Methods

Fifty-nine histopathology-proven HCC patients with conventional 60-Hz MRE examinations (+/−MVI, n = 34/25) were enrolled retrospectively between December 2016 and October 2019, with one subgroup comprising 29/59 patients (+/−MVI, n = 16/13) who also underwent 40- and 30-Hz MRE examinations. Octahedral shear strain (OSS) maps were calculated, and the percentage of peritumoral interface length with low shear strain (i.e., a low-shear-strain length, pLSL, %) was recorded. For OSS-pLSL, differences between the MVI (+) and MVI (−) groups and diagnostic performance at different MRE frequencies were analyzed using the Mann-Whitney test and area under the receiver operating characteristic curve (AUC), respectively.

Results

The peritumor OSS-pLSL was significantly higher in the MVI (+) group than in the MVI (−) group at the three frequencies (all p < 0.01). The AUC of peritumor OSS-pLSL for predicting MVI was good/excellent in all frequency groups (60-Hz: 0.73 (n = 59)/0.80 (n = 29); 40-Hz: 0.84; 30-Hz: 0.90). On further analysis of the 29 cases with all frequencies, the AUCs were not significantly different. As the frequency decreased from 60-Hz, the specificity of OSS increased at 40-Hz (53.8–61.5%) and further increased at 30-Hz (53.8–76.9%), and the sensitivity remained high at lower frequencies (100.0–93.8%) (all p > 0.05).

Conclusions

MRE-based shear strain mapping is a promising technique for noninvasively predicting the presence of MVI in patients with HCC, and the most recommended frequency for OSS is 30-Hz.

Key Points

• MR elastography (MRE)–based shear strain mapping has the potential to predict the presence of microvascular invasion (MVI) in hepatocellular carcinoma preoperatively.

• The low interface shear strain identified at tumor–liver boundaries was highly correlated with the presence of MVI.

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Abbreviations

AUC:

Area under the receiver operating characteristic curve

HCC:

Hepatocellular carcinoma

MRE:

MR elastography

MVI:

Microvascular invasion

NPV:

Negative predicted value

OSS:

Octahedral shear strain

pLSL:

Percentage of low-shear-strain length

PPV:

Positive predicted value

ROI:

Region of interest

SII:

Slip interface imaging

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Acknowledgements

The authors thank Dr. Jing Zhou for assessment of pathologic specimens.

Funding

The authors state that this study has received funding by National Natural Science Foundation of China grant 91959118 (JW), Clinical Research Foundation of the 3rd Affiliated Hospital of Sun Yat-Sen University YHJH201901 (JW), Guangdong Basic and Applied Basic Research Foundation (No.2021A1515010582) (JW), National Natural Science Foundation of China grant 82101994 (Linqi Zhang), the US Department of Defence (W81XWH-19-1-0583-01) (Meng Yin), and NIH R01 NS113760 (Ziying Yin).

Author information

Author notes

  1. Mengsi Li and Ziying Yin contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, the Third Affiliated Hospital, Sun Yat-Sen University (SYSU), No 600, Tianhe Road, Guangzhou, Guangdong, 510630, People’s Republic of China

    Mengsi Li, Bing Hu, Ning Guo, Linqi Zhang, Lina Zhang, Jie Zhu, Wenying Chen & Jin Wang

  2. Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA

    Ziying Yin, Meng Yin, Jun Chen & Richard L. Ehman

Authors
  1. Mengsi Li
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Corresponding author

Correspondence to Jin Wang.

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The scientific guarantor of this publication is Jin Wang.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry:

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• performed at one institution

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Li, M., Yin, Z., Hu, B. et al. MR Elastography-Based Shear Strain Mapping for Assessment of Microvascular Invasion in Hepatocellular Carcinoma. Eur Radiol 32, 5024–5032 (2022). https://doi.org/10.1007/s00330-022-08578-w

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  • DOI: https://doi.org/10.1007/s00330-022-08578-w

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