Skip to main content
Erschienen in:

18.03.2021 | Hepatobiliary

Radiomics-based model using gadoxetic acid disodium-enhanced MR images: associations with recurrence-free survival of patients with hepatocellular carcinoma treated by surgical resection

verfasst von: Ling Zhang, Jianming Hu, Jingyu Hou, Xinhua Jiang, Lei Guo, Li Tian

Erschienen in: Abdominal Radiology | Ausgabe 8/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To develop a prediction model that combined magnetic resonance images (MRI)-based radiomics features with clinical factors to predict recurrence-free survival (RFS) of hepatocellular carcinoma (HCC) patients treated with surgical resection.

Methods

HCC patients treated with surgical resection (n = 153) were randomly divided into training (n = 107) and validation (n = 46) datasets. The volumes of interest were manually outlined around the lesion and additional 2 mm and 5 mm peritumoral areas were created with automated dilatation in MRI to extract tumoral (T) and peritumoral (PT) radiomics features. The radiomics models were constructed using least absolute shrinkage and selection operator Cox regression. The combined model incorporated clinical factors and radiomics features using multivariable Cox regression based on the Akaike information criterion principle. Predictive performance of different models were evaluated by receiver operating characteristic (ROC) curves, decision curves, and calibration curves.

Results

Among the radiomics models, similar performance was observed in the 2 mm and 5 mm PT models (C-index both 0.657), which were better than the T model or T + PT model (C-index 0.607 and 0.641, respectively) in the validation dataset, whereas the model combined with the three identified clinical risk factors showed the best performance (C-index 0.725). Results of the ROC curves, decision curves, and the calibration curves indicated that the combined model and the derived nomogram had better prediction performance, greater clinical benefits, and fair calibration efficiency.

