He-Qing Wang1, Chun Yang2, Meng-Su Zeng3, Sheng-Xiang Rao4, Yuan Ji5, Xin Weng6, Ji-Yong Wang7, Ruo-Fan Sheng8. 1. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China; Department of Radiology, First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian, 116011, China. Electronic address: betteralice@163.com. 2. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China. Electronic address: 15096792@qq.com. 3. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China. 4. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China. Electronic address: raoxray@163.com. 5. Department of Pathology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China. Electronic address: ji_yuan2013@126.com. 6. Shanghai United Imaging Healthcare Co., Ltd. No. 2258 Chengbei Road, Jiading District, Shanghai, 201815, China. Electronic address: xin.weng@united-imaging.com. 7. Shanghai United Imaging Healthcare Co., Ltd. No. 2258 Chengbei Road, Jiading District, Shanghai, 201815, China. Electronic address: jiyong.wang@united-imaging.com. 8. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China. Electronic address: ruofansheng@163.com.
Abstract
PURPOSE: To investigate potential findings associated with cytokeratin 19 (CK19)-positive HCC, with special emphasis on MR texture analysis. MATERIALS AND METHODS: Forty-eight patients with CK19-negative HCC and 38 patients with CK19-positive were retrospectively evaluated by texture analysis based on conventional MRI. Clinicalpathological characteristics, conventional MR imaging findings, and the MR texture analysis contained of 2415 texture features in the seven conventional sequences were compared. Significant features for differentiating were identified by univariate and multivariate analyses. Receiver operating characteristic analyses of the significant findings were performed and compared to evaluate their diagnostic performance. RESULTS: There was no significant difference between the top1 texture feature (three-dimensional standard deviation separation of intensity on T2-weighted original images, abbreviated as: StdSeparation 3D) and the combined top1-6 feature in identifying CK19-positive HCC(P = 0.660). Univariate and multivariate analyses indicated that serum alpha-fetoprotein (AFP) level ≥400 ng/mL(P = 0.013), arterial rim enhancement(P = 0.005), and StdSeparation 3D texture character(P = 0.002) were independent variables associated with CK19-positive HCCs. The combination of the three indices showed a better performance than AFP level(P = 0.0028), arterial rim enhancement(P < 0.0001), and their combination(P = 0.0098); while no significantly better than the StdSeparation 3D texture character alone(P = 0.0788). An acceptable discrimination(AUC = 0.765) with both sensitivity and specificity greater than 75% was achieved for StdSeparation 3D texture character. CONCLUSION: Serum AFP level ≥400 ng/mL, arterial rim enhancement, and the StdSeparation 3D texture character were independently associated with CK19-positive HCC. The StdSeparation 3D texture character may be a reliable imaging biomarker which can improve the diagnostic performance.
PURPOSE: To investigate potential findings associated with cytokeratin 19 (CK19)-positive HCC, with special emphasis on MR texture analysis. MATERIALS AND METHODS: Forty-eight patients with CK19-negative HCC and 38 patients with CK19-positive were retrospectively evaluated by texture analysis based on conventional MRI. Clinicalpathological characteristics, conventional MR imaging findings, and the MR texture analysis contained of 2415 texture features in the seven conventional sequences were compared. Significant features for differentiating were identified by univariate and multivariate analyses. Receiver operating characteristic analyses of the significant findings were performed and compared to evaluate their diagnostic performance. RESULTS: There was no significant difference between the top1 texture feature (three-dimensional standard deviation separation of intensity on T2-weighted original images, abbreviated as: StdSeparation 3D) and the combined top1-6 feature in identifying CK19-positive HCC(P = 0.660). Univariate and multivariate analyses indicated that serum alpha-fetoprotein (AFP) level ≥400 ng/mL(P = 0.013), arterial rim enhancement(P = 0.005), and StdSeparation 3D texture character(P = 0.002) were independent variables associated with CK19-positive HCCs. The combination of the three indices showed a better performance than AFP level(P = 0.0028), arterial rim enhancement(P < 0.0001), and their combination(P = 0.0098); while no significantly better than the StdSeparation 3D texture character alone(P = 0.0788). An acceptable discrimination(AUC = 0.765) with both sensitivity and specificity greater than 75% was achieved for StdSeparation 3D texture character. CONCLUSION: Serum AFP level ≥400 ng/mL, arterial rim enhancement, and the StdSeparation 3D texture character were independently associated with CK19-positive HCC. The StdSeparation 3D texture character may be a reliable imaging biomarker which can improve the diagnostic performance.
Authors: Emily Harding-Theobald; Jeremy Louissaint; Bharat Maraj; Edward Cuaresma; Whitney Townsend; Mishal Mendiratta-Lala; Amit G Singal; Grace L Su; Anna S Lok; Neehar D Parikh Journal: Aliment Pharmacol Ther Date: 2021-08-12 Impact factor: 9.524