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. 2012 Jun;85(1014):778-83.
doi: 10.1259/bjr/65897774. Epub 2011 Aug 9.

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

C-T Chou  1 , R-C Chen, C-W Lee, C-J Ko, H-K Wu, Y-L Chen
Affiliations

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

C-T Chou et al. Br J Radiol. 2012 Jun.

Abstract

Objective: The aim of this study was to diagnose microvascular invasion in patients with solitary hepatocellular carcinoma (HCC) from pre-operative CT imaging.

Methods: 102 patients with solitary HCC who underwent curative hepatectomy were retrospectively included in our study. The pre-operative 3-phase CT imaging and laboratory data for the 102 patients were reviewed. Tumour size, tumour margin, peritumoral enhancement and α-fetoprotein level were assessed. Surgical pathology was reviewed; tumour differentiation, liver fibrosis score and microvascular invasion were recorded.

Results: The histopathological results revealed that 50 HCCs were positive and the other 52 were negative for microvascular invasion. Univariate analysis revealed that tumour size (p = 0.036), higher Edmondson-Steiner grade (p = 0.047) and non-smooth tumour margin (p < 0.001) showed statistically significant associations with microvascular invasion. Multivariate logistic regression analysis showed that non-smooth tumour margin had a statistically significant association with microvascular invasion only (p < 0.001). The sensitivity, specificity, positive predictive value and negative predictive value of the non-smooth tumour margin in the prediction of microvascular invasion were 66%, 86.5%, 82.5% and 72.6%, respectively.

Conclusion: Non-smooth tumour margin in pre-operative CT had a statistically significant association with microvascular invasion. More aggressive treatment should be considered in HCC patients with suspected positive microvascular invasion.

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Figures

Figure 1
Figure 1
A 57-year-old male with a moderately differentiated hepatocellular carcinoma within segment 5 underwent right hemihepatectomy. (a) The tumour with smooth margin on axial imaging. (b) The tumour depicted smooth margin on both coronary and sagittal reformatted images.
Figure 2
Figure 2
Illustration of the patterns of non-smooth tumour margin. (a) A tumour with focal extranodular extension (arrow). (b) A tumour with crescent extranodular extension (arrows) beyond the tumour capsule. (c) A tumour with multinodular confluent appearance. (d) A tumour with focal infiltrative margin (arrowheads).
See this image and copyright information in PMC

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