Conclusion

The prediction model that combined MRI radiomics signatures with clinical factors can effectively predict the prognosis of patients with HCC treated with surgical resection.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Jemal A, Ward EM, Johnson CJ, Cronin KA, Ma J, Ryerson B, et al. Annual Report to the Nation on the Status of Cancer, 1975-2014, Featuring Survival. J Natl Cancer Inst 2017, 109. Jemal A, Ward EM, Johnson CJ, Cronin KA, Ma J, Ryerson B, et al. Annual Report to the Nation on the Status of Cancer, 1975-2014, Featuring Survival. J Natl Cancer Inst 2017, 109.
2.
Zurück zum Zitat Singal AG, Lampertico P, Nahon P. Epidemiology and surveillance for hepatocellular carcinoma: New trends. J Hepatol 2020, 72: 250-261. Singal AG, Lampertico P, Nahon P. Epidemiology and surveillance for hepatocellular carcinoma: New trends. J Hepatol 2020, 72: 250-261.
3.
Zurück zum Zitat Ding C, Fu X, Zhou Y, Liu X, Wu J, Huang C, et al. Disease burden of liver cancer in China from 1997 to 2016: an observational study based on the Global Burden of Diseases. BMJ Open 2019, 9: e025613. Ding C, Fu X, Zhou Y, Liu X, Wu J, Huang C, et al. Disease burden of liver cancer in China from 1997 to 2016: an observational study based on the Global Burden of Diseases. BMJ Open 2019, 9: e025613.
4.
Zurück zum Zitat Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology 2018, 67: 358-380. Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology 2018, 67: 358-380.
5.
Zurück zum Zitat Choi SH, Choi GH, Kim SU, Park JY, Joo DJ, Ju MK, et al. Role of surgical resection for multiple hepatocellular carcinomas. World J Gastroenterol 2013, 19: 366-374. Choi SH, Choi GH, Kim SU, Park JY, Joo DJ, Ju MK, et al. Role of surgical resection for multiple hepatocellular carcinomas. World J Gastroenterol 2013, 19: 366-374.
6.
Zurück zum Zitat You DD, Kim DG, Seo CH, Choi HJ, Yoo YK, Park YG. Prognostic factors after curative resection hepatocellular carcinoma and the surgeon's role. Ann Surg Treat Res 2017, 93: 252-259. You DD, Kim DG, Seo CH, Choi HJ, Yoo YK, Park YG. Prognostic factors after curative resection hepatocellular carcinoma and the surgeon's role. Ann Surg Treat Res 2017, 93: 252-259.
7.
Zurück zum Zitat Tabrizian P, Jibara G, Shrager B, Schwartz M, Roayaie S. Recurrence of hepatocellular cancer after resection: patterns, treatments, and prognosis. Ann Surg 2015, 261: 947-955. Tabrizian P, Jibara G, Shrager B, Schwartz M, Roayaie S. Recurrence of hepatocellular cancer after resection: patterns, treatments, and prognosis. Ann Surg 2015, 261: 947-955.
8.
Zurück zum Zitat Verslype C, Rosmorduc O, Rougier P, Group EGW. Hepatocellular carcinoma: ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2012, 23 Suppl 7: vii41-48. Verslype C, Rosmorduc O, Rougier P, Group EGW. Hepatocellular carcinoma: ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2012, 23 Suppl 7: vii41-48.
9.
Zurück zum Zitat (NCCN) NCCN. NCCN clinical practice guidelines in oncology: Hepatobiliary Cancers (Version 2.2020). 2020. (NCCN) NCCN. NCCN clinical practice guidelines in oncology: Hepatobiliary Cancers (Version 2.2020). 2020.
10.
Zurück zum Zitat Peng ZW, Zhang YJ, Liang HH, Lin XJ, Guo RP, Chen MS. Recurrent hepatocellular carcinoma treated with sequential transcatheter arterial chemoembolization and RF ablation versus RF ablation alone: a prospective randomized trial. Radiology 2012, 262: 689-700. Peng ZW, Zhang YJ, Liang HH, Lin XJ, Guo RP, Chen MS. Recurrent hepatocellular carcinoma treated with sequential transcatheter arterial chemoembolization and RF ablation versus RF ablation alone: a prospective randomized trial. Radiology 2012, 262: 689-700.
11.
Zurück zum Zitat Sherman M. Recurrence of hepatocellular carcinoma. N Engl J Med 2008, 359: 2045-2047. Sherman M. Recurrence of hepatocellular carcinoma. N Engl J Med 2008, 359: 2045-2047.
12.
Zurück zum Zitat Giuseppe M, Silvana E, Ascanio M, Antonio G. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients: the Cancer of the Liver Italian Program (CLIP) investigators. Hepatology 1998, 28: 751-755. Giuseppe M, Silvana E, Ascanio M, Antonio G. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients: the Cancer of the Liver Italian Program (CLIP) investigators. Hepatology 1998, 28: 751-755.
13.
Zurück zum Zitat Kudo M, Chung H, Haji S, Osaki Y, Oka H, Seki T, et al. Validation of a new prognostic staging system for hepatocellular carcinoma: the JIS score compared with the CLIP score. Hepatology 2004, 40: 1396-1405. Kudo M, Chung H, Haji S, Osaki Y, Oka H, Seki T, et al. Validation of a new prognostic staging system for hepatocellular carcinoma: the JIS score compared with the CLIP score. Hepatology 2004, 40: 1396-1405.
14.
Zurück zum Zitat Kudo M, Chung H, Osaki Y. Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging Score (JIS score). J Gastroenterol 2003, 38: 207-215. Kudo M, Chung H, Osaki Y. Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging Score (JIS score). J Gastroenterol 2003, 38: 207-215.
15.
Zurück zum Zitat Nanashima A, Sumida Y, Abo T, Shindou H, Fukuoka H, Takeshita H, et al. Modified Japan Integrated Staging is currently the best available staging system for hepatocellular carcinoma patients who have undergone hepatectomy. J Gastroenterol 2006, 41: 250-256. Nanashima A, Sumida Y, Abo T, Shindou H, Fukuoka H, Takeshita H, et al. Modified Japan Integrated Staging is currently the best available staging system for hepatocellular carcinoma patients who have undergone hepatectomy. J Gastroenterol 2006, 41: 250-256.
