LI-RADS CT and MRI Major Feature Association with Vessels Encapsulating Tumor Clusters Pattern and Recurrence in
Miaomiao Wang1, Yinzhong Wang2, Liang Cao2
1The First Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, China; Department of Radiology, The First Hospital of Lanzhou University, Lanzhou City, Gansu Province, China.
Purpose:
This study aimed to assess the relationship of the Liver Imaging Reporting and Data System (LI-RADS) major feature with vessels encapsulating tumor clusters (VETC) pattern and recurrence in hepatocellular carcinoma (HCC).
Methods:
Patients with HCC who underwent hepatectomy between January 2016 and August 2024 were included and underwent enhanced magnetic resonance imaging or computed tomography. The study assessed LI-RADS major features and clinicopathological characteristics. Logistic regression was used to screen variables associated with the VETC pattern and construct predictive models. Diagnostic performance was assessed by the area under the curve (AUC). Risk factors associated with recurrence-free survival (RFS) were identified by Cox regression, and recurrence curves were plotted by the Kaplan-Meier method.
Results:
A total of 290 patients with HCC were included. Multivariate analysis revealed that maximal diameter (odds ratio [OR], 1.15; 95% CI, 1.04-1.28; P =.007), nonperipheral washout (OR, 2.22; 95% CI, 1.14-4.33; P =.02), and enhancing capsule (OR, 1.84; 95% CI, 1.08-3.13; P =.02) were associated with VETC-positive HCC, based on which the LI-RADS model was constructed, with sensitivity, specificity, and AUC of 82.2%, 46.6%, and 0.67 (0.62-0.73), respectively. In contrast, the inclusion of clinical characteristics (aspartate transaminase and hepatitis C) constituted a hybrid model with sensitivity, specificity, and AUC of 74.1%, 62.1%, and 0.72 (0.66-0.77), respectively. Cox regression demonstrated that TNM stage (hazard ratio [HR], 2.09; 95% CI, 1.07-4.09; P =.03) and VETC pattern (HR, 2.45; 95% CI, 1.39-4.32; P =.002) were risk factors for RFS, and the VETC pattern had a higher risk of recurrence.
Conclusion:
A model based on major features of LI-RADS may provide some support for the initial clinical assessment of VETC-positive HCC, and VETC patterns are associated with an increased risk of postoperative recurrence of HCC. However, this needs to be supported by more studies.
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