Evaluate the recurrence of hepatocellular carcinoma after transarterial chemoembolization therapy using dynamic contrast-enhanced magnetic resonance perfusion imaging combined with serum vascular endothelial growth factor levels

Abstract

Abstract: Objective To assess the value of dynamic contrast-enhanced magnetic resonance perfusion imaging (DCE-MRI) combined with serum vascular endothelial growth factor (VEGF) levels in evaluating postoperative recurrence of hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE) therapy. Methods A total of 141 HCC patients treated between January 2019 and January 2023 were selected in this study. All patients underwent TACE. Preoperative DCE-MRI was used to measure the parameters such as the volume transfer constant (K^trans), the efflux rate constant between extravascular extracellular space and plasma (K_ep), and the volume fraction of the extravascular extracellular space (V_e). Peripheral venous blood was drawn to determine serum VEGF levels. All patients were followed up for one year post operation and categorized into recurrence (n=51) and non-recurrence groups (n=90). Logistic regression analysis was used to identify factors influencing postoperative recurrence, and the predictive value of DCE-MRI parameters and serum VEGF levels was evaluated using receiver operating characteristic (ROC) curves method. Results Patients in the recurrence group were characterized by a higher proportion of poorly differentiated tumors (66.67%) and the presence of portal vein tumor thrombus (56.86%), which were higher than those in the non-recurrence group. Additionally, preoperative levels of K^trans, K_ep, V_e, and VEGF in the recurrence group were (0.59±0.25) min, (0.98±0.33) min, (0.57±0.28) %, and (383.71±39.41) pg/mL, respectively. Multifactorial analysis indicated that K^trans, K_ep, V_e, and VEGF are important factors influencing postoperative recurrence (P<0.05). The ROC curve analysis demonstrated that the combined assessment of DCE-MRI parameters and serum VEGF levels had a predictive accuracy of 96.5% for postoperative recurrence of HCC patients after TACE therapy. Conclusion Higher preoperative DCE-MRI parameters and serum VEGF levels are associated with an increased risk of recurrence after TACE therapy in HCC patients.

Key words: Dynamic contrast-enhanced magnetic resonance perfusion imaging, Vascular endothelial growth factor, Hepatocellular carcinoma, Transarterial chemoembolization

WANG Bao, JI Sheng-chao, MA Le, TIAN Peng. Evaluate the recurrence of hepatocellular carcinoma after transarterial chemoembolization therapy using dynamic contrast-enhanced magnetic resonance perfusion imaging combined with serum vascular endothelial growth factor levels[J]. Chinese Hepatolgy, 2025, 30(12): 1632-1636.

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