scholarly journals A Radiomics Approach to Predict the Emergence of New Hepatocellular Carcinoma in Computed Tomography for High-Risk Patients with Liver Cirrhosis

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1650
Author(s):  
Eric Tietz ◽  
Daniel Truhn ◽  
Gustav Müller-Franzes ◽  
Marie-Luise Berres ◽  
Karim Hamesch ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Tumor Therapy ◽  
Univariate Analysis ◽  
Cirrhotic Liver ◽  
Multivariate Logistic Regression Model ◽  
Risk Patients ◽  
Independent Features ◽  
Enhanced Computed Tomography

Liver cirrhosis poses a major risk for the development of hepatocellular carcinoma (HCC). This retrospective study investigated to what extent radiomic features allow the prediction of emerging HCC in patients with cirrhosis in contrast-enhanced computed tomography (CECT). A total of 51 patients with liver cirrhosis and newly detected HCC lesions (n = 82) during follow-up (FU-CT) after local tumor therapy were included. These lesions were not to have been detected by the radiologist in the chronologically prior CECT (PRE-CT). For training purposes, segmentations of 22 patients with liver cirrhosis but without HCC-recurrence were added. A total of 186 areas (82 HCCs and 104 cirrhotic liver areas without HCC) were analyzed. Using univariate analysis, four independent features were identified, and a multivariate logistic regression model was trained to classify the outlined regions as “HCC probable” or “HCC improbable”. In total, 60/82 (73%) of segmentations with later detected HCC and 84/104 (81%) segmentations without HCC were classified correctly (AUC of 81%, 95% CI 74–87%), yielding a sensitivity of 72% (95% CI 57–83%) and a specificity of 86% (95% CI 76–96%). In conclusion, the model predicted the occurrence of new HCCs within segmented areas with an acceptable sensitivity and specificity in cirrhotic liver tissue in CECT.

scholarly journals The APAC Score: A Novel and Highly Performant Serological Tool for Early Diagnosis of Hepatocellular Carcinoma in Patients with Liver Cirrhosis

2021 ◽  
Vol 10 (15) ◽  
pp. 3392
Author(s):  
Joeri Lambrecht ◽  
Mustafa Porsch-Özçürümez ◽  
Jan Best ◽  
Fabian Jost-Brinkmann ◽  
Christoph Roderburg ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
At Risk ◽  
Liver Cirrhosis ◽  
Early Stage ◽  
Treatment Options ◽  
Growth Factor Receptor ◽  
Serum Samples ◽  
Disease Etiology ◽  
Risk Patients ◽  
Scoring Tool

(1) Background: Surveillance of at-risk patients for hepatocellular carcinoma (HCC) is highly necessary, as curative treatment options are only feasible in early disease stages. However, to date, screening of patients with liver cirrhosis for HCC mostly relies on suboptimal ultrasound-mediated evaluation and α-fetoprotein (AFP) measurement. Therefore, we sought to develop a novel and blood-based scoring tool for the identification of early-stage HCC. (2) Methods: Serum samples from 267 patients with liver cirrhosis, including 122 patients with HCC and 145 without, were collected. Expression levels of soluble platelet-derived growth factor receptor beta (sPDGFRβ) and routine clinical parameters were evaluated, and then utilized in logistic regression analysis. (3) Results: We developed a novel serological scoring tool, the APAC score, consisting of the parameters age, sPDGFRβ, AFP, and creatinine, which identified patients with HCC in a cirrhotic population with an AUC of 0.9503, which was significantly better than the GALAD score (AUC: 0.9000, p = 0.0031). Moreover, the diagnostic accuracy of the APAC score was independent of disease etiology, including alcohol (AUC: 0.9317), viral infection (AUC: 0.9561), and NAFLD (AUC: 0.9545). For the detection of patients with (very) early (BCLC 0/A) HCC stage or within Milan criteria, the APAC score achieved an AUC of 0.9317 (sensitivity: 85.2%, specificity: 89.2%) and 0.9488 (sensitivity: 91.1%, specificity 85.3%), respectively. (4) Conclusions: The APAC score is a novel and highly accurate serological tool for the identification of HCC, especially for early stages. It is superior to the currently proposed blood-based algorithms, and has the potential to improve surveillance of the at-risk population.

