Skip to main content

Advertisement

SpringerLink
Log in

Prediction of macrotrabecular-massive hepatocellular carcinoma by using MR-based models and their prognostic implications

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the efficacy of MRI-based radiomics and clinical models in predicting MTM-HCC. Additionally, to investigate the ability of the radiomics model designed for MTM-HCC identification in predicting disease-free survival (DFS) in patients with HCC.

Methods

A total of 336 patients who underwent oncological resection for HCC between June 2007 and March 2021 were included. 127 patients in Cohort1 were used for MTM-HCC identification, and 209 patients in Cohort2 for prognostic analyses. Radiomics analysis was performed using volumes of interest of HCC delineated on pre-operative MRI images. Radiomics and clinical models were developed using Random Forest algorithm in Cohort1 and a radiomics probability (RP) of MTM-HCC was obtained from the radiomics model. Based on the RP, patients in Cohort2 were divided into a RAD-MTM-HCC (RAD-M) group and a RAD-non-MTM-HCC (RAD-nM) group. Univariate and multivariate Cox regression analyses were employed to identify the independent predictors for DFS of patients in Cohort2. Kaplan–Meier curves were used to compare the DFS between different groups pf patients based on the predictors.

Results

The radiomics model for identifying MTM-HCC showed AUCs of 0.916 (95% CI: 0.858–0.960) and 0.833 (95% CI: 0.675–0.935), and the clinical model showed AUCs of 0.760 (95% CI: 0.669–0.836) and 0.704 (95% CI: 0.532–0.843) in the respective training and validation sets. Furthermore, the radiomics biomarker RP, portal or hepatic vein tumor thrombus, irregular rim-like arterial phase hyperenhancement (IRE) and AFP were independent predictors of DFS in patients with HCC. The DFS of RAD-nM group was significantly higher than that of the RAD-M group (p < .001).

Conclusion

MR-based clinical and radiomic models have the potential to accurately diagnose MTM-HCC. Moreover, the radiomics signature designed to identify MTM-HCC also can be used to predict prognosis in patients with HCC, realizing the diagnostic and prognostic aims at the same time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Abbreviations

HCC:

Hepatocellular carcinoma

MTM-HCC:

Macrotrabecular-massive hepatocellular carcinoma

DFS:

Disease-free survival

IRE:

Irregular rim-like arterial phase hyperenhancement

WHO:

World health organization

AFP:

Alpha-fetoprotein

RFA:

Radiofrequency ablation

TACE:

Transarterial chemoembolization

VOI:

Volume of interest

AP:

Arterial phase

PVP:

Portal venous phase

ICC:

Inter/intra-observer coefficients

LASSO:

Least absolute shrinkage and selection operator

RF:

Random forest

RP:

Radiomics probability

References

  1. Torbenson MS, Ng IOL, Park YN, Roncalli M, Sakamato M (2019) Hepatocellular carcinoma. WHO Classification of Tumours: Digestive System Tumour 229-239

  2. Ziol M, Poté N, Amaddeo G et al (2018) Macrotrabecular-massive hepatocellular carcinoma: A distinctive histological subtype with clinical relevance. Hepatology 68:103-112

    Article  PubMed  Google Scholar 

  3. Boyault S, Rickman DS, de Reyniès A et al (2007) Transcriptome classification of HCC is related to gene alterations and to new therapeutic targets. Hepatology 45:42-52

    Article  CAS  PubMed  Google Scholar 

  4. Calderaro J, Couchy G, Imbeaud S et al (2017) Histological subtypes of hepatocellular carcinoma are related to gene mutations and molecular tumour classification. J Hepatol 67:727-738

    Article  CAS  PubMed  Google Scholar 

  5. Aggarwal A, Te HS, Verna EC, Desai AP (2021) A National Survey of Hepatocellular Carcinoma Surveillance Practices Following Liver Transplantation. Transplant Direct 7:e638

    Article  PubMed  Google Scholar 

  6. Lee S, Kang TW, Song KD et al (2021) Effect of Microvascular Invasion Risk on Early Recurrence of Hepatocellular Carcinoma After Surgery and Radiofrequency Ablation. Ann Surg 273:564-571

