肝脏 ›› 2024, Vol. 29 ›› Issue (11): 1346-1348.

• 肝癌 • 上一篇    下一篇

增强CT影像组学用于预测肝细胞癌微血管侵犯的相关研究

高敏, 徐亚运, 张宇宸, 朱海雪, 房海燕   

  1. 210023 江苏 南京大学医学院附属泰康仙林鼓楼医院放射科
  • 收稿日期:2023-12-13 出版日期:2024-11-30 发布日期:2025-01-10
  • 通讯作者: 房海燕,Email:15850660377@163.com
  • 基金资助:
    江苏省“333工程”科研项目(BRA2019078)

Radiomics-based prediction of microvascular invasion in hepatocellular carcinoma using contrast-enhanced CT imaging

GAO Min, XU Ya-yun, ZHANG Yu-chen, ZHU Hai-xue, FANG Hai-yan   

  1. Department of Radiology, Taikang Xianlin Gulou Hospital, Affiliated to Nanjing University School of Medicine, Jiangsu 210023, China
  • Received:2023-12-13 Online:2024-11-30 Published:2025-01-10
  • Contact: FANG Hai-yan,Email:15850660377@163.com

摘要: 目的 探讨放射组学分析技术在肝细胞癌(hepatocellular carcinoma, HCC)微血管侵犯(microvascular invasion, MVI)中的预测作用。方法 纳入210例经手术确认的HCC患者,患者均接受增强CT扫描检查以及手术切除获得病理标本。从增强CT影像中提取多个放射组学特征,收集患者的临床数据。通过单变量分析,确定与MVI显著相关的临床和放射组学特征。然后纳入多元回归模型,筛选出影响MVI的最终预测因素。结果 210例患者中67例患者术后病理证实为MVI,发生率为31.9%。回归分析结果发现,血清AFP(95% CI: 1.787~4.321, P=0.039)、最大肿瘤长度(95% CI: 1.322~3.422, P=0.021)和肿瘤内部动脉(95% CI: 0.834~4.231, P=0.023)是MVI的最终影响因素,ROC曲线下面积(AUC)为0.895。结论 放射组学特征在HCC患者的MVI预测中具有重要作用。

关键词: 肝细胞癌,微血管侵犯,影响因素,增强X线电子计算机断层扫描

Abstract: Objective To explore the application of radiomics-based analysis in predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients. Methods This retrospective study included 210 patients with surgically confirmed diagnosis of HCC, all of whom underwent contrast-enhanced CT scans and obtained pathological specimens. Multiple radiomics features were extracted from the contrast-enhanced CT images. The clinical data of the patients were also collected. Univariate analysis was performed to identify clinical and radiomics features that were significantly associated with MVI. Subsequently, a multivariate regression model was used to select the predictive factors for MVI. Results Of the 210 patients, 67 were confirmed with MVI through postoperative pathology, resulting in an incidence rate of 31.9%. By univariate and logistic multivariate regression analyses, serum AFP (P=0.039), maximum tumor length (P=0.021), and intra-tumoral arteries (P=0.023) were identified as the influencing factors for MVI. The area under the ROC curve (AUC) for assessing the model's performance was 0.895. Conclusion This study demonstrates a crucial role of radiomics features in predicting MVI in HCC, with promising predictive performance. The radiomics-based model may provide clinicians with comprehensive and accurate information for individualized treatment decisions, thus potentially improve the survival rate and quality of life for HCC patients.

Key words: Hepatocellular carcinoma, Microvascular invasion, Influencing factors, Enhanced computed tomography