16.
Zurück zum Zitat Nanashima A, Sumida Y, Morino S, Yamaguchi H, Tanaka K, Shibasaki S, et al. The Japanese integrated staging score using liver damage grade for hepatocellular carcinoma in patients after hepatectomy. Eur J Surg Oncol 2004, 30: 765-770. Nanashima A, Sumida Y, Morino S, Yamaguchi H, Tanaka K, Shibasaki S, et al. The Japanese integrated staging score using liver damage grade for hepatocellular carcinoma in patients after hepatectomy. Eur J Surg Oncol 2004, 30: 765-770.
17.
Zurück zum Zitat Tateishi R, Yoshida H, Shiina S, Imamura H, Hasegawa K, Teratani T, et al. Proposal of a new prognostic model for hepatocellular carcinoma: an analysis of 403 patients. Gut 2005, 54: 419-425. Tateishi R, Yoshida H, Shiina S, Imamura H, Hasegawa K, Teratani T, et al. Proposal of a new prognostic model for hepatocellular carcinoma: an analysis of 403 patients. Gut 2005, 54: 419-425.
18.
Zurück zum Zitat Lambin P, Rios-Velazquez E, Leijenaar R, Carvalho S, van Stiphout RG, Granton P, et al. Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer 2012, 48: 441-446. Lambin P, Rios-Velazquez E, Leijenaar R, Carvalho S, van Stiphout RG, Granton P, et al. Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer 2012, 48: 441-446.
19.
Zurück zum Zitat Aerts HJ, Velazquez ER, Leijenaar RT, Parmar C, Grossmann P, Carvalho S, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun 2014, 5: 4006. Aerts HJ, Velazquez ER, Leijenaar RT, Parmar C, Grossmann P, Carvalho S, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun 2014, 5: 4006.
20.
Zurück zum Zitat Bakr S, Echegaray S, Shah R, Kamaya A, Louie J, Napel S, et al. Noninvasive radiomics signature based on quantitative analysis of computed tomography images as a surrogate for microvascular invasion in hepatocellular carcinoma: a pilot study. J Med Imaging (Bellingham) 2017, 4: 041303. Bakr S, Echegaray S, Shah R, Kamaya A, Louie J, Napel S, et al. Noninvasive radiomics signature based on quantitative analysis of computed tomography images as a surrogate for microvascular invasion in hepatocellular carcinoma: a pilot study. J Med Imaging (Bellingham) 2017, 4: 041303.
21.
Zurück zum Zitat Wakabayashi T, Ouhmich F, Gonzalez-Cabrera C, Felli E, Saviano A, Agnus V, et al. Radiomics in hepatocellular carcinoma: a quantitative review. Hepatol Int 2019, 13: 546-559. Wakabayashi T, Ouhmich F, Gonzalez-Cabrera C, Felli E, Saviano A, Agnus V, et al. Radiomics in hepatocellular carcinoma: a quantitative review. Hepatol Int 2019, 13: 546-559.
22.
Zurück zum Zitat Guo D, Gu D, Wang H, Wei J, Wang Z, Hao X, et al. Radiomics analysis enables recurrence prediction for hepatocellular carcinoma after liver transplantation. Eur J Radiol 2019, 117: 33-40. Guo D, Gu D, Wang H, Wei J, Wang Z, Hao X, et al. Radiomics analysis enables recurrence prediction for hepatocellular carcinoma after liver transplantation. Eur J Radiol 2019, 117: 33-40.
23.
Zurück zum Zitat Wang XH, Long LH, Cui Y, Jia AY, Zhu XG, Wang HZ, et al. MRI-based radiomics model for preoperative prediction of 5-year survival in patients with hepatocellular carcinoma. Br J Cancer 2020, 122: 978-985. Wang XH, Long LH, Cui Y, Jia AY, Zhu XG, Wang HZ, et al. MRI-based radiomics model for preoperative prediction of 5-year survival in patients with hepatocellular carcinoma. Br J Cancer 2020, 122: 978-985.
24.
Zurück zum Zitat Cheng J, Zhao P, Liu J, Liu X, Wu X. Preoperative aspartate aminotransferase-to-platelet ratio index (APRI) is a predictor on postoperative outcomes of hepatocellular carcinoma. Medicine 2016, 95. Cheng J, Zhao P, Liu J, Liu X, Wu X. Preoperative aspartate aminotransferase-to-platelet ratio index (APRI) is a predictor on postoperative outcomes of hepatocellular carcinoma. Medicine 2016, 95.
25.
Zurück zum Zitat Erstad DJ, Tanabe KK. Prognostic and therapeutic implications of microvascular invasion in hepatocellular carcinoma. Annals of surgical oncology 2019, 26: 1474-1493. Erstad DJ, Tanabe KK. Prognostic and therapeutic implications of microvascular invasion in hepatocellular carcinoma. Annals of surgical oncology 2019, 26: 1474-1493.
26.
Zurück zum Zitat Yu M-C, Chan K-M, Lee C-F, Lee Y-S, Eldeen FZ, Chou H-S, et al. Alkaline phosphatase: does it have a role in predicting hepatocellular carcinoma recurrence? Journal of Gastrointestinal Surgery 2011, 15: 1440-1449. Yu M-C, Chan K-M, Lee C-F, Lee Y-S, Eldeen FZ, Chou H-S, et al. Alkaline phosphatase: does it have a role in predicting hepatocellular carcinoma recurrence? Journal of Gastrointestinal Surgery 2011, 15: 1440-1449.
27.
Zurück zum Zitat Lin DC, Mayakonda A, Dinh HQ, Huang P, Lin L, Liu X, et al. Genomic and Epigenomic Heterogeneity of Hepatocellular Carcinoma. Cancer Res 2017, 77: 2255-2265. Lin DC, Mayakonda A, Dinh HQ, Huang P, Lin L, Liu X, et al. Genomic and Epigenomic Heterogeneity of Hepatocellular Carcinoma. Cancer Res 2017, 77: 2255-2265.
28.
Zurück zum Zitat Lu LC, Hsu CH, Hsu C, Cheng AL. Tumor Heterogeneity in Hepatocellular Carcinoma: Facing the Challenges. Liver Cancer 2016, 5: 128-138. Lu LC, Hsu CH, Hsu C, Cheng AL. Tumor Heterogeneity in Hepatocellular Carcinoma: Facing the Challenges. Liver Cancer 2016, 5: 128-138.
29.
Zurück zum Zitat Martins-Filho SN, Paiva C, Azevedo RS, Alves VAF. Histological Grading of Hepatocellular Carcinoma-A Systematic Review of Literature. Front Med (Lausanne) 2017, 4: 193. Martins-Filho SN, Paiva C, Azevedo RS, Alves VAF. Histological Grading of Hepatocellular Carcinoma-A Systematic Review of Literature. Front Med (Lausanne) 2017, 4: 193.
