MRI-based Risk Scoring System to Predict Early Recurrence after Resection of Solitary Hepatocellular Carcinoma 5 cm...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Existing MRI models for hepatocellular carcinoma (HCC) recurrence prediction often include large or multiple tumors, limiting their use for small, solitary HCC.
• Accurate prediction of early recurrence is crucial for managing patients with small solitary HCC after resection.

Purpose of the Study:

• To develop and validate an MRI-based Early Recurrence Individualized Score (MERIS) for predicting early recurrence in patients with solitary HCCs ≤ 5 cm.
• To compare MERIS performance against pathology-based models and established prognostic systems.

Main Methods:

• Retrospective analysis of 325 patients with solitary HCCs ≤ 5 cm undergoing curative resection.
• Multivariable Cox regression used to identify MRI features for MERIS training.
• MERIS performance evaluated using the c-index and compared with other models in training and external test sets.

Main Results:

• MERIS incorporates elevated AST, tumor size, nonsmooth margin, and peritumoral hypointensity.
• MERIS achieved high predictive performance (c-index 0.75) in both training and external test sets.
• MERIS demonstrated superior predictive accuracy compared to pathology-based and existing prognostic systems in the external test set.

Conclusions:

• MERIS is a robust tool for predicting early recurrence risk in patients with small solitary HCC after resection.
• The MERIS score offers improved prognostic capabilities over current methods for this specific HCC patient population.