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Updated: Aug 5, 2026
A Three-Dimensional Digital Model for Early Diagnosis of Hepatic Fibrosis Based on Magnetic Resonance Elastography
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.
Objective:
To differentiate vessel-encapsulating tumor clusters (VETC), microvascular invasion (MVI), macrotrabecular-massive (MTM), and early recurrence using preoperative MR elastography (MRE) in hepatocellular carcinoma (HCC).
Methods:
220 HCC patients scheduled for hepatectomy were prospectively recruited, with preoperative MRE quantifying tissue stiffness and viscosity. Multivariate logistic regression identified independent predictors, evaluated by an area under the curve (AUC).
Results:
78 of 220 patients encountered postoperative 2-year relapse. VETC (odds ratio [OR] 2.320, p = 0.046), MTM (OR 2.573, p = 0.024), MVI (OR 2.613, p = 0.035), elevated liver stiffness (OR 3.257, p = 0.015), carbohydrate antigen 125 > 24 U/mL (OR 4.742, p = 0.010), and peritumoral enhancement (OR 2.351, p = 0.040) were independent indicators of early recurrence, which was higher than that without MRE (AUC = 0.834 vs. 0.798, DeLong test, p < 0.001). Increased tumor viscosity (OR 1.449, p = 0.017), men (OR 8.475, p = 0.001), elevated alpha-fetoprotein levels (OR 1.980, p = 0.002), and non-smooth margin (OR 2.693, p = 0.002) were independent predictors of MTM, significantly higher than the non-MRE model (AUC = 0.748 vs. 0.706, p = 0.009). MTM exhibited significantly higher tumor viscosity (1.171 vs. 0.900 rad, p = 0.002) but looser cell junction proteins than non-MTM: E-cadherin (10.440% vs. 19.685%, p = 0.001), Occludins (14.521% vs. 27.029%, p = 0.001), and ZO-1 (5.875% vs. 8.083%, p = 0.046). Additionally, stiffer tumor (OR 1.567, p = 0.042), male (OR 4.102, p = 0.002), alanine aminotransferase > 64 U/L (OR 2.801, p = 0.049), elevated alpha-fetoprotein levels (OR 2.359, p < 0.001), and tumor capsule (OR 3.101, p = 0.012) were markedly indicative of VETC (AUC = 0.747 vs. non-MRE 0.710, p = 0.078). Conversely, softer tumor (OR 1.887, p = 0.045), multifocality (OR 3.881, p = 0.002), incomplete or absent capsule (OR 3.746, p < 0.001), and non-smooth margin (OR 6.771, p < 0.001) were independently associated with MVI-positivity (AUC = 0.864 vs. non-MRE 0.841, p = 0.068).
Conclusions:
MRE-derived mechanical biomarkers are instrumental in risk stratification of aggressive HCC phenotypes and relapse.