30.
Zurück zum Zitat Mazzaferro V, Llovet JM, Miceli R, Bhoori S, Schiavo M, Mariani L, et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol 2009, 10: 35-43. Mazzaferro V, Llovet JM, Miceli R, Bhoori S, Schiavo M, Mariani L, et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol 2009, 10: 35-43.
31.
Zurück zum Zitat Llovet JM, Bru C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 1999, 19: 329-338. Llovet JM, Bru C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 1999, 19: 329-338.
32.
Zurück zum Zitat Francesco P, Bruno D, Giovanni B, Sandro P. Prospective validation of the CLIP score: a new prognostic system for patients with cirrhosis and hepatocellular carcinoma. The Cancer of the Liver Italian Program (CLIP) Investigators. Hepatology 2000, 31: 840-845. Francesco P, Bruno D, Giovanni B, Sandro P. Prospective validation of the CLIP score: a new prognostic system for patients with cirrhosis and hepatocellular carcinoma. The Cancer of the Liver Italian Program (CLIP) Investigators. Hepatology 2000, 31: 840-845.
33.
Zurück zum Zitat Okuda K, Ohtsuki T, Obata H, Tomimatsu M, Okazaki N, Hasegawa H, et al. Natural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patients. Cancer 1985, 56: 918-928. Okuda K, Ohtsuki T, Obata H, Tomimatsu M, Okazaki N, Hasegawa H, et al. Natural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patients. Cancer 1985, 56: 918-928.
34.
Zurück zum Zitat Bruix J, Gores GJ, Mazzaferro V. Hepatocellular carcinoma: clinical frontiers and perspectives. Gut 2014, 63: 844-855. Bruix J, Gores GJ, Mazzaferro V. Hepatocellular carcinoma: clinical frontiers and perspectives. Gut 2014, 63: 844-855.
35.
Zurück zum Zitat Peng J, Zhang J, Zhang Q, Xu Y, Zhou J, Liu L. A radiomics nomogram for preoperative prediction of microvascular invasion risk in hepatitis B virus-related hepatocellular carcinoma. Diagn Interv Radiol 2018, 24: 121-127. Peng J, Zhang J, Zhang Q, Xu Y, Zhou J, Liu L. A radiomics nomogram for preoperative prediction of microvascular invasion risk in hepatitis B virus-related hepatocellular carcinoma. Diagn Interv Radiol 2018, 24: 121-127.
36.
Zurück zum Zitat Wu M, Tan H, Gao F, Hai J, Ning P, Chen J, et al. Predicting the grade of hepatocellular carcinoma based on non-contrast-enhanced MRI radiomics signature. Eur Radiol 2019, 29: 2802-2811. Wu M, Tan H, Gao F, Hai J, Ning P, Chen J, et al. Predicting the grade of hepatocellular carcinoma based on non-contrast-enhanced MRI radiomics signature. Eur Radiol 2019, 29: 2802-2811.
37.
Zurück zum Zitat Blanc-Durand P, Van Der Gucht A, Jreige M, Nicod-Lalonde M, Silva-Monteiro M, Prior JO, et al. Signature of survival: a (18)F-FDG PET based whole-liver radiomic analysis predicts survival after (90)Y-TARE for hepatocellular carcinoma. Oncotarget 2018, 9: 4549-4558. Blanc-Durand P, Van Der Gucht A, Jreige M, Nicod-Lalonde M, Silva-Monteiro M, Prior JO, et al. Signature of survival: a (18)F-FDG PET based whole-liver radiomic analysis predicts survival after (90)Y-TARE for hepatocellular carcinoma. Oncotarget 2018, 9: 4549-4558.
38.
Zurück zum Zitat Zhou Y, He L, Huang Y, Chen S, Wu P, Ye W, et al. CT-based radiomics signature: a potential biomarker for preoperative prediction of early recurrence in hepatocellular carcinoma. Abdom Radiol (NY) 2017, 42: 1695-1704. Zhou Y, He L, Huang Y, Chen S, Wu P, Ye W, et al. CT-based radiomics signature: a potential biomarker for preoperative prediction of early recurrence in hepatocellular carcinoma. Abdom Radiol (NY) 2017, 42: 1695-1704.
39.
Zurück zum Zitat Hu HT, Shan QY, Chen SL, Li B, Feng ST, Xu EJ, et al. CT-based radiomics for preoperative prediction of early recurrent hepatocellular carcinoma: technical reproducibility of acquisition and scanners. Radiol Med 2020, 125: 697-705. Hu HT, Shan QY, Chen SL, Li B, Feng ST, Xu EJ, et al. CT-based radiomics for preoperative prediction of early recurrent hepatocellular carcinoma: technical reproducibility of acquisition and scanners. Radiol Med 2020, 125: 697-705.
40.
Zurück zum Zitat Shan QY, Hu HT, Feng ST, Peng ZP, Chen SL, Zhou Q, et al. CT-based peritumoral radiomics signatures to predict early recurrence in hepatocellular carcinoma after curative tumor resection or ablation. Cancer Imaging 2019, 19: 11. Shan QY, Hu HT, Feng ST, Peng ZP, Chen SL, Zhou Q, et al. CT-based peritumoral radiomics signatures to predict early recurrence in hepatocellular carcinoma after curative tumor resection or ablation. Cancer Imaging 2019, 19: 11.
41.
Zurück zum Zitat Wang W-T, Yang L, Yang Z-X, Hu X-X, Ding Y, Yan X, et al. Assessment of microvascular invasion of hepatocellular carcinoma with diffusion kurtosis imaging. Radiology 2018, 286: 571-580. Wang W-T, Yang L, Yang Z-X, Hu X-X, Ding Y, Yan X, et al. Assessment of microvascular invasion of hepatocellular carcinoma with diffusion kurtosis imaging. Radiology 2018, 286: 571-580.
Metadaten
Titel
Radiomics-based model using gadoxetic acid disodium-enhanced MR images: associations with recurrence-free survival of patients with hepatocellular carcinoma treated by surgical resection
verfasst von
Ling Zhang
Jianming Hu
Jingyu Hou
Xinhua Jiang
Lei Guo
Li Tian
Publikationsdatum
18.03.2021
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 8/2021
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-021-03034-7

