Prediction of microvascular invasion in hepatocellular carcinoma with conventional ultrasound, Sonazoid-enhanced ultrasound, and biochemical indicator: a multicenter study

作者：Dan Lu, Lifan Wang, Hong Han, Linlin Li, Wentao Kong, Qian Zhou, Boyang Zhou, Yi-Kang Sun, Haohao Yin, Ming-Rui Zhu, Xinyuan Hu, Qing Lü, Han-Sheng Xia, X. L. Wang, Chong‐Ke Zhao, Jianhua Zhou, Hui‐Xiong Xu · 发表于：Insights into Imaging · 年份：2024 · DOI：10.1186/s13244-024-01743-3 · 被引用次数：4 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Ultrasound and Hyperthermia Applications、Colorectal Cancer Surgical Treatments

PURPOSE: To develop and validate a preoperative prediction model based on multimodal ultrasound and biochemical indicator for identifying microvascular invasion (MVI) in patients with a single hepatocellular carcinoma (HCC) ≤ 5 cm. METHODS: From May 2022 to November 2023, a total of 318 patients with pathologically confirmed single HCC ≤ 5 cm from three institutions were enrolled. All of them underwent preoperative biochemical, conventional ultrasound (US), and contrast-enhanced ultrasound (CEUS) (Sonazoid, 0.6 mL, bolus injection) examinations. Univariate and multivariate logistic regression analyses on clinical information, biochemical indicator, and US imaging features were performed in the training set to seek independent predictors for MVI-positive. The models were constructed and evaluated using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis in both validation and test sets. Subgroup analyses in patients with different liver background and tumor sizes were conducted to further investigate the model's performance. RESULTS: Logistic regression analyses showed that obscure tumor boundary in B-mode US, intra-tumoral artery in pulsed-wave Doppler US, complete Kupffer-phase agent clearance in Sonazoid-CEUS, and biomedical indicator PIVKA-II were independently correlated with MVI-positive. The combined model comprising all predictors showed the highest AUC, which were 0.937 and 0.893 in the validation and test s...