Hepatocellular carcinoma in the non-cirrhotic liver

2021 ◽  
pp. 1-14
Author(s):  
Dong Yi ◽  
Wang Wen-Ping ◽  
Won Jae Lee ◽  
Maria Franca Meloni ◽  
Dirk-Andre Clevert ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Risk Factor ◽  
High Risk ◽  
Current Knowledge ◽  
Cirrhotic Liver ◽  
Imaging Features ◽  
Advanced Stage ◽  
High Risk Factor ◽  
Cirrhotic Patients

Liver cirrhosis is an established high-risk factor for HCC and the majority of patients diagnosed with HCC have cirrhosis. However, HCC also arises in non-cirrhotic livers in approximately 20 %of all cases. HCC in non-cirrhotic patients is often clinically silent and surveillance is usually not recommended. HCC is often diagnosed at an advanced stage in these patients. Current information about HCC in patients with non-cirrhotic liver is limited. Here we review the current knowledge on epidemiology, clinical features and imaging features of those patiens.

scholarly journals Metabolic Alterations Associated with Early-Stage Hepatocellular Carcinoma and Their Correlation with Aging and Enzymatic Activity in Patients with Viral Hepatitis-Induced Liver Cirrhosis: A Preliminary Study

2020 ◽  
Vol 9 (3) ◽  
pp. 765
Author(s):  
Chung-Man Moon ◽  
Sang Soo Shin ◽  
Suk Hee Heo ◽  
Yong Yeon Jeong
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Lactate Dehydrogenase ◽  
Enzymatic Activity ◽  
Viral Hepatitis ◽  
Potential Risk ◽  
Early Stage ◽  
Liver Parenchyma ◽  
Cirrhotic Liver ◽  
1H Mrs

Liver cirrhosis (LC) can develop hepatocellular carcinoma (HCC). However, noninvasive early diagnosis of HCCs in the cirrhotic liver is still challenging. We aimed to quantify the hepatic metabolites in normal control (NC), cirrhotic liver without HCC, cirrhotic liver with HCC (CLH), and early-stage HCC groups using proton magnetic resonance spectroscopy (1H-MRS) with a long echo-time (TE) and to assess the potential association between the levels of hepatic metabolites in these four groups and aging and enzymatic activity. Thirty NCs, 30 viral hepatitis-induced LC patients without HCC, and 30 viral hepatitis-induced LC patients with HCC were included in this study. 1H-MRS measurements were performed on a localized voxel of the normal liver parenchyma (n = 30) from NCs, cirrhotic liver parenchyma (n = 30) from LC patients without HCC, and each of the cirrhotic liver parenchyma (n = 30) and HCC (n = 30) from the same patients in the CLH group. Generalized estimating equations were used to evaluate potential risk factors for changes in metabolite levels. Potential associations between metabolite levels and age and serum enzymatic activities were assessed by correlation analysis. The levels of lactate+triglyceride (Lac+TG) and choline (Cho) in HCC were significantly higher compared to those in LC and CLH. A potential risk factor for changes in the Lac+TG and Cho levels was age, specifically 60–80 years of age. In particular, the Lac+TG level was associated with a high odds ratio of HCC in males aged 60–80 years. The Lac+TG and Cho concentrations were positively correlated with lactate dehydrogenase and alkaline phosphatase activities, respectively. Our findings suggested that 1H-MRS measurement with a long TE was useful in quantifying hepatic Lac+TG and Cho levels, where higher Lac+TG and Cho levels were most likely associated with HCC-related metabolism in the viral hepatitis-induced cirrhotic liver. Further, the level of Lac+TG in HCC was highly correlated with older age and lactate dehydrogenase activity.

scholarly journals Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment - Part 1

2017 ◽  
Vol 50 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Miguel Ramalho ◽  
António P. Matos ◽  
Mamdoh AlObaidy ◽  
Fernanda Velloni ◽  
Ersan Altun ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Magnetic Resonance ◽  
Cirrhotic Liver ◽  
Response To Treatment ◽  
Arterial Phase ◽  
Resonance Imaging ◽  
Regenerative Nodules ◽  
Magnetic Resonance Imaging Mri