Neu im Fachgebiet Radiologie

KI-gestütztes Mammografiescreening überzeugt im Praxistest

Mit dem Einsatz künstlicher Intelligenz lässt sich die Detektionsrate im Mammografiescreening offenbar deutlich steigern. Mehr unnötige Zusatzuntersuchungen sind laut der Studie aus Deutschland nicht zu befürchten.

Stumme Schlaganfälle − ein häufiger Nebenbefund im Kopf-CT?

In 4% der in der Notfallambulanz initiierten zerebralen Bildgebung sind „alte“ Schlaganfälle zu erkennen. Gar nicht so selten handelt es sich laut einer aktuellen Studie dabei um unbemerkte Insulte. Bietet sich hier womöglich die Chance auf ein effektives opportunistisches Screening?

Die elektronische Patientenakte kommt: Das sollten Sie jetzt wissen

Am 15. Januar geht die „ePA für alle“ zunächst in den Modellregionen an den Start. Doch schon bald soll sie in allen Praxen zum Einsatz kommen. Was ist jetzt zu tun? Was müssen Sie wissen? Wir geben in einem FAQ Antworten auf 21 Fragen.

Stören weiße Wände und viel Licht die Bildqualitätskontrolle?

Wenn es darum geht, die technische Qualität eines Mammogramms zu beurteilen, könnten graue Wandfarbe und reduzierte Beleuchtung im Bildgebungsraum von Vorteil sein. Darauf deuten zumindest Ergebnisse einer kleinen Studie hin. 

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.