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Preoperative determination of pathological grades of primary single HCC: development and validation of a scoring model

  • Hepatobiliary
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to establish a reliable diagnostic score model for the preoperative determination of pathological grade in HCC based on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI and biochemical indicators.

Methods

In this retrospective study, we analyzed 139 patients with HCC who underwent Gd-EOB-DTPA MRI between 2014 and 2020, including an establishment cohort of 76 patients and a validation cohort of 63 patients. Based on the imaging features demonstrated on Gd-EOB-DTPA MRI images and biochemical indicators of the establishment cohort, a scoring model based on logistic regression was developed, and compared with postoperative pathological findings in terms of effective determination of pathological grade. The validity of the scoring model was assessed by ROC curves and an independent external validation cohort.

Results

Three parameters related to pathological grades were identified, including maximum diameter of the tumor, peritumoral hypointensity in the hepatobiliary phase, and [alkaline phosphatase (U/L) + gamma glutamyl transpeptidase (U/L)]/ lymphocyte count (× 109/L) (AGLR) ratios. Based on these three parameters, a scoring model was developed. ROC curve showed that a score of > 5 was set as the threshold for determining pathological grades with accuracy, sensitivity, specificity, PPV, and NPV of 89.5%, 75.0%, 95.1%, 85.7%, and 90.7%, respectively.

Conclusion

The study provided the groundwork for a promising and easily implementable scoring model for preoperative determination of HCC pathological grades, for which further validation should be pursued.

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Data availability

All data and materials support the published claims.

Code availability

Not applicable.

Abbreviations

ADC:

Apparent diffusion coefficient

AFP:

Alpha fetoprotein

ALP:

Alkaline phosphatase

AGLR:

Ratio of (ALP [U/L] + GGT [U/L]) / lymphocyte count (× 109/L)

Gd-EOB-DTPA:

Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid

GGT:

Gamma glutamyl transpeptidase

HBP:

Hepatobiliary phase

HCC:

Hepatocellular carcinoma

Max-D:

Maximum diameter of the tumor

NLR:

Neutrophil-to-lymphocyte ratio

NPD:

Non-poorly differentiated

PD:

Poorly differentiated

PLR:

Platelet-to-lymphocyte ratio

ROC:

Receiver operating characteristic

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Acknowledgements

One of the authors (Zhi-Wei Shen) is an employee of Philips Healthcare. The remaining authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

This study was funded by the National Natural Science Fund of China (81901710); National Natural Science Fund of China (81873888). Science and Technology fund of Tianjin (QN20024). Science and Technology fund of Tianjin (TJWJ2021QN011).

Author information

Author notes

  1. Zhao-Xiang Ye and Wen Shen have contributed equally to this work and share corresponding Authorship.

Authors and Affiliations

  1. Department of Radiology, Tianjin First Central Hospital, funded by Tianjin Key Medical Discipline (Specialty) Construction Project, Tianjin Institute of imaging medicine, 24 Fukang Road, Nankai District, Tianjin, 300192, China

    Kun Zhang, Shuang-Shuang Xie & Wen Shen

  2. Department of Radiology, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China

    Wen-Cui Li & Zhao-Xiang Ye

  3. Tianjin’s Clinical Research Center for Cancer, Tianjin, 300060, China

    Wen-Cui Li & Zhao-Xiang Ye

  4. First Central Clinical College, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China

    Li-Ying Lin

  5. Philips Healthcare, Beijing, The world profit centre, No. 16 Tianze Road, Chaoyang Dustrict, Beijing, 100125, China

    Zhi-Wei Shen

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  1. Kun Zhang
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Correspondence to Zhao-Xiang Ye or Wen Shen.

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One of the authors (Zhi-Wei Shen) is an employee of Philips Healthcare. The remaining authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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This study was approved by the ethics committee of our hospital.

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Zhang, K., Li, WC., Xie, SS. et al. Preoperative determination of pathological grades of primary single HCC: development and validation of a scoring model. Abdom Radiol 47, 3468–3477 (2022). https://doi.org/10.1007/s00261-022-03606-1

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