一种强调薄缘 APHE 的改良 Targetoid 特征可提高 LI-RADS 对恶性肝肿瘤的诊断性能

IF 4.2 3区 医学 Q2 ONCOLOGY Journal of Hepatocellular Carcinoma Pub Date : 2024-04-26 DOI:10.2147/jhc.s448257
Runqian Huang, Chunling Zheng, Guixiao Xu, Xuanwei Chen, Jingxian Shen, Siyue Mao
{"title":"一种强调薄缘 APHE 的改良 Targetoid 特征可提高 LI-RADS 对恶性肝肿瘤的诊断性能","authors":"Runqian Huang, Chunling Zheng, Guixiao Xu, Xuanwei Chen, Jingxian Shen, Siyue Mao","doi":"10.2147/jhc.s448257","DOIUrl":null,"url":null,"abstract":"<strong>Objective:</strong> To identify imaging features that help distinguish between HCCs and non-HCC malignancies assigned to LI-RADS M (LR-M) and evaluate the diagnostic performance of a LI-RADS with targetoid criteria using thin-rim arterial phase hyperenhancement (APHE).<br/><strong>Materials and Methods:</strong> This retrospective study included 381 patients (387 observations) at high-risk for HCC who underwent enhanced-MRI before surgery. Three radiologists reviewed images for LI-RADS categorization of hepatic observations. Univariate and multivariate analysis was conducted to determine reliable features to differentiate between HCC and non-HCC malignancies among the LR-M lesions. The thin-rim (&lt; 30%) APHE was defined based on the thickest thickness of rim APHE compared with the tumor radius, and a modified LI-RADS emphasizing thin-rim APHE as a specific feature of LR-M was established. We compared the diagnostic performance of modified LR-M and LI-RADS 5 (LR-5) with the conventional one.<br/><strong>Results:</strong> Thin-rim APHE and targetoid diffusion-weighted imaging (DWI) were found as independent predictive factors of non-HCC malignancies, while enhancing capsule, thick-rim APHE and peripheral washout were noted as independent variables significantly associated with HCC of LR-M (<em>P</em>&lt; 0.05). The noticeable diagnostic performance of thin-rim APHE in distinguishing non-HCC malignancies from HCCs using the ROC curve. Emphasizing thin-rim APHE on targetoid features, the modified LR-M revealed significantly superior specificity and accuracy (89.4% vs 81.1%, <em>P</em>=0.004; and 87.9% vs 82.2%, <em>P</em>=0.027, respectively) while maintaining high sensitivity (82.2% vs 86.0%; <em>P</em>=0.529) compared with the LR-M. Meanwhile, the modified LR-5 achieved greater sensitivity and accuracy (88.6% vs 79.7%, <em>P</em>=0.004; and 85.8% vs 80.1%, <em>P</em>=0.036, respectively) for diagnosing HCC, without compromising specificity (78.3% vs.81.1%; <em>P</em>=0.608) compared with the LR-5.<br/><strong>Conclusion:</strong> Thin-rim APHE may be the specific imaging feature for differentiating non-HCC malignancies from HCCs within LR-M. The modified targetoid criteria emphasizing thin-rim APHE can improve the diagnostic performance of LI-RADS for hepatic malignancies.<br/><br/><strong>Keywords:</strong> hepatic tumors, malignant, targetoid feature, Rim APHE, liver imaging reporting and data system<br/>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":null,"pages":null},"PeriodicalIF":4.2000,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Modified Targetoid Feature Emphasizing Thin-Rim APHE to Improve the Diagnostic Performance of LI-RADS for Malignant Hepatic Tumors\",\"authors\":\"Runqian Huang, Chunling Zheng, Guixiao Xu, Xuanwei Chen, Jingxian Shen, Siyue Mao\",\"doi\":\"10.2147/jhc.s448257\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<strong>Objective:</strong> To identify imaging features that help distinguish between HCCs and non-HCC malignancies assigned to LI-RADS M (LR-M) and evaluate the diagnostic performance of a LI-RADS with targetoid criteria using thin-rim arterial phase hyperenhancement (APHE).