    Article  PubMed  Google Scholar 

  7. Zhang EL, Cheng Q, Huang ZY, Dong W (2021) Revisiting Surgical Strategies for Hepatocellular Carcinoma With Microvascular Invasion. Front Oncol 11:691354

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Liu LL, Zhang SW, Chao X et al (2021) Coexpression of CMTM6 and PD-L1 as a predictor of poor prognosis in macrotrabecular-massive hepatocellular carcinoma. Cancer Immunol Immunother 70:417-429

    Article  CAS  PubMed  Google Scholar 

  9. Sherman M, Bruix J (2015) Biopsy for liver cancer: how to balance research needs with evidence-based clinical practice. Hepatology 61:433-436

    Article  PubMed  Google Scholar 

  10. Department of Medical Administration, National Health and Health Commission of the People’s Republic of China (2020) [Guidelines for diagnosis and treatment of primary liver cancer in China (2019 edition)]. Zhonghua Gan Zang Bing Za Zhi 28:112–128

  11. European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer (2012) EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 56:908–943

  12. Heimbach JK, Kulik LM, Finn RS et al (2018) AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology 67:358-380

    Article  PubMed  Google Scholar 

  13. Feng Z, Li H, Zhao H et al (2021) Preoperative CT for Characterization of Aggressive Macrotrabecular-Massive Subtype and Vessels That Encapsulate Tumor Clusters Pattern in Hepatocellular Carcinoma. Radiology 300:219-229

    Article  PubMed  Google Scholar 

  14. Rhee H, An C, Kim HY, Yoo JE, Park YN, Kim MJ (2019) Hepatocellular Carcinoma with Irregular Rim-Like Arterial Phase Hyperenhancement: More Aggressive Pathologic Features. Liver Cancer 8:24-40

    Article  CAS  PubMed  Google Scholar 

  15. Rhee H, Cho ES, Nahm JH et al (2021) Gadoxetic acid-enhanced MRI of macrotrabecular-massive hepatocellular carcinoma and its prognostic implications. J Hepatol 74:109-121

    Article  CAS  PubMed  Google Scholar 

  16. Zhu Y, Weng S, Li Y et al (2021) A radiomics nomogram based on contrast-enhanced MRI for preoperative prediction of macrotrabecular-massive hepatocellular carcinoma. Abdom Radiol (NY) 46:3139-3148

    Article  PubMed  Google Scholar 

  17. Cannella R, Dioguardi Burgio M, Beaufrère A et al (2021) Imaging features of histological subtypes of hepatocellular carcinoma: Implication for LI-RADS. JHEP Rep 3:100380

    Article  PubMed  PubMed Central  Google Scholar 

  18. Yang L, Wang M, Zhu Y et al (2023) Corona enhancement combined with microvascular invasion for prognosis prediction of macrotrabecular-massive hepatocellular carcinoma subtype. Front Oncol 13:1138848

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Gong Q, Zhang Y, Wu T, Du Z, Zhang Y (2023) Comparison of computed tomography and magnetic resonance imaging findings and histopathological features of macrotrabecular-massive hepatocellular carcinoma. Quant Imaging Med Surg 13:4633-4640

    Article  PubMed  PubMed Central  Google Scholar 

  20. Zhang Y, He D, Liu J, Wei YG, Shi LL (2023) Preoperative prediction of macrotrabecular-massive hepatocellular carcinoma through dynamic contrast-enhanced magnetic resonance imaging-based radiomics. World J Gastroenterol 29:2001-2014

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Bilal Masokano I, Pei Y, Chen J et al (2022) Development and validation of MRI-based model for the preoperative prediction of macrotrabecular hepatocellular carcinoma subtype. Insights Imaging 13:201

    Article  PubMed  PubMed Central  Google Scholar 

  22. Hu S, Kang Y, Xie Y et al (2023) (18)F-FDG PET/CT-based radiomics nomogram for preoperative prediction of macrotrabecular-massive hepatocellular carcinoma: a two-center study. Abdom Radiol (NY) 48:532-542

    Article  PubMed  Google Scholar 

  23. Wei J, Jiang H, Zeng M et al (2021) Prediction of Microvascular Invasion in Hepatocellular Carcinoma via Deep Learning: A Multi-Center and Prospective Validation Study. Cancers (Basel) 13