Abstract Magnetic resonance imaging (MRI) is the modern gold standard for the noninvasive evaluation of the cirrhotic liver. The combination of arterial phase hyperenhancement and delayed wash-out allows a definitive diagnosis of hepatocellular carcinoma (HCC) in patients with liver cirrhosis or chronic liver disease, without the requirement for confirmatory biopsy. That pattern is highly specific and has been endorsed in Western and Asian diagnostic guidelines. However, the sensitivity of the combination is relatively low for small HCCs. In this two-part review paper, we will address MRI of the cirrhotic liver. In this first part, we provide a brief background on liver cirrhosis and HCC, followed by descriptions of imaging surveillance of liver cirrhosis and the diagnostic performance of the different imaging modalities used in clinical settings. We then describe some of the requirements for the basic MRI technique, as well as the standard MRI protocol, and provide a detailed description of the appearance of various types of hepatocellular nodules encountered in the setting of the carcinogenic pathway in the cirrhotic liver, ranging from regenerative nodules to HCC.

Сравнение эффективности применения систем CEUS LI-RADS 2017 и CT/MRI LI-RADS 2018 в дифференциальной диагностике новообразований печени

2019 ◽  
pp. 18-35
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Цель исследования - сравнение эффективности использования систем CT/MRI LI-RADS 2018 и CEUS LI-RADS 2017 в дифференциальной диагностике новообразований печени у пациентов с факторами риска (цирроз печени, вирусный гепатит B и C) гепатоцеллюлярной карциномы и без них. На основании морфологических данных проведен ретроспективный анализ резуль татов обследования 165 пациентов с новообразованиями печени (165 узлов). В группу 1 вошел 61 пациент с циррозом печени и хроническими вирусными гепатитами B и C (61 узел), в группу 2 - 104 пациента без факторов риска развития гепатоцеллюлярной карциномы (104 узла). Всем пациентам выполнялись ультразвуковое исследование с контрастным усилением (КУУЗИ) с присвоением категорий CEUS LI-RADS 2017 и компьютерная томо графия (КТ) с внутривенным контрас ти рованием с присвоением категорий CT/MRI LI-RADS. Диагностическая эффективность использования критериев CEUS LI-RADS 2017 и CT/MRI LI-RADS 2018 для диагностики гепатоцеллюлярной карциномы (LR-4, LR-5) у пациентов из группы риска (группа 1) составила: чувствительность КУУЗИ - 100,0%, специфичность - 87,0%, точность - 95,1%; чувствительность КТ с внутривенным контрастированием - 92,1%, специфичность - 95,7%, точность - 93,4%. В случае негепатоцеллюлярной природы опухоли (LR-M) показатели диагностической информативности в группе 1 распределились следующим образом: чувствительность КУУЗИ - 77,8%, специфичность - 100,0%, точность - 96,7%; чувствительность КТ с внутривенным контрастированием - 88,9%, специфичность - 100,0%, точность - 98,4%. В группе пациентов без факторов риска (группа 2) были получены следующие показатели эффективности в диагностике гепатоцеллюлярной карциномы: чувствительность КУУЗИ - 100,0%, специфичность - 90,1%, точность - 91,3%; чувствительность КТ с внутривенным контрас тированием - 100,0%, специфичность - 72,5%, точность - 76,0%. В случае негепато цел люлярной природы опухоли (LR-M) показатели диагностической информативности в группе 2 распределились следующим образом: чувствительность КУУЗИ - 89,6%, специфичность - 96,4%, точность - 93,3%; чувст вительность КТ с внутривенным контрас тированием - 87,5%, специфичность - 100,0%, точность - 94,2%. Использование LI-RADS стандартизирует интер претацию полученных данных у пациентов с риском развития гепато целлюлярной карциномы. Полученные результаты позволяют надеяться, что по мере накопления опыта применения и внесения изменений в обновленные версии сис темы она будет рекомендована к применению в группе пациентов без факторов риска гепато целлюлярной карциномы. Ключевые слова: ультразвуковое исследование с контрастным усилением (КУУЗИ), компьютерная томография с внутривенным контрастированием, CEUS LI-RADS, CT/MRI LI-RADS, гепатоцеллюлярная карцинома, contrast-enhanced ultrasound (CEUS), contrast-enhanced computed tomography, CEUS LI-RADS, CT/MRI LI-RADS, hepatocellular carcinoma

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