<br/><strong>Materials and Methods:</strong> This retrospective study included 381 patients (387 observations) at high-risk for HCC who underwent enhanced-MRI before surgery. Three radiologists reviewed images for LI-RADS categorization of hepatic observations. Univariate and multivariate analysis was conducted to determine reliable features to differentiate between HCC and non-HCC malignancies among the LR-M lesions. The thin-rim (&lt; 30%) APHE was defined based on the thickest thickness of rim APHE compared with the tumor radius, and a modified LI-RADS emphasizing thin-rim APHE as a specific feature of LR-M was established. We compared the diagnostic performance of modified LR-M and LI-RADS 5 (LR-5) with the conventional one.<br/><strong>Results:</strong> Thin-rim APHE and targetoid diffusion-weighted imaging (DWI) were found as independent predictive factors of non-HCC malignancies, while enhancing capsule, thick-rim APHE and peripheral washout were noted as independent variables significantly associated with HCC of LR-M (<em>P</em>&lt; 0.05). The noticeable diagnostic performance of thin-rim APHE in distinguishing non-HCC malignancies from HCCs using the ROC curve. Emphasizing thin-rim APHE on targetoid features, the modified LR-M revealed significantly superior specificity and accuracy (89.4% vs 81.1%, <em>P</em>=0.004; and 87.9% vs 82.2%, <em>P</em>=0.027, respectively) while maintaining high sensitivity (82.2% vs 86.0%; <em>P</em>=0.529) compared with the LR-M. Meanwhile, the modified LR-5 achieved greater sensitivity and accuracy (88.6% vs 79.7%, <em>P</em>=0.004; and 85.8% vs 80.1%, <em>P</em>=0.036, respectively) for diagnosing HCC, without compromising specificity (78.3% vs.81.1%; <em>P</em>=0.608) compared with the LR-5.<br/><strong>Conclusion:</strong> Thin-rim APHE may be the specific imaging feature for differentiating non-HCC malignancies from HCCs within LR-M. The modified targetoid criteria emphasizing thin-rim APHE can improve the diagnostic performance of LI-RADS for hepatic malignancies.<br/><br/><strong>Keywords:</strong> hepatic tumors, malignant, targetoid feature, Rim APHE, liver imaging reporting and data system<br/>\",\"PeriodicalId\":15906,\"journal\":{\"name\":\"Journal of Hepatocellular Carcinoma\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2024-04-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hepatocellular Carcinoma\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/jhc.s448257\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepatocellular Carcinoma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/jhc.s448257","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的确定有助于区分HCC和被归入LI-RADS M(LR-M)的非HCC恶性肿瘤的成像特征,并评估使用薄缘动脉相增强(APHE)的LI-RADS的诊断性能:这项回顾性研究纳入了 381 例(观察 387 例)HCC 高危患者,他们都在手术前接受了增强型 MRI 检查。三名放射科医生对图像进行了审查,以便对肝脏观察结果进行 LI-RADS 分类。我们进行了单变量和多变量分析,以确定在 LR-M 病变中区分 HCC 和非 HCC 恶性肿瘤的可靠特征。根据APHE边缘与肿瘤半径相比的最厚厚度定义了薄边缘(< 30% )APHE,并建立了强调薄边缘APHE作为LR-M特异特征的改良LI-RADS。我们比较了改良 LR-M 和 LI-RADS 5(LR-5)与传统 LR-M 的诊断性能:结果:发现薄缘 APHE 和靶状弥散加权成像(DWI)是非 HCC 恶性肿瘤的独立预测因素,而增强囊、厚缘 APHE 和外周冲洗是与 LR-M HCC 显著相关的独立变量(P< 0.05)。利用 ROC 曲线,薄缘 APHE 在区分非 HCC 恶性肿瘤和 HCC 方面具有明显的诊断性能。与 LR-M 相比,强调薄层 APHE 靶状特征的改良 LR-M 在保持高灵敏度(82.2% vs 86.0%;P=0.529)的同时,特异性和准确性也明显优于 LR-M(分别为 89.4% vs 81.1%,P=0.004;87.9% vs 82.2%,P=0.027)。同时,与 LR-5 相比,改良 LR-5 诊断 HCC 的灵敏度和准确性更高(分别为 88.6% vs 79.7%,P=0.004;85.8% vs 80.1%,P=0.036),而特异性(78.3% vs 81.1%;P=0.608)却没有降低:薄缘 APHE 可能是 LR-M 鉴别非 HCC 恶性肿瘤和 HCC 的特异性成像特征。关键词:肝脏肿瘤;恶性;类靶组织特征;Rim APHE;肝脏成像报告和数据系统
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
A Modified Targetoid Feature Emphasizing Thin-Rim APHE to Improve the Diagnostic Performance of LI-RADS for Malignant Hepatic Tumors
Objective: To identify imaging features that help distinguish between HCCs and non-HCC malignancies assigned to LI-RADS M (LR-M) and evaluate the diagnostic performance of a LI-RADS with targetoid criteria using thin-rim arterial phase hyperenhancement (APHE).