    Article  PubMed  Google Scholar 

  24. Guarino M, Cucchetti A, Pontillo G et al (2021) Pattern of macrovascular invasion in hepatocellular carcinoma. Eur J Clin Invest 51:e13542

    Article  PubMed  Google Scholar 

  25. Yang T, Lu JH, Lau WY et al (2016) Perioperative blood transfusion does not influence recurrence-free and overall survivals after curative resection for hepatocellular carcinoma: A Propensity Score Matching Analysis. J Hepatol 64:583-593

    Article  PubMed  Google Scholar 

  26. van Griethuysen JJM, Fedorov A, Parmar C et al (2017) Computational Radiomics System to Decode the Radiographic Phenotype. Cancer Res 77:e104-e107

    Article  PubMed  PubMed Central  Google Scholar 

  27. Huang W, Jiang Y, Xiong W et al (2022) Noninvasive imaging of the tumor immune microenvironment correlates with response to immunotherapy in gastric cancer. Nat Commun 13:5095

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Fang JH, Zhou HC, Zhang C et al (2015) A novel vascular pattern promotes metastasis of hepatocellular carcinoma in an epithelial-mesenchymal transition-independent manner. Hepatology 62:452-465

    Article  CAS  PubMed  Google Scholar 

  29. Kawamura Y, Ikeda K, Seko Y et al (2011) Heterogeneous type 4 enhancement of hepatocellular carcinoma on dynamic CT is associated with tumor recurrence after radiofrequency ablation. AJR Am J Roentgenol 197:W665-673

    Article  PubMed  Google Scholar 

  30. An C, Kim DW, Park YN, Chung YE, Rhee H, Kim MJ (2015) Single Hepatocellular Carcinoma: Preoperative MR Imaging to Predict Early Recurrence after Curative Resection. Radiology 276:433-443

    Article  PubMed  Google Scholar 

  31. Kierans AS, Leonardou P, Hayashi P et al (2010) MRI findings of rapidly progressive hepatocellular carcinoma. Magn Reson Imaging 28:790-796

    Article  PubMed  Google Scholar 

  32. Mulé S, Galletto Pregliasco A, Tenenhaus A et al (2020) Multiphase Liver MRI for Identifying the Macrotrabecular-Massive Subtype of Hepatocellular Carcinoma. Radiology 295:562-571

    Article  PubMed  Google Scholar 

  33. Fraum TJ, Tsai R, Rohe E et al (2018) Differentiation of Hepatocellular Carcinoma from Other Hepatic Malignancies in Patients at Risk: Diagnostic Performance of the Liver Imaging Reporting and Data System Version 2014. Radiology 286:158-172

    Article  PubMed  Google Scholar 

Download references

Funding

No funds, grants, or other support was received.

Author information

Author notes

  1. Fan Chai and Yingteng Ma have contributed equally as co-first authors.

Authors and Affiliations

  1. Department of Radiology, Peking University People’s Hospital, 11 Xizhimen South St., Xicheng District, Beijing, 100044, China

    Fan Chai, Caizhen Feng, Xiaoxuan Jia, Jin Cheng, Nan Hong & Yi Wang

  2. Department of Pathology, Peking University People’s Hospital, Beijing, China

    Yingteng Ma

  3. United Imaging Intelligence (Beijing) Co., Ltd, Beijing, China

    Jingjing Cui

Authors
  1. Fan Chai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yingteng Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Caizhen Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiaoxuan Jia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jingjing Cui
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jin Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nan Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yi Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by FC, YM, CF, XJ and JC. The first draft of the manuscript was written by FC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yi Wang.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This retrospective cohort study was approved by the Institutional Review Board of Peking University People’s Hospital.

Informed consent

The requirement for written informed consent was waived.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 469 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chai, F., Ma, Y., Feng, C. et al. Prediction of macrotrabecular-massive hepatocellular carcinoma by using MR-based models and their prognostic implications. Abdom Radiol 49, 447–457 (2024). https://doi.org/10.1007/s00261-023-04121-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-023-04121-7

Keywords

Search

Navigation