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Comparison of non-radiomics imaging features and radiomics models based on contrast-enhanced ultrasound and Gd-EOB-DTPA-enhanced MRI for predicting microvascular invasion in hepatocellular carcinoma within 5 cm

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A Commentary to this article was published on 30 June 2023

Abstract

Objectives

The purpose of this study is to establish microvascular invasion (MVI) prediction models based on preoperative contrast-enhanced ultrasound (CEUS) and ethoxybenzyl-enhanced magnetic resonance imaging (EOB-MRI) in patients with a single hepatocellular carcinoma (HCC) ≤ 5 cm.

Methods

Patients with a single HCC ≤ 5 cm and accepting CEUS and EOB-MRI before surgery were enrolled in this study. Totally, 85 patients were randomly divided into the training and validation cohorts in a ratio of 7:3. Non-radiomics imaging features, the CEUS and EOB-MRI radiomics scores were extracted from the arterial phase, portal phase and delayed phase images of CEUS and the hepatobiliary phase images of EOB-MRI. Different MVI predicting models based on CEUS and EOB-MRI were constructed and their predictive values were evaluated.

Results

Since univariate analysis revealed that arterial peritumoral enhancement on the CEUS image, CEUS radiomics score, and EOB-MRI radiomics score were significantly associated with MVI, three prediction models, namely the CEUS model, the EOB-MRI model, and the CEUS-EOB model, were developed. In the validation cohort, the areas under the receiver operating characteristic curve of the CEUS model, the EOB-MRI model, and the CEUS-EOB model were 0.73, 0.79, and 0.86, respectively.

Conclusions

Radiomics scores based on CEUS and EOB-MRI, combined with arterial peritumoral enhancement on CEUS, show a satisfying performance of MVI predicting. There was no significant difference in the efficacy of MVI risk evaluation between radiomics models based on CEUS and EOB-MRI in patients with a single HCC ≤ 5 cm.

Clinical relevance statement

Radiomics models based on CEUS and EOB-MRI are effective for MVI predicting and conducive to pretreatment decision-making in patients with a single HCC within 5 cm.

Key Points

• Radiomics scores based on CEUS and EOB-MRI, combined with arterial peritumoral enhancement on CEUS, show a satisfying performance of MVI predicting.

• There was no significant difference in the efficacy of MVI risk evaluation between radiomics models based on CEUS and EOB-MRI in patients with a single HCC ≤ 5 cm.

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Abbreviations

AFP:

Alpha-fetoprotein

AP:

Arterial phase

AUROC:

Area under the receiver operating characteristic curve

CEUS:

Contrast-enhanced ultrasound

DP:

Delayed phase

EOB-MRI:

Ethoxybenzyl-enhanced magnetic resonance imaging

Gd-EOB-DTPA:

Gadolinium ethoxybenzyl diethylene-triaminepentaacetic acid

HBP:

Hepatobiliary phase

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

MVI:

Microvascular invasion

NPV:

Negative predictive value

PP:

Portal phase

PPV:

Positive predictive value

Sen:

Sensitivity

Spe:

Specificity

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Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 92059201).

Author information

Author notes

  1. Ruiying Zheng and Xiaoer Zhang are co-first authors and contributed equally.

Authors and Affiliations

  1. Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

    Ruiying Zheng, Xiaoer Zhang, Baoxian Liu, Yi Zhang, Hui Shen, Xiaoyan Xie & Guangliang Huang

  2. Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

    Shurong Li

  3. Department of Medical Ultrasonics, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangxi, China

    Guangliang Huang

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  1. Ruiying Zheng
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Correspondence to Shurong Li or Guangliang Huang.

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The scientific guarantor of this publication is Guangliang Huang.

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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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Zheng, R., Zhang, X., Liu, B. et al. Comparison of non-radiomics imaging features and radiomics models based on contrast-enhanced ultrasound and Gd-EOB-DTPA-enhanced MRI for predicting microvascular invasion in hepatocellular carcinoma within 5 cm. Eur Radiol 33, 6462–6472 (2023). https://doi.org/10.1007/s00330-023-09789-5

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