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Hepatocellular carcinoma: preoperative gadoxetic acid–enhanced MR imaging can predict early recurrence after curative resection using image features and texture analysis

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Abstract

Purpose

To investigate whether pre-operative gadoxetic acid–enhanced MRI can predict early recurrence after curative resection of single HCC using image features and texture analysis.

Materials and methods

179 patients with single HCC and who underwent pre-operative MRI were included. Two reviewers analyzed MR findings, including the tumor margin, peritumoral enhancement, peritumoral hypointensity on the hepatobiliary phase (HBP), diffusion restriction, capsule, tumoral fat, washout, portal-vein thrombus, signal intensity on HBP, and satellite nodule. Texture analysis on the HBP was also quantified. A multivariate analysis was used to identify predictive factors for early recurrence, microvascular invasion (MVI), and the tumor grade.

Results

For early recurrence, satellite nodule, peritumoral hypointensity, absence of capsule, and GLCM ASM were predictors (P < 0.05). For MVI, satellite nodule, peritumoral hypointensity, washout, and sphericity were predictors (P < 0.05). Satellite nodules, peritumoral hypointensity, diffusion restriction, and iso to high signal intensity on HBP were predictor for higher tumor grade (P < 0.05). Satellite nodules and peritumoral hypointensity were important showed common predictors for early recurrence, MVI, and grade (P < 0.05). The sensitivity and specificity for satellite nodule were 47.36% and 96.25%. When added texture variables to MRI findings, the diagnostic performance for predicting early recurrence is improved from 0.7 (SD 0.604–0.790) to 0.83 (SD 0.787–0.894).

Conclusion

MR finding, including satellite nodule and peritumoral hypointensity on the HBP, as well as the texture parameters are useful to predict not only early recurrence, but also MVI and higher grade.

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Acknowledgments

We also thank Bonnie Hami, M.A. (USA) for her editorial assistance in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 101 Daehangno, Chongno-gu, Seoul, 110-744, Korea

    Su Joa Ahn, Jung Hoon Kim, Sang Joon Park, Seung Tack Kim & Joon Koo Han

  2. Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea

    Jung Hoon Kim & Joon Koo Han

Authors
  1. Su Joa Ahn
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  2. Jung Hoon Kim
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  3. Sang Joon Park
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Corresponding author

Correspondence to Jung Hoon Kim.

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Funding

No funding.

Conflict of interest

All authors confirm that no disclosure of potential conflicts of interest.

Ethical approval

This retrospective study was approved by our institutional review board, and the requirement to obtain written, informed consent was waived.

Appendix

Appendix

See Table 5.

Table 5 MR imaging parameters
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Ahn, S.J., Kim, J.H., Park, S.J. et al. Hepatocellular carcinoma: preoperative gadoxetic acid–enhanced MR imaging can predict early recurrence after curative resection using image features and texture analysis. Abdom Radiol 44, 539–548 (2019). https://doi.org/10.1007/s00261-018-1768-9

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  • DOI: https://doi.org/10.1007/s00261-018-1768-9

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