Dynamic contrast-enhanced ultrasound perfusion analysis for preoperative prediction of aggressive hepatocellular
Xin Guan1, Xiao Li2,3, Daohui Yang1
1Department of Ultrasound, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China.
Objective:
To evaluate the potential of dynamic contrast-enhanced ultrasound (CEUS) quantitative parameters in preoperative prediction of macrotrabecular-massive (MTM) subtype and high Ki-67 pattern in hepatocellular carcinoma (HCC) patients.
Materials And Methods:
This study included a retrospective primary cohort and a multicenter prospective validation cohort comprising HCC patients who underwent surgical resection and preoperative CEUS between January 2023 and April 2024. The Clinic-CEUS model was established by combining clinical data and CEUS features, while the Clinic-Q-CEUS model was constructed by combining clinical data and CEUS features with matched quantitative parameters. Model performance was tested with the area under the receiver operating characteristic curve (AUC) in the validation cohort.
Results:
A total of 170 patients (mean age, 61 years ± 11 [SD]; 130 men; primary cohort, n = 118; validation cohort, n = 52) were included. The Clinic-Q-CEUS model better predicted MTM subtype and high Ki-67 pattern than the Clinic-CEUS model (AUC, 0.860 vs. 0.753, p = 0.027 and AUC, 0.836 vs. 0.738, p = 0.036) in the primary cohort, with similar performance in the validation cohort (AUC, 0.868 vs. 0.693, p = 0.046 and AUC, 0.787 vs. 0.610, p = 0.018).
Conclusions:
Dynamic CEUS quantification analysis could be used as an effective adjunct tool for preoperative identification of MTM subtype and high Ki-67 pattern in HCC patients.
Critical Relevance Statement:
Dynamic contrast-enhanced ultrasound (CEUS) quantitative parameters can help radiologists more accurately identify aggressive macrotrabecular-massive (MTM) subtype and high Ki-67 pattern in HCC patients preoperatively, which provides useful information for subsequent treatment planning.
Key Points:
Macrotrabecular-massive (MTM) subtype and high Ki-67 pattern in HCC affect prognosis, but diagnosis relies on invasive histopathology. A clinical-Q-CEUS model performed well in preoperative predicting aggressive HCC subtypes. Quantitative parameters of dynamic CEUS can provide valuable information to help accurately identify aggressive HCC subtypes.
