Diagnostic Model for Proliferative HCC Using LI‐RADS : Assessing Therapeutic Outcomes in Hepatectomy and TKI‐ICI Combination

作者：Mengtian Lu, Zuyi Yan, Qi Qu, Guodong Zhu, Lei Xu, Maotong Liu, Jifeng Jiang, Chunyan Gu, Ying Chen, Tao Zhang, Xueqin Zhang · 发表于：Journal of Magnetic Resonance Imaging · 年份：2024 · DOI：10.1002/jmri.29400 · 被引用次数：10 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Radiomics and Machine Learning in Medical Imaging、Cholangiocarcinoma and Gallbladder Cancer Studies

BACKGROUND: Proliferative hepatocellular carcinoma (HCC), aggressive with poor prognosis, and lacks reliable MRI diagnosis. PURPOSE: To develop a diagnostic model for proliferative HCC using liver imaging reporting and data system (LI-RADS) and assess its prognostic value. STUDY TYPE: Retrospective. POPULATION: 241 HCC patients underwent hepatectomy (90 proliferative HCCs: 151 nonproliferative HCCs), divided into the training (N = 167) and validation (N = 74) sets. 57 HCC patients received combination therapy with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs). FIELD STRENGTH/SEQUENCE: 3.0 T, T1- and T2-weighted, diffusion-weighted, in- and out-phase, T1 high resolution isotropic volume excitation and dynamic gadoxetic acid-enhanced imaging. ASSESSMENT: LI-RADS v2018 and other MRI features (intratumoral artery, substantial hypoenhancing component, hepatobiliary phase peritumoral hypointensity, and irregular tumor margin) were assessed. A diagnostic model for proliferative HCC was established, stratifying patients into high- and low-risk groups. Follow-up occurred every 3-6 months, and recurrence-free survival (RFS), progression-free survival (PFS) and overall survival (OS) in different groups were compared. STATISTICAL TESTS: Fisher's test or chi-square test, t-test or Mann-Whitney test, logistic regression, Harrell's concordance index (C-index), Kaplan-Meier curves, and Cox proportional hazards. Significance level: P < 0.05. RESULTS: The diagnostic...