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Published on: July 21, 2023
Preoperative MR elastography for characterizing aggressive vascular phenotypes in hepatocellular carcinoma
Huanhuan Chong1, Weiwei Rui2, Rong Deng3
1Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
European Journal of Radiology
|July 28, 2026
Summary
Preoperative MR elastography (MRE) can identify aggressive hepatocellular carcinoma (HCC) subtypes and predict early recurrence. MRE-derived mechanical biomarkers improve risk stratification for patients with HCC.
Area of Science:
- Hepatocellular Carcinoma (HCC) Research
- Medical Imaging and Diagnostics
- Tumor Biology and Progression
Background:
- Hepatocellular carcinoma (HCC) is a significant global health concern with variable clinical outcomes.
- Accurate preoperative assessment of tumor aggressiveness and recurrence risk is crucial for effective patient management.
- Existing methods for predicting HCC recurrence have limitations in differentiating aggressive tumor phenotypes.
Purpose of the Study:
- To evaluate the utility of preoperative magnetic resonance elastography (MRE) in differentiating aggressive hepatocellular carcinoma (HCC) subtypes.
- To assess the capability of MRE-derived mechanical biomarkers in predicting early tumor recurrence in HCC patients.
- To differentiate vessel-encapsulating tumor clusters (VETC), microvascular invasion (MVI), and macrotrabecular-massive (MTM) patterns using MRE.
Main Methods:
- Prospective study involving 220 HCC patients undergoing hepatectomy.
- Preoperative MRE was performed to quantify tissue stiffness and viscosity.
- Multivariate logistic regression analysis identified independent predictors of recurrence and aggressive tumor features, with performance evaluated using the area under the curve (AUC).
Main Results:
- MRE demonstrated significant predictive value for early recurrence (AUC = 0.834), identifying VETC, MTM, MVI, elevated liver stiffness, and peritumoral enhancement as key indicators.
- Tumor viscosity, male gender, elevated alpha-fetoprotein, and non-smooth margins were independent predictors of MTM.
- MRE identified distinct mechanical properties associated with VETC (stiffer tumors) and MVI (softer tumors, multifocality, incomplete capsule, non-smooth margins).
Conclusions:
- MRE-derived mechanical biomarkers are valuable tools for the risk stratification of aggressive HCC phenotypes.
- Preoperative MRE enhances the prediction of early tumor recurrence in patients with HCC.
- MRE provides insights into the underlying mechanical differences of aggressive HCC subtypes, aiding in clinical decision-making.