Materials and Methods: This retrospective study included 381 patients (387 observations) at high-risk for HCC who underwent enhanced-MRI before surgery. Three radiologists reviewed images for LI-RADS categorization of hepatic observations. Univariate and multivariate analysis was conducted to determine reliable features to differentiate between HCC and non-HCC malignancies among the LR-M lesions. The thin-rim (< 30%) APHE was defined based on the thickest thickness of rim APHE compared with the tumor radius, and a modified LI-RADS emphasizing thin-rim APHE as a specific feature of LR-M was established. We compared the diagnostic performance of modified LR-M and LI-RADS 5 (LR-5) with the conventional one.
Results: Thin-rim APHE and targetoid diffusion-weighted imaging (DWI) were found as independent predictive factors of non-HCC malignancies, while enhancing capsule, thick-rim APHE and peripheral washout were noted as independent variables significantly associated with HCC of LR-M (P< 0.05). The noticeable diagnostic performance of thin-rim APHE in distinguishing non-HCC malignancies from HCCs using the ROC curve. Emphasizing thin-rim APHE on targetoid features, the modified LR-M revealed significantly superior specificity and accuracy (89.4% vs 81.1%, P=0.004; and 87.9% vs 82.2%, P=0.027, respectively) while maintaining high sensitivity (82.2% vs 86.0%; P=0.529) compared with the LR-M. Meanwhile, the modified LR-5 achieved greater sensitivity and accuracy (88.6% vs 79.7%, P=0.004; and 85.8% vs 80.1%, P=0.036, respectively) for diagnosing HCC, without compromising specificity (78.3% vs.81.1%; P=0.608) compared with the LR-5.
Conclusion: Thin-rim APHE may be the specific imaging feature for differentiating non-HCC malignancies from HCCs within LR-M. The modified targetoid criteria emphasizing thin-rim APHE can improve the diagnostic performance of LI-RADS for hepatic malignancies.

Keywords: hepatic tumors, malignant, targetoid feature, Rim APHE, liver imaging reporting and data system
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
0.50
自引率
2.40%
发文量
108
审稿时长
16 weeks
期刊最新文献
Predicting Pathological Response of Neoadjuvant Conversion Therapy for Hepatocellular Carcinoma Patients Using CT-Based Radiomics Model. Circulating Biomarkers Predict Immunotherapeutic Response in Hepatocellular Carcinoma Using a Machine Learning Method. Long-Term Outcomes of Patients with Liver Cirrhosis After Eradication of Chronic Hepatitis C with Direct-Acting Antiviral Drugs (DAAs). A Comparative Study of Surgical Approaches for Hepatocellular Carcinoma: Conversion versus Direct Resection. FOLFOX-Based Hepatic Arterial Infusion Chemotherapy with Sequential Drug-Eluting Bead Transarterial Chemoembolization for Unresectable Large Hepatocellular Carcinoma: A Single-Center Retrospective Cohort Study.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1