Histopathologic correlation of two-phased dynamic incremental CT in hepatocellular carcinomas using multivariate...

Area of Science:

• Hepatobiliary Imaging
• Oncologic Pathology
• Radiology

Background:

• Hepatocellular carcinoma (HCC) diagnosis relies on imaging, but CT findings can be influenced by underlying pathology.
• Understanding the correlation between computed tomography (CT) features and histopathologic factors is crucial for accurate grading.

Purpose of the Study:

• To statistically assess the correlation between pathologic factors and CT findings in hepatocellular carcinomas (HCCs).
• To identify key determinants influencing tumor density, internal structure, and margins on CT scans.

Main Methods:

• Analysis of 75 hepatocellular carcinoma lesions using univariate and multivariate statistical methods.
• Comparison of early and delayed phase CT scans (two-phase dynamic incremental CT - TDICT) with resected specimen pathology.
• Calculation of category scores for each pathologic finding to establish CT-pathologic correlations.

Main Results:

• Histopathologic differentiation and growth pattern were primary determinants of tumor density.
• Cytological variants, histologic differentiation, and macroscopic classification influenced internal tumor structure.
• Macroscopic classification, histologic differentiation, fibrous capsule characteristics, and growth pattern were key for tumor margins.
• Histologic differentiation emerged as the most significant factor for TDICT findings in HCCs.
• Parenchymal liver disease and cytologic variants were identified as modifiers of CT findings.

Conclusions:

• Histologic differentiation is the most critical factor influencing CT findings in hepatocellular carcinoma.
• Pathologic characteristics significantly impact the appearance of HCC on CT, aiding in more precise characterization.
• CT-pathologic correlation provides valuable insights for grading and understanding HCC behavior.