Preoperative MR imaging for predicting early recurrence of solitary hepatocellular carcinoma without microvascular invasion.

Abstract

OBJECTIVES\nThis study aimed to identify preoperative MR imaging features for predicting early recurrence after curative resection of solitary hepatocellular carcinoma (HCC) without microvascular invasion (MVI).\n\n\nMETHODS\n124 patients with MVI-negative HCC who underwent preoperative dynamic contrast-enhanced 1.5-T MR imaging before surgical resection were included. Liver Imaging Reporting and Data System (LI-RADS v2018) imaging features and three non-LI-RADS MR imaging features for predicting early recurrence (intrahepatic recurrence<2 years) were identified by univariable and multivariable analyses. A nomogram was constructed for individualized risk estimation, and its predictive accuracy and discriminative ability were identified by concordance index (C-index) and calibration curve.\n\n\nRESULTS\nIn multivariable analysis, tumor size (p\u202f=\u202f0.045), nonsmooth tumor margin (p\u202f=\u202f0.013), and presence of mosaic architecture (p\u202f=\u202f0.035) were independent significant variables associated with early recurrence. These were all incorporated to establish the nomogram. The C-index of the nomogram was 0.743 (95 % CI: 0.697-0.788).\n\n\nCONCLUSION\nAt dynamic contrast-enhanced MR imaging, tumor size, nonsmooth tumor margin, and presence of mosaic architecture may be helpful to predict early recurrence of solitary HCC without MVI after curative resection.